简介：随着循证实践的蓬勃发展,医疗各个领域的临床实践指南日益增多,在规范临床实践、改善患者结局和优化资源配置等方面发挥了重要作用。目前,构建临床实践指南的方法主要有制定新指南和整合现有指南。针对某个健康问题,如果目前已经有相关的指南,则可以考虑进行指南整合。指南整合是指基于系统的、透明的方法,使用和/或修改现有的指南,以便将指南应用于其他临床环境。

简介：BackgroundCentralaorticsystolicbloodpressure(CASP)hasbeenshowntobeastrongerpredictoroftarget-organdamageandcardiovasculareventsthanbrachialsystolicbloodpressure(BSBP),buttherewasnodataaboutwhetherCASPcanpredictprolongedQRSdurationmorethanBSBP.WeexaminedtheassociationofCASPandBSBPwithQRSdurationinruralcommunityresidents.MethodsWeretrospectivelyanalyzed490ruralcommunityresidents.Standardresting12-leadECGandcentralaorticbloodpressure(CABP)weremeasurednoninvasivelyinallsubjectsatbaseline.TheQRSdurationwasequaltoormorethan120msbeingdefinedasprolongedQRSduration.ResultsTheprolongedQRSdurationgroupshowedhigherCASP(139.38±11.67vs.135.36±16.22,P=0.031)andBSBP(136.03±6.74vs.124.44±13.01,P<0.001)ascomparedwithcontrols.MultivariatelinearregressionanalysisshowedthatCASP,BSBPandheartratewereindependentlyaffectingQRSduration.LogisticregressionanalysesshowedthatCASP(OR1.057,95%CI:1.027,1.088,P<0.001)andBSBP(OR1.056,95%CI:1.027,1.086,P=0.032)wereindependentpredictorsofprolongedQRSdurationafteradjustmentforage,sex,bodymassindex,heartrate.CASPhadabetterpredictivevalueforprolongedQRSdurationthan(AUC:0.793vs.0.601,P<0.001)BSBP.ConclusionsOurfindingsdemonstratethatbothCASPandBSBParerisksforprolongedQRSduration,butCASPcanpredictprolongedQRSdurationbetterthanBSBP.