Association Between Ambulatory Blood Pressure and Risk of Home Hypertension in a Normotensive Population: The Ohasama Study
Association Between Ambulatory Blood Pressure and Risk of Home Hypertension in a Normotensive Population: The Ohasama Study
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血压正常人群中动态血压与家庭高血压风险之间的关联：Ohasama 研究
DOI：
10.1093/ajh/hpac121
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发表时间：
2022
影响因子：
3.2
通讯作者：
Ohkubo Takayoshi
中科院分区：
文献类型：
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作者：
Nakayama Shingo;Satoh Michihiro;Metoki Hirohito;Murakami Takahisa;Tatsumi Yukako;Asayama Kei;Hara Azusa;Hirose Takuo;Tsubota-Utsugi Megumi;Kikuya Masahiro;Mori Takefumi;Hozawa Atsushi;Imai Yutaka;Ohkubo Takayoshi
背景我们调查了血压正常人群中动态血压（BP）和家庭高血压风险之间的关系，以及考虑动态血压是否改善了家庭高血压风险的10年预测模型，该模型是在以前的Ohasama研究中开发的。（83.2%的女性;年龄，53.6岁）没有家和动态高血压的一般人群中的Ohasama，日本。考克斯模型被用来评估家庭高血压（家庭血压≥ 135/≥85毫米汞柱或开始降压治疗）和模型improvementation.ResultsDuring平均14.2年的随访，225家高血压发病率（HR）。 校正可能的混杂因素（包括基线家庭SBP）后，24小时收缩压（SBP）每升高1-SD（≥ 6.76 mmHg）家庭高血压发生率的HR（95%置信区间）为1.59（1.33 - 1.90）。当将24小时SBP添加到基本的10年家庭高血压预测模型中时，Harrell的C统计量从0.72增加到0.73（P=0.11），该模型包括性别，年龄，体重指数，吸烟状况，办公室SBP和基线家庭SBP。 结论24 h SBP可作为预测未来家庭高血压的独立指标。 家庭血压和24小时血压在长期内可以纵向相互影响。
BackgroundWe investigated the association between ambulatory blood pressure (BP) and the risk of home hypertension in a normotensive population and whether considering ambulatory BP improves the 10-year prediction model for home hypertension risk, which was developed in the previous Ohasama Study.MethodsIn this prospective study, we followed up with 410 participants (83.2% women; age, 53.6 years) without a home and ambulatory hypertension in the general population of Ohasama, Japan. The Cox model was used to assess the hazard ratios (HRs) for home hypertension (home BP ≥ 135/≥85 mmHg or the initiation of antihypertensive treatment) and model improvement.ResultsDuring a mean 14.2-year follow-up, 225 home hypertension incidences occurred. The HR (95% confidence interval) for home hypertension incidence per 1-SD higher (=6.76 mmHg) 24-hour systolic BP (SBP) was 1.59 (1.33 to 1.90), after adjustments for possible confounding factors, including baseline home SBP. Harrell’s C-statistics increased from 0.72 to 0.73 (P= 0.11) when 24-hour SBP was added to the basic 10-year home hypertension prediction model, which includes sex, age, body mass index, smoking status, office SBP, and baseline home SBP. Continuous net reclassification improvement (0.53,P< 0.0001) and integrated discrimination improvement (0.028,P= 0.0014) revealed improvement in the model.ConclusionsA total of 24-hour SBP could be an independent predictor of future home hypertension. Home BP and 24-hour BP can longitudinally influence each other in the long term.