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高血压和主动脉血管疾病患者的中心血压与臂部血压之间的关联:对临床实践的启示。

Associations between central and brachial blood pressure in patients with hypertension and aortovascular disease: Implications for clinical practice.

机构信息

Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Emergency Medical Services, Applied Medical Sciences College, Najran University, Saudi Arabia.

Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Danish Centre for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

出版信息

Curr Probl Cardiol. 2025 Jan;50(1):102874. doi: 10.1016/j.cpcardiol.2024.102874. Epub 2024 Oct 5.

Abstract

Central blood pressure (CBP) measurements, compared to brachial blood pressure (bBP), offer a superior predictive accuracy for aortovascular disease outcomes. This emphasises the distinctiveness of central hemodynamic metrics such as CBP, measuring the pressure directly exerted from the cardiac muscle to the major arteries, and provides a more direct assessment of cardiovascular workload than bBP, which measures the pressure against peripheral artery walls. This review synthesises findings evaluating the correlation between CBP and key aortovascular disease markers. Thoracic aortic aneurysm (TAA) growth is a crucial aspect of aortovascular assessment. CBP more accurately correlates with arterial stiffness (AS), the growth of TAA, and cardiovascular diseases, offering a more dependable prediction of aortovascular diseases, adverse cardiovascular events (CVE) and organ damage compared to bBP. The incorporation of CBP into routine clinical practice could enhance aortovascular assessments and therapeutic strategies when compared to bBP, particularly through a deeper understanding of aortic wave dynamics, which could fundamentally alter aortovascular diagnostics and treatment. In conclusion, integrating CBP into aortovascular and cardiovascular risk management is encouraged. Further research is necessary to substantiate these aspects and explore the operative implications of CBP in clinical settings.

摘要

中心血压(CBP)测量与肱动脉血压(bBP)相比,对大血管疾病结局具有更高的预测准确性。这强调了 CBP 等中心血流动力学指标的独特性,它直接测量心肌对主要动脉的压力,比 bBP 更直接地评估心血管工作量,后者测量的是外周动脉壁上的压力。这篇综述综合评估了 CBP 与关键大血管疾病标志物之间的相关性。胸主动脉瘤(TAA)的生长是大血管评估的一个关键方面。CBP 与动脉僵硬度(AS)、TAA 的生长和心血管疾病更准确相关,与 bBP 相比,它能更可靠地预测大血管疾病、不良心血管事件(CVE)和器官损伤。与 bBP 相比,将 CBP 纳入常规临床实践可增强大血管评估和治疗策略,特别是通过更深入地了解主动脉波动力学,这可能从根本上改变大血管疾病的诊断和治疗。总之,鼓励将 CBP 纳入大血管和心血管风险管理。需要进一步的研究来证实这些方面,并探讨 CBP 在临床环境中的应用意义。

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