Significance of WhiteCoat Hypertension in Older Persons With Isolated Systolic Hypertension
Significance of WhiteCoat Hypertension in Older Persons With Isolated Systolic Hypertension
复制标题
白大衣高血压对患有孤立性收缩期高血压的老年人的意义
DOI：
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
J. Staessen
中科院分区：
文献类型：
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作者：
L. Thijs;T. Hansen;Yan Li;J. Boggia;M. Kikuya;Kristina Björklund;T. Ohkubo;J. Jeppesen;C. Torp‐Pedersen;E. Dolan;T. Kuznetsova;K. Stolarz;V. Tikhonoff;S. Malyutina;E. Casiglia;Y. Nikitin;L. Lind;E. Sandoya;K. Kawecka;Y. Imai;Ji;H. Ibsen;E. O’Brien;J. Staessen
白大衣高血压在老年单纯收缩期高血压中的意义仍然知之甚少。我们分析了以人群为基础的11个国家的国际动态血压监测数据库中与心血管结果数据库相关的受试者，这些受试者有白天动态血压(BP；ABP)和常规血压(CBP)测量。排除有心血管疾病病史的CBP(90 Mm Hg)或白天ABP(85 Mm Hg)的舒张期高血压者和18岁的人后，本研究共分析了7295人，其中1593人患有单纯的收缩期高血压。在10.6年的中位随访期内，共有655例致命性和非致命性心血管事件。这些分析是按治疗状态分层的。在未经治疗的受试者中，白大衣高血压患者(CBP140/90 mm Hg和ABP135/85 mm Hg)和血压正常的受试者(CBP140/90 mm Hg和ABP135/85 mm Hg)的风险相似(调整后的危险比：1.17[95%CI：0.87-1.57]；P 0.29)。此外，在接受治疗的单纯收缩期高血压患者中，日间常规和正常收缩压升高的心血管风险与日间常规血压正常和日间正常收缩压正常的患者相似(调整后的危险比：1.10[95%CI：0.79-1.53]；P 0.57)。然而，与未经治疗的正常血压组相比，经治疗的单纯收缩期高血压合并白大衣高血压患者(调整后的危险率：2.00；[95%CI：1.43~2.79]；P 0.0001)和经治疗的血压正常的患者(调整后的危险率：1.98[95%CI：1.49~2.62]；P 0.0001)均有更高的危险性。总而言之，在降压治疗中ABP正常化，但CBP测量显示残留白大衣效应的持续性高血压患者有一个实体，我们称之为“治疗的正常化高血压”。因此，在将“白大衣高血压”一词用于接受降压治疗的患者时应谨慎。(高血压。2012；59：564-571。)在线数据补充
The significance of white-coat hypertension in older persons with isolated systolic hypertension remains poorly understood. We analyzed subjects from the population-based 11-country International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes database who had daytime ambulatory blood pressure (BP; ABP) and conventional BP (CBP) measurements. After excluding persons with diastolic hypertension by CBP ( 90 mm Hg) or by daytime ABP ( 85 mm Hg), a history of cardiovascular disease, and persons 18 years of age, the present analysis totaled 7295 persons, of whom 1593 had isolated systolic hypertension. During a median follow-up of 10.6 years, there was a total of 655 fatal and nonfatal cardiovascular events. The analyses were stratified by treatment status. In untreated subjects, those with white-coat hypertension (CBP 140/ 90 mm Hg and ABP 135/ 85 mm Hg) and subjects with normal BP (CBP 140/ 90 mm Hg and ABP 135/ 85 mm Hg) were at similar risk (adjusted hazard rate: 1.17 [95% CI: 0.87–1.57]; P 0.29). Furthermore, in treated subjects with isolated systolic hypertension, the cardiovascular risk was similar in elevated conventional and normal daytime systolic BP as compared with those with normal conventional and normal daytime BPs (adjusted hazard rate: 1.10 [95% CI: 0.79–1.53]; P 0.57). However, both treated isolated systolic hypertension subjects with white-coat hypertension (adjusted hazard rate: 2.00; [95% CI: 1.43–2.79]; P 0.0001) and treated subjects with normal BP (adjusted hazard rate: 1.98 [95% CI: 1.49–2.62]; P 0.0001) were at higher risk as compared with untreated normotensive subjects. In conclusion, subjects with sustained hypertension who have their ABP normalized on antihypertensive therapy but with residual white-coat effect by CBP measurement have an entity that we have termed, “treated normalized hypertension.” Therefore, one should be cautious in applying the term “white-coat hypertension” to persons receiving antihypertensive treatment. (Hypertension. 2012;59:564-571.) ● Online Data Supplement
影响因子：
1.3
作者：
Kikuya, Masahiro;Hansen, Jine W.;Staessen, Jan A.
通讯作者：
Staessen, Jan A.
影响因子：
37.8
作者：
Kikuya, Masahiro;Hansen, Tine W.;Staessen, Jan A.
通讯作者：
Staessen, Jan A.