Home-Measured Blood Pressure Is a Stronger Predictor of Cardiovascular Risk Than Office Blood Pressure The Finn-Home Study
Home-Measured Blood Pressure Is a Stronger Predictor of Cardiovascular Risk Than Office Blood Pressure The Finn-Home Study
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DOI：
10.1161/hypertensionaha.109.149336
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发表时间：
2010-06-01
期刊：
影响因子：
8.3
通讯作者：
Jula, Antti M.
中科院分区：
文献类型：
--
作者：
Niiranen, Teemu J.;Hanninen, Marjo-Riitta;Jula, Antti M.
先前的研究存在一些局限性，对于家庭测量血压（BP）的预后意义提供了模棱两可的结果。我们调查了家庭测量的血压是否比办公室血压与心血管事件和总死亡率的相关性更强。 2000 年至 2001 年启动了一项全国性前瞻性研究，随机选择了 2081 名年龄在 45 岁至 74 岁之间的受试者。在基线时确定家庭和办公室血压以及其他心血管危险因素。主要终点是心血管事件的发生率（心血管死亡率、非致命性心肌梗死、非致命性卒中、心力衰竭住院、经皮冠状动脉介入治疗或冠状动脉搭桥手术）。次要终点是总死亡率。经过平均 6.8 年的随访，162 名受试者经历了心血管事件，118 名受试者死亡。在针对其他心血管危险因素进行调整的 Cox 比例风险模型中，诊室血压（血压每增加 10/5 mm Hg，收缩压/舒张压风险比 [HR]，1.13/1.13；收缩压/舒张压 95% 置信区间 [CI]，1.05 至 1.22/1.05 至 1.22）和家庭血压（HR，1.23/1.18； 95% CI（1.13 至 1.34/1.10 至 1.27）可预测心血管事件。然而，当两种血压同时纳入模型时，只有家庭血压（HR，1.22/1.15；95% CI，1.09至1.37/1.05至1.26）而非诊室血压（HR，1.01/1.06；95% CI，0.92至1.12/0.97至1.16）可以预测心血管事件。家庭收缩压是总死亡率的唯一预测因素（HR，1.11；95% CI，1.01/1.23）。我们的研究结果表明，家庭测量血压的预后优于办公室血压。根据本次研究和之前的研究结果，可以得出结论，家庭血压测量比传统的办公室测量具有更多的特定优势。 （高血压。2010；55：1346-1351。）
Previous studies with some limitations have provided equivocal results for the prognostic significance of home-measured blood pressure (BP). We investigated whether home-measured BP is more strongly associated with cardiovascular events and total mortality than is office BP. A prospective nationwide study was initiated in 2000 to 2001 on 2081 randomly selected subjects aged 45 to 74 years. Home and office BP were determined at baseline along with other cardiovascular risk factors. The primary end point was incidence of a cardiovascular event (cardiovascular mortality, nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, percutaneous coronary intervention, or coronary artery bypass graft surgery). The secondary end point was total mortality. After a mean follow-up of 6.8 years, 162 subjects had experienced a cardiovascular event, and 118 subjects had died. In Cox proportional hazard models adjusted for other cardiovascular risk factors, office BP (systolic/diastolic hazard ratio [HR] per 10/5 mm Hg increase in BP, 1.13/1.13; systolic/diastolic 95% confidence interval [CI], 1.05 to 1.22/1.05 to 1.22) and home BP (HR, 1.23/1.18; 95% CI, 1.13 to 1.34/1.10 to 1.27) were predictive of cardiovascular events. However, when both BPs were simultaneously included in the models, only home BP (HR, 1.22/1.15; 95% CI, 1.09 to 1.37/1.05 to 1.26), not office BP (HR, 1.01/1.06; 95% CI, 0.92 to 1.12/0.97 to 1.16), was predictive of cardiovascular events. Systolic home BP was the sole predictor of total mortality (HR, 1.11; 95% CI, 1.01/1.23). Our findings suggest that home-measured BP is prognostically superior to office BP. On the basis of the results of this and previous studies, it can be concluded that home BP measurement offers specific advantages more than conventional office measurement. (Hypertension. 2010; 55: 1346-1351.)