Limited reproducibility of MUCH and WUCH: evidence from the ELSA study
Limited reproducibility of MUCH and WUCH: evidence from the ELSA study
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DOI：
10.1093/eurheartj/ehz651
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发表时间：
2020-04-21
影响因子：
39.3
通讯作者：
Grassi, Guido
中科院分区：
文献类型：
--
作者：
Mancia, Giuseppe;Facchetti, Rita;Grassi, Guido
目的评估蒙面高血压（MUCH）和白大褂未控制高血压（WUCH）的长期可重复性，这是确定这些疾病的长期预后影响的关键信息。方法和结果对1664名参加欧洲拉西地平动脉粥样硬化研究并接受阿替洛尔或拉西地平（+/-附加药物）治疗的高血压患者进行了4年时间内MUCH和WUCH的可重复性评估。在基线和治疗期间每年测量办公室和24小时血压（BP），允许两种情况重复分类。治疗1年后，分别有21.1%和17.8%的患者被分类为MUCH和WUCH。对于这两种情况，患病率在随后的几年中相似，尽管患者组成发生了很大变化，因为只有约1/3的患者在一组办公室和动态血压测量中被分类为MUCH或WUCH，在随后的一组测量中保持相同的分类。在整个治疗期间，只有4.5%和6.2%的患者持续存在MUCH和WUCH。与办公室血压和动态血压控制或缺乏控制（即高血压控制和不控制）的患者相比，MUCH和WUCH的再现性更差。结论随着时间的推移，MUCH和WUCH的重现性较差。在仅基于一组血压测量来评估这些疾病的长期预后价值的研究中，应考虑到这一点。
Aims To evaluate the long-term reproducibility of masked (MUCH) and white-coat uncontrolled hypertension (WUCH), an information crucial for determining the long-term prognostic impact of these conditions.Methods and results Reproducibility of MUCH and WUCH was assessed in 1664 hypertensive patients recruited for the European Lacidipine Study on Atherosclerosis and treated with atenolol or lacidipine (+/- additional drugs) during a 4-year period. Office and 24 h blood pressure (BP) was measured at baseline and every year during treatment, allowing repeated classification of either condition. After 1 year of treatment 21.1% and 17.8% of the patients were classified as MUCH and WUCH, respectively. For both conditions the prevalence was similar in the following years, although with a large change in patients composition because only about 1/3 of patients classified as MUCH or WUCH at one set of office and ambulatory BP measurements maintained the same classification at a subsequent set of measurements. In only 4.5% and 6.2% MUCH and WUCH persisted throughout the treatment period. MUCH and WUCH reproducibility was worse than that of patients showing control or lack of control of both office and ambulatory BP, i.e. controlled and uncontrolled hypertension, respectively.Conclusion Both MUCH and WUCH display poor reproducibility over time. This should be taken into account in studies assessing the long-term prognostic value of these conditions based on only one set of BP measurements.