Masked Hypertension and Cardiovascular Disease Events in a Prospective Cohort of Blacks: The Jackson Heart Study.
Masked Hypertension and Cardiovascular Disease Events in a Prospective Cohort of Blacks: The Jackson Heart Study.
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DOI：
10.1161/hypertensionaha.116.07553
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发表时间：
2016-08
期刊：
影响因子：
--
通讯作者：
Shimbo D
中科院分区：
文献类型：
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作者：
Booth JN 3rd;Diaz KM;Seals SR;Sims M;Ravenell J;Muntner P;Shimbo D
隐性高血压被定义为非临床血压升高，但门诊血压升高，在欧洲人和亚洲人中与心血管疾病(CVD)风险增加有关。关于非裔美国人(AAs)中的隐性高血压和心血管疾病以及死亡风险的数据很少。我们分析了杰克逊心脏研究的数据，这是一项针对AA的前瞻性队列研究。分析对象包括临床测量的收缩压/舒张压(SBP/DBP)和140/90毫米汞柱的参与者，他们在2000-2004年的基线检查后完成了动态血压监测(ABPM)(n=738)。掩蔽性白天(上午10：00~晚上8：00)高血压定义为平均动态收缩压/舒张压≥135/85 mm Hg。夜间(午夜至早上6：00时)高血压定义为平均动态收缩压/舒张压≥为120/70 mm Hg。24小时隐匿性高血压定义为平均收缩压/舒张压、≥130/80 mm Hg。对截至2010年12月确认的心血管事件(非致命性/致命性中风、非致命性心肌梗死或致命性冠心病)和死亡进行了裁决。52.2%的受试者存在任何隐性高血压(隐性白天、夜间或24小时高血压)；28.2%、48.2%和31.7%的受试者分别有白天、夜间和24小时高血压。在中位数分别为8.2年和8.5年的随访中，有51例心血管事件和44例死亡。有无任何隐性高血压的受试者每千人年心血管疾病发生率(95%CI)分别为13.5(9.9-18.4)和3.9(2.2-7.1)。任何隐性高血压的多变量调整危险比(95%CI)分别为2.49(1.26~4.93)、2.86(1.59~5.13)、2.35(1.23~4.50)和2.52(1.39~4.58)。隐匿性高血压与全因死亡率无关。隐匿性高血压很常见，并与腹主动脉心血管事件的风险增加有关。
Masked hypertension, defined as non-elevated clinic blood pressure (BP) with elevated out-of-clinic BP, has been associated with increased cardiovascular disease (CVD) risk in Europeans and Asians. Few data are available on masked hypertension and CVD and mortality risk among African Americans (AAs). We analyzed data from the Jackson Heart Study, a prospective cohort study of AAs. Analyses included participants with clinic-measured systolic/diastolic BP (SBP/DBP)<140/90mmHg who completed ambulatory BP monitoring (ABPM) following the baseline exam in 2000–2004 (n=738). Masked daytime (10:00am–8:00pm) hypertension was defined as mean ambulatory SBP/DBP≥135/85mmHg. Masked nighttime (midnight-6:00am) hypertension was defined as mean ambulatory SBP/DBP≥120/70mmHg. Masked 24-hour hypertension was defined as mean SBP/DBP≥130/80mmHg. CVD events (nonfatal/fatal stroke, nonfatal myocardial infarction or fatal coronary heart disease) and deaths identified through December 2010 were adjudicated. Any masked hypertension (masked daytime, nighttime or 24-hour hypertension) was present in 52.2% of participants; 28.2%, 48.2% and 31.7% had masked daytime, nighttime and 24-hour hypertension, respectively. There were 51 CVD events and 44 deaths over a median follow-up of 8.2 and 8.5 years, respectively. CVD rates per 1,000 person-years (95% CI) in participants with and without any masked hypertension were 13.5 (9.9–18.4) and 3.9 (2.2–7.1), respectively. The multivariable adjusted hazard ratio (95% CI) for CVD was 2.49 (1.26–4.93) for any masked hypertension and 2.86 (1.59–5.13), 2.35 (1.23–4.50) and 2.52 (1.39–4.58) for masked daytime, nighttime and 24-hour hypertension, respectively. Masked hypertension was not associated with all-cause mortality. Masked hypertension is common and associated with increased risk for CVD events in AAs.