Chinese Medical Sciences Journal ›› 2023, Vol. 38 ›› Issue (3): 242-249.doi: 10.24920/004219
收稿日期:
2023-02-27
接受日期:
2023-05-16
出版日期:
2023-09-30
发布日期:
2023-06-09
通讯作者:
* 吴绮思,E-mail: Ke-Qiong Yan,Qi-Si Wu*(),Jun Yang*()
Received:
2023-02-27
Accepted:
2023-05-16
Published:
2023-09-30
Online:
2023-06-09
Contact:
* Qi-Si Wu, E-mail: 摘要:
尽管近年来发病率和死亡率有所下降,但缺血性脑卒中(ischemic stroke, IS)仍然是脑血管疾病致死、致残的主要原因之一。干预可控性危险因素是临床管理IS的基础。高血压是IS最常见的可治疗危险因素之一,并与不良结局有关。动态血压监测结果显示高血压患者的血压变异性(blood pressure variability, BPV)高于非高血压患者。同时,BPV升高已被证明是IS的危险因素。BPV越高,IS发生的风险越高,卒中后的预后越差,无论是在急性期还是亚急性期。BPV受多因素影响,其变化反映了个体的生理病理改变。本文综述了目前BPV与IS关系的研究进展,旨在提高临床医生和IS患者对BPV的认识,探讨BPV升高是IS的可控危险因素。对于高血压患者,不仅需要控制血压平均水平,同时需要关注血压变异性,以更好地开展个性化血压管理。
Ke-Qiong Yan, Qi-Si Wu, Jun Yang. Blood Pressure Variability May Be a New Predictor for the Occurrence and Prognosis of Ischemic Stroke[J].Chinese Medical Sciences Journal, 2023, 38(3): 242-249.
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Author citation | Size (n) | BPV measures | Findings |
---|---|---|---|
Minhas et al. [ | 11,093 | CV | SBPV was significantly associated with poor outcomes in IS patients. |
Kang et al. [ | 4,415 | SD | For patients with IS, BPV but not mean BP increased the 1-year risk of major vascular events. |
Chung et al. [ | 1,161 | SD, CV | BPV was significantly associated with worse neurologic outcomes after IS. |
Dai et al. [ | 2,325 | CV | IS recurrence was associated with both SBPV and DBPV. |
Naito et al. [ | 626 | SD, CV | The SD of SBP and DBP, CV of DBP, and morning BP surge were associated with poor outcomes for IS. |
Zhang et al. [ | 592 | SD, CV | SBPV was a critical predictor for short-term outcomes among patients with IS. |
Martins et al. [ | 674 | SD | SBPV showed an association with 3-month clinical outcome for IS. |
Geng et al. [ | 704 | SD, CV | SBPV was the strongest independent predictor of functional outcomes in IS patients. |
de Havenon et al. [ | 1,891 | SD, CV | Increased SBPV was associated with worse neurologic outcome after IS. |
Kamieniarz-Medrygal et al. [ | 174 | SD | In the acute phase of IS, the SD of BPV was robustly associated with 30-day outcomes. |
Yong et al. [ | 615 | Successive variation in the BP profile | DBPV was an independent predictor of outcomes in IS patients. |
Yamamoto et al. [ | 105 | [(mean daytime BP?mean nighttime BP)/average BP for 24 hours]×100% | Non-dipper BP had an adverse effect on the risk of recurrent IS and poor outcomes. |
Dai et al. [ | 52,387 | CV | Visit-to-visit BPV was associated with the mortality rate of cerebrovascular disease. |
Fukuda et al. [ | 2,566 | SD | Day-by-day BPV was associated with the 3-month functional outcome after acute IS. |
Yang et al. [ | 367 | SD, CV | Increased day-by-day SBPV or DBPV in the IS was associated with a higher risk for unfavorable outcome at 3 months, independent of mean BP levels. |
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[1] | 吕双杰, 丁杨楠, 裴小雅, 赵翔, 郝德龙, 张祝琴, 陈厚早, 刘德培. 血管转录组测序发现血管紧张素2诱导的高血压小鼠动脉组织衰老相关基因改变[J]. Chinese Medical Sciences Journal, 2020, 35(1): 43-53. |
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