Reproducibility of white-coat and masked hypertension in ambulatory BP monitoring
Reproducibility of white-coat and masked hypertension in ambulatory BP monitoring
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DOI：
10.1016/j.ijcard.2006.04.088
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发表时间：
2007-05-02
影响因子：
3.5
通讯作者：
Bursztyn, Michael
中科院分区：
文献类型：
--
作者：
Ben-Dov, Iddo Z.;Ben-Arie, Liora;Bursztyn, Michael
背景：白大衣高血压和隐匿性高血压具有临床和预后后果。然而，这些现象的再现性是未知的。我们研究了再现性的白大衣和掩蔽效应与现实生活中的动态血压监测（ABPM）。方法：在回顾性分析的前瞻性组装ABPM数据库有196例（年龄58 +/- 16岁，59%的女性，73%的高血压治疗）进行重复ABPM标准的临床适应症。白大衣高血压（或孤立的手动不受控制的高血压）定义为清醒时血压（BP）正常（< 135/85 mmHg）和手动血压异常（>= 140/ 90 mmHg）。隐性高血压（或单纯性动态血压控制不佳）定义为清醒时血压异常，但血压正常。结果：治疗组和未治疗组的高血压亚组分布相似; 16%白大衣高血压（在接受治疗的受试者中，孤立的手动不受控制的高血压），13%的高血压被掩盖（在治疗的受试者中，孤立的动态不受控制的高血压），59%不受控制的高血压，12%正常血压（或控制的高血压）。在第二阶段，白大衣和蒙面高血压的患病率增加。在第一次治疗中，31例白大衣高血压受试者中有19例（61%）在第二次治疗中保持动态血压正常，而25例盲法高血压受试者中有18例（72%）保持动态高血压。收缩压手动清醒血压差的再现性不劣于其他动态变量。在未经治疗的受试者的白大衣高血压，掩盖高血压和白大衣的效果是更好的再现性。结论：在现实生活中的ABPM数据库，我们发现白大衣高血压和掩蔽现象是合理的再现，相比其他BP变量。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
Background: White-coat hypertension and masked hypertension have clinical and prognostic consequences. However, reproducibility of these phenomena is unknown. We examined the reproducibility of the white-coat and masking effects with real-life ambulatory blood pressure monitoring (ABPM).Methods: In a retrospective analysis of a prospectively assembled ABPM database there were 196 subjects (age 58 +/- 16 years, 59% female, 73% treated for hypertension) who underwent repeat ABPM for standard clinical indications. White-coat hypertension (or isolated manual uncontrolled hypertension) was defined as normal (< 135/85 mmHg) awake blood pressure (BP) and abnormal (>= 140/ 90 mmHg) manual BP. Masked hypertension (or isolated ambulatory uncontrolled hypertension) was defined as abnormal awake BP with normal manual BP.Results: Treated and untreated subjects had similar distribution among hypertension subgroups; 16% white-coat hypertension (in treated subjects, isolated manual uncontrolled hypertension), 13% masked hypertension (in treated subjects, isolated ambulatory uncontrolled hypertension), 59% uncontrolled hypertension, 12% normal blood pressure (or controlled hypertension). In the second session the prevalence of white-coat and masked hypertension increased. Of 31 subjects with white-coat hypertension in the first session 19 (61%) remained ambulatory normotensive in the second session, while 18 of 25 (72%) masked hypertensive subjects remained ambulatory hypertensive. The reproducibility of the systolic manual-awake blood pressure difference was not inferior to that of other ambulatory variables. In untreated subjects the reproducibility of white-coat hypertension, masked hypertension and the white-coat effect was even better.Conclusion: In a real-life ABPM database, we found white-coat hypertension and the masking phenomenon to be reasonably reproducible, as compared to other BP variables. (c) 2006 Elsevier Ireland Ltd. All rights reserved.