Detection of carotid atherosclerosis in individuals with masked hypertension and white-coat hypertension by self-measured blood pressure at home: The Ohasama Study
Detection of carotid atherosclerosis in individuals with masked hypertension and white-coat hypertension by self-measured blood pressure at home: The Ohasama Study
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DOI：
10.1097/hjh.0b013e3280115bbf
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发表时间：
2007-02-01
影响因子：
4.9
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Hara, Azusa;Ohkubo, Takayoshi;Imai, Yutaka
目的探讨隐匿性高血压（MHT）和白大衣性高血压（WCHT）患者颈动脉粥样硬化的发生情况。方法对812名年龄在55岁以上（平均66.4岁）的日本普通人群进行在家自测血压（HBP）和偶然血压（CBP）测量。测量双侧颈总动脉近、远壁内膜中层厚度（IMT）并取平均值。颈动脉粥样硬化与动脉粥样硬化的关系（IMT和斑块）和四个血压组（持续正常血压：HBP < 135/85 mmHg，CBP < 140/ 90 mmHg; WCHT：HBP < 135/85 mmHg，CBP < 140/ 90 mmHg; MHT：HBP < 135/85 mmHg，CBP < 140/ 90 mmHg;持续高血压：结果持续性高血压患者校正后的IMT为0.77 mm，95%可信区间（CI）为0.75 ~ 0.79 mm，MHT为0.75 ~ 0.79 mm。持续正常血压组（0.71 mm; 95% CI 0.69 ~ 0.72 mm）和WCHT组（0.72 mm; 95% CI 0.71 ~ 0.74 mm）的平均血压（0.77 mm; 95% CI 0.73 ~ 0.80 mm）显著高于WCHT组（P < 0.0001）。在所有四组斑块的存在的优势比是相似的趋势，在IMT。结论我们的研究结果意味着，CBP测量单独是不足以区分个人在高风险的颈动脉粥样硬化从那些在低风险。然而，这些人确实有不同的HBP测量，这表明HBP测量可能成为预测颈动脉粥样硬化的有价值的工具。J Hypertens 25：321 - 327（c）2007 Lippincott威廉姆斯和威尔金斯。
Objective To investigate carotid atherosclerosis in individuals with masked hypertension (MHT) and white-coat hypertension (WCHT) in a general population.Methods Self-measurement of blood pressure at home (HBP) and casual blood pressure (CBP) measurements were recorded in 812 individuals aged at least 55 years (mean 66.4 years) from the general Japanese population. The intima-media thickness (IMT) of the near and far wall of both common carotid arteries was measured and averaged. The relationships between carotid atherosclerosis (IMT and plaque) and the four blood pressure groups (sustained normal blood pressure: HBP < 135/85 mmHg, CBP < 140/ 90 mmHg; WCHT: HBP < 135/85 mmHg, CBP < 140/ 90 mmHg; MHT: HBP < 135/85 mmHg, CBP < 140/ 90 mmHg; sustained hypertension: HBP >= 135/85 mmHg, CBP >= 140/90 mmHg) were examined using multivariate analysis adjusted for possible confounding factors.Results Adjusted IMT in individuals with sustained hypertension [0.77 mm; 95% confidence interval (Cl) 0.75 to 0.79 mm] and MHT (0.77 mm; 95% Cl 0.73 to 0.80 mm) was significantly greater than in those with sustained normal blood pressure (0.71 mm; 95% Cl 0.69 to 0.72 mm) and WCHT (0.72 mm; 95% Cl 0.71 to 0.74 mm) (P < 0.0001). The odds ratios for the presence of plaques in all four groups were similar to the trends in IMT.Conclusions Our findings imply that CBP measurements alone are insufficient to distinguish individuals at high risk of carotid atherosclerosis from those at low risk. However, these individuals do have distinct HBP measurements, suggesting that HBP measurement could become a valuable tool for predicting carotid atherosclerosis. J Hypertens 25:321 -327 (c) 2007 Lippincott Williams & Wilkins.