Tai Chenhui, Sun Yuxi, Dai Neng, Xu Dachun, Chen Wei, Wang Jiguang, Protogerou Athanase, van Sloten Thomas T, Blacher Jacques, Safar Michel E, Zhang Yi, Xu Yawei
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
J Clin Hypertens (Greenwich). 2015 Feb;17(2):107-15. doi: 10.1111/jch.12484. Epub 2015 Feb 3.
In recent clinical investigations, visit-to-visit systolic blood pressure (SBP) variability was proven as a predictor of cardiovascular events and all-cause mortality. However, inconsistent results exist in this association. A meta-analysis of 13 prospective studies was conducted to evaluate the prognostic value of visit-to-visit SBP variability by different parameters in 77,299 patients with a mean follow-up of 6.3 years. The pooled age- and mean SBP-adjusted hazard ratios (HRs) for all-cause mortality were 1.03 (95% confidence interval [CI], 1.02-1.04; P<.001) per 1-mm Hg increase in SBP standard deviation (SD) and 1.04 (1.02-1.06, P<.001) per 1% in SBP coefficient of variation, and the corresponding values of cardiovascular mortality were 1.10 (1.02-1.17, P<.001) and 1.01 (0.99-1.03, P=.32), respectively. Moreover, a 1-mm Hg increase in SD was significantly associated with stroke, with an HR of 1.02 (1.01-1.03, P<.001). Visit-to-visit SBP variability, independent of age and mean SBP, is a predictor of cardiovascular and all-cause mortality and stroke.
在最近的临床研究中，就诊间收缩压（SBP）变异性被证实是心血管事件和全因死亡率的预测指标。然而，这一关联存在不一致的结果。对13项前瞻性研究进行了荟萃分析，以评估在77299例患者中，不同参数的就诊间SBP变异性的预后价值，平均随访时间为6.3年。收缩压标准差（SD）每增加1 mmHg，全因死亡率的合并年龄和平均SBP校正风险比（HR）为1.03（95%置信区间[CI]，1.02 - 1.04；P <.001），收缩压变异系数每增加1%，相应值为1.04（1.02 - 1.06，P <.001），心血管死亡率的相应值分别为1.10（1.02 - 1.17，P <.001）和1.01（0.99 - 1.03，P =.32）。此外，SD每增加1 mmHg与中风显著相关，HR为1.02（1.01 - 1.03，P <.001）。独立于年龄和平均SBP的就诊间SBP变异性是心血管和全因死亡率以及中风的预测指标。
