Oba Yusuke, Kabutoya Tomoyuki, Kohro Takahide, Imai Yasushi, Kario Kazuomi, Sato Hisahiko, Nochioka Kotaro, Nakayama Masaharu, Akashi Naoyuki, Fujita Hideo, Mizuno Yoshiko, Kiyosue Arihiro, Iwai Takamasa, Miyamoto Yoshihiro, Nakano Yasuhiro, Ishii Masanobu, Nakamura Taishi, Tsujita Kenichi, Matoba Tetsuya, Nagai Ryozo
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
Department of Clinical Informatics, Jichi Medical University School of Medicine, Shimotsuke, Japan.
Hypertens Res. 2025 Feb;48(2):632-639. doi: 10.1038/s41440-024-01902-5. Epub 2024 Sep 19.
The Japanese Society of Hypertension have established a blood pressure (BP) target of 130/80 mmHg for patients with coronary artery disease (CAD). We evaluated the data of 8793 CAD patients in the Clinical Deep Data Accumulation System database who underwent cardiac catheterization at six university hospitals and the National Cerebral and Cardiovascular Center (average age 70 ± 11 years, 78% male, 43% with acute coronary syndrome [ACS]). Patients were divided into two groups based on whether or not they achieved the guideline-recommended BP of <130/80 mmHg. We analyzed the relationship between BP classification and major adverse cardiac and cerebral event (MACCE) separately in two groups: those with ACS and those with chronic coronary syndrome (CCS). During an average follow-up period of 33 months, 710 MACCEs occurred. A BP below 130/80 mmHg was associated with fewer MACCEs in both the overall (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.70-1.00, p = 0.048) and the ACS group (HR 0.67, 95%CI 0.51-0.88, p = 0.003). In particular, stroke events were also lower among those with a BP below 130/80 mmHg in both the overall (HR 0.69, 95%CI 0.53-0.90, p = 0.006) and ACS groups (HR 0.44, 95%CI 0.30-0.67, p < 0.001). In conclusion, the achievement of BP guidelines was associated with improved outcomes in CAD patients, particularly in reducing stroke risk among those with ACS.
日本高血压学会为冠状动脉疾病（CAD）患者设定了130/80 mmHg的血压目标。我们评估了临床深度数据积累系统数据库中8793例CAD患者的数据，这些患者在6家大学医院和国家脑心血管中心接受了心导管检查（平均年龄70±11岁，78%为男性，43%患有急性冠状动脉综合征[ACS]）。根据患者是否达到指南推荐的血压<130/80 mmHg，将患者分为两组。我们分别分析了ACS组和慢性冠状动脉综合征（CCS）组中血压分类与主要不良心脑血管事件（MACCE）之间的关系。在平均33个月的随访期内，发生了710例MACCE。血压低于130/80 mmHg与总体（风险比[HR]0.83，95%置信区间[CI]0.70 - 1.00，p = 0.048）和ACS组（HR 0.67，95%CI 0.51 - 0.88，p = 0.003）中较少的MACCE相关。特别是，在总体（HR 0.69，95%CI 0.53 - 0.90，p = 0.006）和ACS组（HR 0.44，95%CI 0.30 - 0.67，p < 0.oo1）中，血压低于130/80 mmHg的患者中风事件也较少。总之，达到血压指南与CAD患者预后改善相关，特别是在降低ACS患者的中风风险方面。
