Prevalence, Determinants, and Clinical Significance of Masked Hypertension in a Population-Based Sample of African Americans: The Jackson Heart Study
Prevalence, Determinants, and Clinical Significance of Masked Hypertension in a Population-Based Sample of African Americans: The Jackson Heart Study
复制标题
DOI：
10.1093/ajh/hpu241
复制
发表时间：
2015-07-01
影响因子：
3.2
通讯作者：
Hickson, DeMarc A.
中科院分区：
文献类型：
--
作者：
Diaz, Keith M.;Veerabhadrappa, Praveen;Hickson, DeMarc A.
背景：非裔美国人心血管疾病的不成比例的比率，部分可能是由于单独使用临床血压测量对血压（BP）的评估不理想。然而，迄今为止，隐匿性高血压在非裔美国人中的患病率尚未得到充分的描述。本研究的目的是评估以非洲裔美国人为基础的大量人群样本中隐蔽性高血压的患病率，并检查其决定因素及其与靶器官损伤（TOD）指标的关系。方法对参加Jackson心脏研究的972名非裔美国人进行临床和24小时动态血压监测。评价颈总动脉内膜-中膜厚度、左心室质量指数、尿白蛋白与肌酐排泄比作为TOD的指标。结果调查高血压患病率为25.9%，临床血压正常者为34.4%。蒙面高血压患者的TOD各指标均显著高于持续正常高血压患者，且蒙面高血压患者与持续正常高血压患者的TOD各指标相似。在多变量分析中，男性、吸烟、糖尿病和抗高血压药物使用是隐匿性高血压的独立决定因素。结论：在这个以人群为基础的非裔美国人队列中，大约三分之一的临床血压正常的参与者在日常环境中评估血压时出现了隐蔽性高血压。在这个队列中，隐蔽性高血压伴有较大程度的TOD。
BACKGROUNDThe disproportionate rates of cardiovascular disease in African Americans may, in part, be due to suboptimal assessment of blood pressure (BP) with clinic BP measurements alone. To date, however, the prevalence of masked hypertension in African Americans has not been fully delineated. The purpose of this study was to evaluate masked hypertension prevalence in a large population-based sample of African Americans and examine its determinants and association with indices of target organ damage (TOD).METHODSClinic and 24-hour ambulatory BP monitoring were conducted in 972 African Americans enrolled in the Jackson Heart Study. Common carotid artery intima-media thickness, left ventricular mass index, and the urinary albumin:creatinine excretion ratio were evaluated as indices of TOD.RESULTSMasked hypertension prevalence was 25.9% in the overall sample and 34.4% in participants with normal clinic BP. All indices of TOD were significantly higher in masked hypertensives compared to sustained normotensives and were similar between masked hypertensives and sustained hypertensives. Male gender, smoking, diabetes, and antihypertensive medication use were independent determinants of masked hypertension in multivariate analyses.CONCLUSIONSIn this population-based cohort of African Americans, approximately one-third of participants with presumably normal clinic BP had masked hypertension when BP was assessed in their daily environment. Masked hypertension was accompanied by a greater degree of TOD in this cohort.