Prevalence of resistant hypertension and associated factors for blood pressure control status with optimal medical therapy using Korean ambulatory blood pressure monitoring registry data.
Prevalence of resistant hypertension and associated factors for blood pressure control status with optimal medical therapy using Korean ambulatory blood pressure monitoring registry data.
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DOI：
10.1186/s40885-016-0045-x
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发表时间：
2015
影响因子：
4.2
通讯作者：
Shin J
中科院分区：
文献类型：
--
作者：
Choi SI;Kim SK;Park S;Kim JH;Ihm SH;Kim GI;Kim WS;Pyun WB;Kim YM;Shin J
顽固性高血压（RH）可能是提高高血压（HT）治愈率的平台原因之一。临床血压（BP）对RH的误诊是一个重要的临床问题。本研究的目的是通过动态血压监测（ABPM）调查RH的患病率以及与动态血压控制状态相关的因素。在韩国动态血压监测（korea - abp）登记处登记的1230名服用一种或多种降压药（AHM）的受试者中，计算了RH的患病率，其定义为三种AHM（包括利尿剂）不受控制的血压或需要四种或四种以上AHM的血压。比较了门诊和门诊血压测定的患病率。年龄59.3±12.5岁，女性占44.3%（1230例）。其中服用利尿剂等3种AHM药物的有72人，服用4个及以上AHM课程的有105人。72例受试者中有41例日间血压不受控制，RH患病率为11.9%（146/1230）。通过使用夜间血压标准，临床与夜间血压的RH患病率有显著差异（146/177 vs. 159/177, p = 0.0124）。日间血压控制状态中，蒙面控制血压为16.9%，白大褂效应控制血压为14.1%。对于夜间血压控制状态，吸烟（0.624）、饮酒（1.512）、冠状动脉疾病（0.604）、钙拮抗剂（1.705）和循环利尿剂（0.454）的奇比均具有显著性。以白天血压为标准，患病率为11.9%，而以夜间血压为标准，患病率明显更高。日间血压控制状态误分类率为31.0%。吸烟、饮酒、冠状动脉疾病、钙拮抗剂和利尿剂与夜间血压控制状态相关。
Resistant hypertension (RH) may be one of the cause of the plateau in improving the control rate in hypertension (HT) management. The misdiagnosis of RH by clinic blood pressure (BP) is important clinical problem. Aim of the study were to investigate the prevalence of RH by ambulatory blood pressure monitoring (ABPM) and the factor associated with control status of ambulatory BPs. For 1230 subjects taking one or more antihypertensive medication (AHM) enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) registry, the prevalence of RH was calculated which was defined as uncontrolled BP by three AHM classes including diuretic or BP in need of four or more AHM classes. The prevalence determined by clinic versus ambulatory BP was compared. The age was 59.3 ± 12.5 years, and 44.3 % were female (n = 1230). Among them 72 subjects were taking three AHM drugs including diuretics and 105 subjects were taking four or more AHM classes. With uncontrolled daytime ambulatory BP in 41 among 72 subjects, prevalence of RH was 11.9 % (146/1230). By using nighttime BP criteria, there was significant difference in the prevalence of RH for clinic versus nighttime BP (146/177 vs. 159/177, p = 0.0124). For control status of daytime BP, masked uncontrolled BP was 16.9 % and controlled BP with white-coat effect was 14.1 %. For nighttime BP control status, odd ratios for smoking (0.624), drinking (1.512), coronary artery disease (0.604), calcium antagonist (1.705), and loop diuretics (0.454) were all significant. The prevalence itself was 11.9 % by daytime BP and it was significantly higher when using nighttime BP criteria. Control status of daytime BP was misclassified in 31.0 %. Smoking, drinking, coronary artery disease, calcium antagonist, and loop diuretics were associated with nighttime BP control status.