Morning hypertension is more common in elderly hypertensive patients with controlled documented office blood pressure in primary care clinics: the Minhang study
Morning hypertension is more common in elderly hypertensive patients with controlled documented office blood pressure in primary care clinics: the Minhang study
复制标题
DOI：
10.1097/hjh.0000000000001449
复制
发表时间：
2017-11
影响因子：
4.9
通讯作者：
Yan Wang;Ling Chen;Yajuan Wang;Yuesheng Qain;Jin Zhang;Xiao-feng Tang;Yan Li;Dingliang Zhu
中科院分区：
文献类型：
--
作者：
Yan Wang;Ling Chen;Yajuan Wang;Yuesheng Qain;Jin Zhang;Xiao-feng Tang;Yan Li;Dingliang Zhu
背景：晨起血压升高与致死性和非致死性心血管事件相关，尤其是在亚洲人中。方法：为了检测家庭血压的控制状况，我们进行了一项家庭血压监测研究，包括在中国初级保健诊所控制记录办公室血压的老年高血压患者。在上海新庄县医院的707名参与者中，通过配备记忆的设备连续7天每天测量3次家庭血压。结果：高血压未控制的患病率晨起为51.3%，晚起为42%。未控制的晨起高血压与年龄[比值比（OR）：1.074; 95%置信区间（CI）：1.041-1.108]、办公室SBP（OR：1.027; 95% CI：1.015-1.039），诊室DBP（OR：1.042; 95%CI：1.021-1.064），服用降压药的次数（OR：1.387; 95%CI：1.059-1.817），而与长效降压药的使用呈负相关（OR：0.588; 95%CI：0.355-0.973）。与办公室血压相比，家庭早晨血压与年龄和短效降压药物的相关性更显著。结论：中国老年高血压患者血压控制不佳的发生率较高，尤其是在早晨，监测血压可能是一种可行的方法，使用长效降压药物可能有助于改善早晨高血压。
Background: Increased morning blood pressure (BP) has been associated with fatal and nonfatal cardiovascular events, especially in Asians. Method: To detect the control status of home BP, we performed a home BP monitoring study, including elderly patients with hypertension who had controlled documented office BP in Chinese primary care clinics. In 707 participants from Xinzhuang County Hospital in Shanghai, the home BP was measured by a memory-equipped device three times daily for seven consecutive days. Results: The prevalence of uncontrolled hypertension was 51.3% in the morning and 42% in the evening. Uncontrolled morning hypertension was associated with age [odds ratio (OR): 1.074; 95% confidence interval (CI): 1.041–1.108], office SBP (OR: 1.027; 95% CI: 1.015–1.039), office DBP (OR: 1.042; 95% CI: 1.021–1.064), and the number of antihypertensive drugs taken (OR: 1.387; 95% CI: 1.059–1.817), whereas it was inversely associated with the use of long-acting antihypertensive drugs (OR: 0.588; 95% CI: 0.355–0.973). Compared with office BP, the home morning BP showed a more significant association with age and short-acting antihypertensive drugs. Conclusion: The prevalence of uncontrolled home BP is high in elderly Chinese hypertensive patients, especially in the morning, and home BP monitoring might be a feasible method for detecting it. The use of long-acting antihypertensive drugs might help to improve morning hypertension.