Daily interpersonal conflict predicts masked hypertension in an urban sample.
Daily interpersonal conflict predicts masked hypertension in an urban sample.
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日常人际冲突预示着城市样本中的隐性高血压。
DOI：
10.1038/ajh.2010.141
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发表时间：
2010
影响因子：
3.2
通讯作者：
Brondolo,Elizabeth
中科院分区：
文献类型：
--
作者：
Schoenthaler,AntoinetteM;Schwartz,Joseph;Cassells,Andrea;Tobin,JonathanN;Brondolo,Elizabeth
研究背景隐性高血压是心脑血管疾病的危险因素之一。然而，关于心理社会应激源对MH的影响知之甚少。方法在240名未服用药物的黑人和拉丁裔(A)成年人(63%的女性；平均年龄36岁)的社区样本中，研究了日常人际冲突作为动态血压升高的预测因素，他们的办公室血压读数(≤120/80 mmHg)最佳。电子日记被用来评估日常人际冲突(即在社会交往中受到不公平待遇/骚扰的感觉)。参与者对他们经历的每一次互动的程度给出了不公平或骚扰的评分，从1到100分。使用有效的24小时ABP监测仪采集收缩压和舒张压(分别为SysABP和DiaABP)。如果所有读数的平均值为SysABP：≥135 mm Hg或DiaABP：≥85 mm Hg，则参与者被归类为患有MH。采用Logistic回归分析日常人际冲突是否为MMH的独立预测因素。结果21%的受试者(n=50)存在这种形式的MMH(即最佳办公室血压加升高的平均动脉压)。患有MMH的人(与不患有MMH的人相比)更有可能是男性(P<；0.001)。日常骚扰和不公平待遇得分是MMH组状态的显著预测因素(P<；0.05)。骚扰得分>；30的参与者明显更有可能属于MMH组。结论MH可能是一个令人担忧的问题，即使是对于办公室血压最佳的患者。评估暴露于心理社会应激源，包括常规的人际冲突水平，可能有助于确定哪些患者可能从进一步的临床随访中受益。
BackgroundMasked hypertension (MH) is a risk factor for cardiovascular and cerebrovascular diseases. However, little is known about the effect of psychosocial stressors on MH.MethodsDaily interpersonal conflict was examined as a predictor of elevated ambulatory blood pressure (ABP) in a community sample of 240 unmedicated black and Latino(a) adults (63% women; mean age 36 years) who had optimal office blood pressure (BP) readings (≤120/80mmHg). Electronic diaries were used to assess daily interpersonal conflict (i.e., perceptions of being treated unfairly/harassed during social interactions). Participants rated the degree to which they experienced each interaction as unfair or harassing on a scale of 1–100. Systolic and diastolic ABP (SysABP and DiaABP, respectively) were collected using a validated 24-h ABP monitor. Participants were classified as having marked MH (MMH) if the average of all readings obtained yielded SysABP: ≥135mmHg or DiaABP: ≥85mmHg. Logistic regression was used to examine whether daily interpersonal conflict is an independent predictor of MMH.ResultsThis form of MMH (i.e., optimal office BP plus elevated ABP) was present in 21% of participants (n= 50). Those with MMH (vs. without) were significantly more likely to be men (P< 0.001). Daily harassment and unfair treatment scores were significant predictors of MMH group status (P< 0.05). Participants with harassment scores >30 were significantly more likely to be in the MMH group.ConclusionMH may be a concern, even for patients with optimal office BP. Evaluating exposure to psychosocial stressors, including routine levels of interpersonal conflict may help to identify those patients who might benefit from further clinical follow-up.