Background: Results of the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm(ASCOT-BPLA) show significantly lower rates of coronary and stroke events in individuals allocated an amlodipine-based co...
详细信息
Background: Results of the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm(ASCOT-BPLA) show significantly lower rates of coronary and stroke events in individuals allocated an amlodipine-based combination drug regimen than in those allocated an atenolol-based combination drug regimen(HR 0.86 and 0.77, respectively). Our aim was to assess to what extent these differences were due to significant differences in blood pressures and in other variables noted after randomisation. Methods: We used data from ASCOT-BPLA(n=19 257) and compared differences in accumulated mean blood pressure levels at sequential times in the trial with sequential differences in coronary and stroke events. Serial mean matching for differences in systolic blood pressure was used to adjust HRs for differences in these events. We used an updated Cox-regression model to assess the effects of differences in accumulated mean levels of various measures of blood pressure, serum HDL cholesterol, triglycerides and potassium, fasting blood glucose, heart rate, and bodyweight on differences in event rates. Findings: We noted no temporal link between size of differences in blood pressure and different event rates. Serial mean matching for differences in systolic blood-pressure attenuated HRs for coronary and stroke events to a similar extent as did adjustments for systolic blood-pressure differences in Cox-regression analyses. HRs for coronary events and stroke adjusted for blood pressure rose from 0.86(0.77-0.96) to 0.88(0.79-0.98) and from 0.77(0.66-0.89) to 0.83(0.72-0.96), respectively. Multivariate adjustment gave HRs of 0.94(0.81-1.08) for coronary events(HDL cholesterol being the largest contributor) and 0.87(0.73-1.05) for stroke events. Interpretation: Multivariate adjustment accounted for about half of the differences in coronary events and for about 40% of the differences in stroke events between the treatment regimens tested in ASCOT-BPLA, but residual differences were no lon
该研究旨在评估2型糖尿病患者累积收缩压负荷与心血管事件风险的关系。方法:对百普乐和达美康缓释片对糖尿病和血管疾病的对照评估试验的观察性研究(action in diabetes and vascular disease preterax and diamicron MR controlled eva...
详细信息
该研究旨在评估2型糖尿病患者累积收缩压负荷与心血管事件风险的关系。方法:对百普乐和达美康缓释片对糖尿病和血管疾病的对照评估试验的观察性研究(action in diabetes and vascular disease preterax and diamicron MR controlled evaluation post trial observational study, ADVAnCE-On)中的2型糖尿病患者进行事后分析。
Resolving regional carbon budgets is critical for informing land-based mitigation policy. For nine regions covering nearly the whole globe, we collected inventory estimates of carbon-stock changes complemented by sate...
详细信息
Resolving regional carbon budgets is critical for informing land-based mitigation policy. For nine regions covering nearly the whole globe, we collected inventory estimates of carbon-stock changes complemented by satellite estimates of biomass changes where inventory data are missing. The net land–atmospheric carbon exchange(nEE) was calculated by taking the sum of the carbon-stock change and lateral carbon fluxes from crop and wood trade, and riverine-carbon export to the ocean. Summing up nEE from all regions, we obtained a global ‘bottom-up’ nEE for net land anthropogenic CO2uptake of –2.2 ± 0.6 Pg C yr-1consistent with the independent top-down nEE from the global atmospheric carbon budget during 2000–2009. This estimate is so far the most comprehensive global bottom-up carbon budget accounting, which set up an important milestone for global carbon-cycle studies. By decomposing nEE into component fluxes, we found that global soil heterotrophic respiration amounts to a source of CO2of 39 Pg C yr-1with an interquartile of 33–46 Pg C yr-1—a much smaller portion of net primary productivity than previously reported.
暂无评论