摘要
背景:欧洲高血压学会(ESH)指南推荐两种可能的策略用于评估原发性高血压患者的心血管风险(CVR):分类表法和SCORE风险图表法。但是,未有研究对上述两种方法取得的结果进行比较。目的和方法:对比利时的106例无糖尿病或其他相关临床疾患的高血压患者(年龄52.4±12.9岁,男女性别比为46/60),根据ESH和SCORE策略进行CVR评估。结果:根据ESH分类表法(分别为1例、24例、24例、57例)和SCORE风险图表法(分别为60例、12例、10例、24例)得出的低度、中度、高度和极高度风险分布结果显著不同(k系数=0.08)。
BACKGROUND: The European Society of Hypertension (ESH) guidelines recommend two possible strategies for the assessment of cardiovascular risk(CVR) in essential hypertensive(HT) patients: categorical tables and SCORE risk charts. However, the outcome of these methods has not been compared. OBJECTIVE AND METHODS: We assessed CVR according to ESH and SCORE risk charts adapted to use in Belgium in 106 HT patients (mean age: 52. 4 ± 12. 9 years, male/female ratio: 46/60) without diabetes or other associated clinical conditions. RESULTS: The distribution of low, moderate, high and very high added risk was strikingly different(k coefficient =0. 08) according to ESH categorical tables(n = 1, 24, 24, 57) and SCORE risk charts(n =60, 12, 10, 24) . Furthermore, compared with ESH, CVR class according to SCORE was lower in the majority of patients(n = 72, 68% ) while it was similar in 23(22%) and higher in 11 patients (10%) . Patients for whom risk was lower by SCORE compared to ESH differed from the others by age(46. 7 FF++ 10. 0 versus 64. 6 FF++ 9. 2, P < 0.001) and proportion of females(71 versus 26%, P < 0.0001). CONCLUSIONS: In this series of patients with mainly moderate or severe hypertension, the distribution of cardiovascular risk was strikingly different according to ESH categorical tables and SCORE risk charts. This might be explained in part by the lower weight attributed to blood pressure in risk assessment, especially in young female subjects. If confirmed, these results should prompt the performance of a prospective study to assess which strategy most accurately predicts CVR in hypertensive patients.
