目的 探讨冠心病合并难治性高血压患者临床特征及其预后。方法 入选1030例合并冠心病的高血压患者,参照难治性高血压的诊断路径,排除引起难治性高血压的继发原因,收集难治性高血压病例,可以控制的高血压病例为对照组,了解该人群难治性高血压临床特征及其预后。临床终点事件包括主要心血管事件:心血管死亡、非致死性心肌梗死、卒中。结果 在入选的1030例合并冠心病高血压患者中有88例符合难治性高血压诊断,现患率为8.5%,冠心病合并难治性高血压组心血管事件发生率显著高于对照组。多因素回归分析结果提示,在校正年龄、性别、体重指数、吸烟、基础血压水平、内科合并疾病、内科用药等危险因素后,年龄(OR 1.04,95%CI:1.03～1.05)、体重指数(OR 1.03,95%CI:1.02～1.04)、合并糖尿病(OR 1.70,95%CI:1.52～2.11)、心功能不全(OR 1.25,95%CI:1.52～2.11)为冠心病患者合并难治性高血压的独立危险因素。结论 冠心病合并难治性高血压患者较对照组发生心脑血管事件的发病率和病死率明显增高,明确的诊断和有效的治疗至关重要。
Abstract
Objective To explore the clinical characteristics and prognosis of patients with resistant hypertension and coronary artery disease.Methods We evaluated 1030 patients with coronary artery disease. According to the currently accepted definition of resistant hypertension, the secondary causes of resistant hypertension were excluded. The primary outcome was major cardiovascular events, including fatal coronary heart disease, nonfatal myocardial infarction and stroke.Results Among the 1030 patients in this study, 88 (8.5%) had apparent resistant hypertension. In a multivariable model adjusting for baseline differences, the resistant hypertension group had an increased primary outcome when compared with the no apparent resistant hypertension group. A multivariate analysis showed that older age, higher BMI, a history of diabetes and chronic heart failure were independent risk factors for resistant hypertension.Conclusions In patients with coronary artery disease, resistant hypertension is associated with a significant increase in the risk of cardiovascular morbidity and mortality. Clear diagnoses and effective treatment are of great importance.
关键词
冠心病 /
难治性高血压 /
预后
Key words
coronary artery disease /
resistant hypertension /
prognosis
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