Repeated evening home blood pressure measurement improves prognostic significance for stroke: a 12-year follow-up of the Ohasama study
Repeated evening home blood pressure measurement improves prognostic significance for stroke: a 12-year follow-up of the Ohasama study
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DOI：
10.1097/mbp.0b013e32832a9d91
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发表时间：
2009-06-01
影响因子：
1.3
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Asayama, Kei;Ohkubo, Takayoshi;Imai, Yutaka
目的 比较晚上测量的家庭血压 (HBP) (E-HBP) 和临时筛查血压 (CBP) 对中风风险的预测能力与 E-HBP 测量次数的关系。方法 我们从 2234 名年龄 >= 35 岁的日本参与者中获得了 E-HBP（在晚上睡觉前测量一次，持续 4 周）和 CBP（在健康检查期间测量两次）。 既往没有中风史。参与者的随访时间中位数为 11.9 年。通过 Cox 回归模型确定血压每增加 10 mmHg（收缩压）或 5 mmHg（舒张压）的多变量调整相对风险 (RH) 和 95% 置信区间 (CI)。 结果 共有 226 例中风发生。即使最初的 E-HBP 值也能显着预测未来的卒中事件（收缩压 RH = 1.19，95% CI = 1.11-1.28；舒张压 RH = 1.12，95% CI = 1.06-1.19），并且 E-HBP 的预测能力随着测量次数的增加而逐渐增强。当初始收缩期E-HBP和收缩期CBP值同时纳入Cox模型时，只有初始E-HBP与卒中风险显着相关（E-HBP RH=1.17，95% CI=1.08-1.26；CBP RH=1.07，95% CI=0.99-1.15）。 结论 无论患者数量多少，E-HBP均比CBP具有更强的预测能力。 测量。我们的研究结果强调了 E-HBP 相对于 CBP 的重要临床意义，尽管 E-HBP 的测量条件通常不如早晨 HBP 测量严格。 Blood Press Monit 14:93-98 (C) 2009 Wolters Kluwer Health 垂直条 Lippincott Williams & Wilkins。
Objective To compare the Predictive power of home blood pressure (HBP) measured in the evening (E-HBP) and that of casual screening BP (CBP) for stroke risk in relation to the number of E-HBP measurements.Methods We obtained E-HBP (measured once in the evening just before going to bed for 4 weeks) and CBP (measured twice during the health checkup) from 2234 Japanese participants aged >= 35 years who had no history of a previous stroke. The participants were followed-up for a median duration of 11.9 years. The multivariate adjusted relative hazard (RH) and 95% confidence intervals (CI) for each 10 mmHg (systolic) or 5 mmHg (diastolic) increase in BP was determined by Cox regression model.Results There were 226 incidences of stroke. Even the initial E-HBP values significantly predicted future stroke events (systolic RH = 1.19, 95% CI = 1.11-1.28; diastolic RH = 1.12, 95% CI = 1.06-1.19), and the predictive power of E-HBP increased progressively with the increased number of measurements. When initial systolic E-HBP and systolic CBP values were simultaneously included into the Cox model, only initial E-HBP was significantly related with stroke risk (E-HBP RH=1.17,95% CI=1.08-1.26; CBP RH=1.07,95% CI=0.99-1.15).Conclusion E-HBP has a stronger predictive power than CBP regardless of the number of measurements. Our findings emphasize the important clinical significance of E-HBP over CBP, even though the measurement conditions of E-HBP are generally less strict than that of morning HBP measurements. Blood Press Monit 14:93-98 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.