低舒张压与心血管结局及全因死亡率的关联：一项荟萃分析。

Association of low diastolic blood pressure with cardiovascular outcomes and all-cause mortality: A meta-analysis.

作者信息

Siddiqi Tariq Jamal, Usman Muhammad Shariq, Siddiqui Amna, Salman Ali, Talbot Nicholas, Khan Laibah Arshad, Shabbir Aisha, Hall Michael E, Taffet George E

机构信息

Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.

Department of Medicine, University of Texas Southwestern, Dallas, TX, USA.

出版信息

Curr Probl Cardiol. 2024 Jan;49(1 Pt C):102131. doi: 10.1016/j.cpcardiol.2023.102131. Epub 2023 Oct 20.

DOI:10.1016/j.cpcardiol.2023.102131

PMID:37866417

Abstract

BACKGROUND

Reduction of diastolic blood pressure (DBP) below 70 mmHg may decrease perfusion to the heart and worsen cardiovascular (CV) outcomes.

AIMS

Explore the association between low DBP and CV outcomes.

METHODS

We searched the online databases until August 2023 for studies reporting the risk of all-cause mortality (ACM) or CV outcomes in patients with low versus normal DBP (70-80mm Hg).

RESULTS

Inclusion of 10 studies (n = 1,998,223 patients) found that a mean achieved DBP < 60 mmHg was associated with an increased risk of all-cause mortality (HR 1.48; 95 % CI [1.26-1.74]), especially in patients with pre-existing CV disease. It was also associated to a higher risk of major adverse cardiovascular events (HR 1.84; [1.28-2.65]) and myocardial infarction (HR 1.49; [1.13-1.97]). A DBP of 60-69 mmHg was associated with an increased risk of all-cause mortality (HR 1.11; [1.03-1.20]).

CONCLUSION

Reduction of DBP, particularly below 60 mmHg, is associated with increased risk of ACM.

摘要

背景

舒张压（DBP）降至70mmHg以下可能会减少心脏灌注并恶化心血管（CV）结局。

目的

探讨低舒张压与心血管结局之间的关联。

方法

我们检索了在线数据库直至2023年8月，以查找报告低舒张压（<70mmHg）与正常舒张压（70 - 80mmHg）患者全因死亡率（ACM）或心血管结局风险的研究。

结果

纳入10项研究（n = 1,998,223例患者）发现，平均舒张压<60mmHg与全因死亡率增加相关（HR 1.48；95%CI[1.26 - 1.74]），尤其是在已有心血管疾病的患者中。它还与主要不良心血管事件风险较高（HR 1.84；[1.28 - 2.65]）和心肌梗死风险较高（HR 1.49；[1.13 - 1.97]）相关。舒张压为60 - 69mmHg与全因死亡率增加相关（HR 1.11；[1.03 - 1.20]）。