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心踝血管指数对高血压患者心血管风险评估的预测意义:系统评价。

Predictive significance of cardio ankle vascular index for the assessment of cardiovascular risk in hypertensive patients: A systematic review.

机构信息

Internal Medicine, Madras Medical College, Chennai, India.

Cardiology, Lincoln County Hospital, Lincoln, UK.

出版信息

J Clin Hypertens (Greenwich). 2024 Sep;26(9):1005-1014. doi: 10.1111/jch.14878. Epub 2024 Aug 22.

Abstract

Cardio-ankle vascular index (CAVI) is an innovative indicator of large-artery stiffness, which is evaluated by the pulse wave velocity (PWV) measurement. Mortality and morbidity due to cardiovascular diseases among the general public with high-risk conditions such as hypertension are usually associated with arterial stiffness. CAVI modelizes the hazard of future cardiovascular events with standard risk factors. Additionally, the "European Society of Hypertension and Cardiology" included the aortic PWV assessment in managing hypertension in their updated guidelines in 2007. We conducted this systematic review to collect, summarize, and evaluate the evidence from relevant reported studies. A literature search of four databases was conducted comprehensively until February 2024. Cardiovascular events are the primary outcome of interest in this study, cardiovascular events that have been defined as major adverse cardiac events include "heart failure", "stroke", "myocardial infarction", "cardiovascular deaths", "stable angina pectoris", "coronary revascularization", and "unstable angina pectoris". We included five studies with a 11 698 sample size in this systematic review. All five prospective studies investigated composite cardiovascular events as an outcome. Three of them revealed a statistically significant prediction ability of CAVI to assess Cardiovascular disease (CVD) risk. Further analysis is required. Current evidence is insufficient to confirm the predictive power of CAVI in the assessment of cardiovascular risk in hypertensive patients. CAVI is modestly associated with incidents of CVD risk. It is necessary to conduct further studies to assess CAVI concerning CVD predictor measures in the masses and nations other than Asia.

摘要

心血管踝臂指数(CAVI)是一种评估大动脉僵硬度的创新指标,通过脉搏波速度(PWV)测量来评估。高血压等高危人群的心血管疾病死亡率和发病率通常与动脉僵硬度有关。CAVI 模型化了未来心血管事件的风险,考虑了标准风险因素。此外,“欧洲高血压学会和心脏病学会”在 2007 年更新的高血压管理指南中纳入了主动脉 PWV 评估。我们进行了这项系统评价,以收集、总结和评估相关报告研究的证据。我们全面检索了四个数据库,直到 2024 年 2 月。心血管事件是本研究的主要结局,已定义的心血管事件包括“心力衰竭”、“中风”、“心肌梗死”、“心血管死亡”、“稳定型心绞痛”、“冠状动脉血运重建”和“不稳定型心绞痛”。本系统评价纳入了五项研究,样本量为 11698 例。这五项前瞻性研究均将复合心血管事件作为结局进行研究。其中三项研究表明 CAVI 对评估心血管疾病(CVD)风险具有统计学意义的预测能力。需要进一步分析。目前的证据不足以确认 CAVI 在评估高血压患者心血管风险方面的预测能力。CAVI 与 CVD 风险事件适度相关。需要进一步研究评估 CAVI 在亚洲以外的人群和国家的 CVD 预测指标方面的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41f2/11488310/4250f384710a/JCH-26-1005-g002.jpg

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