Prevalence and Factors Associated With Circadian Blood Pressure Patterns in Hypertensive Patients
Prevalence and Factors Associated With Circadian Blood Pressure Patterns in Hypertensive Patients
复制标题
DOI：
10.1161/hypertensionaha.108.124008
复制
发表时间：
2009-03-01
期刊：
影响因子：
8.3
通讯作者：
Ruilope, Luis M.
中科院分区：
文献类型：
--
作者：
de la Sierra, Alejandro;Redon, Josep;Ruilope, Luis M.
动态血压（BP）监测已成为有用的诊断和管理高血压的个人。除了24小时值外，血压的昼夜变化在预测心血管结局方面也具有预后意义。然而，在大型研究中，昼夜血压模式的大小几乎没有被注意到。我们的目的是确定昼夜血压模式的患病率，并评估与治疗和未治疗的高血压受试者的非浸渍状态相关的临床条件，分别进行研究。临床数据和24小时动态血压监测来自西班牙高血压学会动态血压监测登记处的42947例高血压患者。他们是8384以前未经治疗和34563治疗的高血压。使用血压计（SpaceLabs 90207）进行24小时动态血压监测。当夜间收缩压下降<白天收缩压的10%时定义为非下降型。未治疗组的非浸渍患病率为41%，治疗组为53%。在两组中，高龄、肥胖、糖尿病和明显的心血管或肾脏疾病都与夜间血压下降不明显相关（P < 0.001）。在接受治疗的患者中，非浸渍与使用更多的抗高血压药物有关，但与使用抗高血压药物的时间无关。总之，高血压患者夜间血压下降不明显（非下降型）是常见的。高心血管风险的临床模式与非降压相关，这表明夜间血压下降变钝可能仅仅是高心血管风险的标志。（高血压。2009;53：466-472）。
Ambulatory blood pressure (BP) monitoring has become useful in the diagnosis and management of hypertensive individuals. In addition to 24-hour values, the circadian variation of BP adds prognostic significance in predicting cardiovascular outcome. However, the magnitude of circadian BP patterns in large studies has hardly been noticed. Our aims were to determine the prevalence of circadian BP patterns and to assess clinical conditions associated with the nondipping status in groups of both treated and untreated hypertensive subjects, studied separately. Clinical data and 24-hour ambulatory BP monitoring were obtained from 42 947 hypertensive patients included in the Spanish Society of Hypertension Ambulatory Blood Pressure Monitoring Registry. They were 8384 previously untreated and 34 563 treated hypertensives. Twenty-four-hour ambulatory BP monitoring was performed with an oscillometric device (SpaceLabs 90207). A nondipping pattern was defined when nocturnal systolic BP dip was < 10% of daytime systolic BP. The prevalence of nondipping was 41% in the untreated group and 53% in treated patients. In both groups, advanced age, obesity, diabetes mellitus, and overt cardiovascular or renal disease were associated with a blunted nocturnal BP decline (P < 0.001). In treated patients, nondipping was associated with the use of a higher number of antihypertensive drugs but not with the time of the day at which antihypertensive drugs were administered. In conclusion, a blunted nocturnal BP dip (the nondipping pattern) is common in hypertensive patients. A clinical pattern of high cardiovascular risk is associated with nondipping, suggesting that the blunted nocturnal BP dip may be merely a marker of high cardiovascular risk. (Hypertension. 2009;53:466-472.)