Home blood pressure is as reliable as ambulatory blood pressure in predicting target-organ damage in hypertension
Home blood pressure is as reliable as ambulatory blood pressure in predicting target-organ damage in hypertension
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DOI：
10.1016/j.amjhyper.2006.12.013
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发表时间：
2007-06-01
影响因子：
3.2
通讯作者：
Roussias, Leonidas G.
中科院分区：
文献类型：
--
作者：
Stergiou, George S.;Argyraki, Katerina K.;Roussias, Leonidas G.
背景：我们的目的是评估家庭血压 (BP) 监测与办公室血压测量和动态监测相比，在预测高血压引起的靶器官损伤方面的价值。方法：纳入了 68 名未经治疗的高血压患者，这些患者至少在研究前进行了两次例行就诊（平均年龄，48.6 +/- 9.1 [SD] 岁；50 名男性）。办公室血压在两次研究访问中测量，家庭血压测量 6 个工作日，动态血压监测 24 小时。所有血压测量均使用经过验证的电子设备获得。通过测量超声心动图左心室质量指数 (LVMI)、两次过夜尿液收集中的尿白蛋白排泄率 (AER) 和颈股动脉脉搏波速度 (PWV)（Complior 设备；Colson，Garges-les-Gonesse，巴黎，法国）来评估靶器官损伤。结果：LVMI 与诊室血压的相关系数为 0.24/0.15 （收缩压/舒张压），家庭血压 0.35/0.21（收缩压，P < .01），24 小时动态血压 0.23/0.19，清醒时 0.21/0.16，睡眠时 0.28/0.26（睡眠时，P < .05）。 AER 与诊室血压的相关系数为 0.24/0.31（舒张压，P < .05），家庭血压为 0.28/0.26（均 P < .05），24 小时动态血压为 0.25/0.24，清醒时为 0.24/0.25（舒张压，P < .05），睡眠时0.26/0.18（收缩压，P < .05）。 PWV 和舒张压测量值之间存在负相关趋势（不显着）。在评估靶器官损伤三个指标的独立预测因子的多元回归模型中，收缩压家庭血压和年龄是唯一达到临界统计显着性的 LVMI 增加的独立预测因子。结论：这些数据表明，家庭血压在预测高血压引起的靶器官损伤方面与动态监测一样可靠，并且优于仔细进行的办公室测量。
Background: Our objective was to assess the value of home blood pressure (BP) monitoring in comparison to office BP measurements and ambulatory monitoring in predicting hypertension-induced target-organ damage.Methods: Sixty-eight untreated patients with hypertension with at least two routine prestudy office visits were included (mean age, 48.6 +/- 9.1 [SD] years; 50 men). Office BP was measured in two study visits, home BP was measured for 6 workdays, and ambulatory BP was monitored for 24 h. All BP measurements were obtained using validated electronic devices. Target-organ damage was assessed by measuring the echocardiographic left-ventricular mass index (LVMI), urinary albumin excretion rate (AER) in two overnight urine collections, and carotidfemoral pulse-wave velocity (PWV) (Complior device; Colson, Garges-les-Gonesse, Paris, France).Results: The correlation coefficients of LVMI with office BP were 0.24/0.15 (systolic/diastolic), with home BP 0.35/0.21 (systolic, P < .01), and with 24-h ambulatory BP 0.23/0.19, awake 0.21/0.16, and asleep 0.28/0.26(asleep, both P < .05). The correlation coefficients of AER with office BP were 0.24/0.31 (diastolic, P < .05), with home BP 0.28/0.26 (both P < .05), and with 24-h ambulatory BP 0.25/0.24, awake 0.24/0.25 (diastolic, P < .05), and asleep 0.26/0.18 (systolic, P < .05). There was a trend for negative correlations between PWV and diastolic BP measurements (not significant). In multiple-regression models assessing independent predictors of each of the three indices of target-organ damage, systolic home BP and age were the only independent predictors of increased LVMI that reached borderline statistical significance.Conclusions: These data suggest that home BP is as reliable as ambulatory monitoring in predicting hypertension-induced target-organ damage, and is superior to carefully taken office measurements.