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血压和总胆固醇测量对使用系统性冠状动脉风险评估(SCORE)进行风险预测的影响。

Effect of blood pressure and total cholesterol measurement on risk prediction using the Systematic COronary Risk Evaluation (SCORE).

作者信息

Ulbricht Sabina, Gross Stefan, Brammen Eva, Weymar Franziska, John Ulrich, Meyer Christian, Dörr Marcus

机构信息

University Medicine Greifswald, Institute of Social Medicine and Prevention, Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.

German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Fleischmannstr. 42-44, 17475, Greifswald, Germany.

出版信息

BMC Cardiovasc Disord. 2018 May 4;18(1):84. doi: 10.1186/s12872-018-0823-3.

Abstract

BACKGROUND

To compare the reproducibility in total cholesterol (TC), systolic blood pressure (BP), and the resulting Systematic COronary Risk Evaluation (SCORE) obtained by an in-office cardio-preventive screening program (SP) and a subsequent program performed in a clinical trial examination center (EP).

METHODS

A total of 307 individuals (60.3% female, mean age = 52.8 years) participated. According to TC and BP measurements at the SP and EP, three variables were created: the SCORE = single BP reading at the SP, the SCORE = first BP reading at the EP, and the SCORE = mean second/third BP reading at the EP. Differences in TC and BP were analyzed. Associations between age, sex and mean differences between the SCORE and the SCORE (M1) and the SCORE (M2) were analyzed using multivariable linear and quantile regression.

RESULTS

TC and BP values from the SP were significantly higher than those from the EP. Among individuals with a decreased SCORE value at the EP (compared to the SP), younger age was associated with a higher improvement in risk estimation compared with older age. Female sex was associated with higher risk improvement in the SCORE between the SP and the EP compared with male sex. Associations between both demographics and M1 (M2) achieved statistical significance at the 75.0th (50th) percentile.

CONCLUSIONS

The reproducibility of results in cardiovascular risk prediction seems to be influenced by the accuracy of BP measurement. It seems that younger individuals and females are more likely to benefit from accuracy compared with older individuals and males.

摘要

背景

比较通过门诊心脏预防筛查项目(SP)以及随后在临床试验检查中心进行的项目(EP)所获得的总胆固醇(TC)、收缩压(BP)以及由此得出的系统性冠状动脉风险评估(SCORE)的可重复性。

方法

共有307人参与(60.3%为女性,平均年龄 = 52.8岁)。根据在SP和EP处对TC和BP的测量,创建了三个变量:SCORE = SP处的单次血压读数、SCORE = EP处的首次血压读数以及SCORE = EP处第二次/第三次血压读数的平均值。分析了TC和BP的差异。使用多变量线性回归和分位数回归分析年龄、性别与SCORE和SCORE(M1)以及SCORE(M2)之间的平均差异之间的关联。

结果

SP处的TC和BP值显著高于EP处的。在EP处SCORE值降低的个体中(与SP相比),与老年个体相比,年轻个体的风险估计改善更大。与男性相比,女性在SP和EP之间的SCORE风险改善更高。在第75.0百分位数(第50百分位数)时,人口统计学与M1(M2)之间的关联均达到统计学显著性。

结论

心血管风险预测结果的可重复性似乎受血压测量准确性的影响。与老年个体和男性相比,年轻个体和女性似乎更有可能从准确性中获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c55c/5935918/1db065aeb673/12872_2018_823_Fig1_HTML.jpg

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