Possible interesting link between dipping status and morning surge for subclinical target organ damage in hypertension.
Possible interesting link between dipping status and morning surge for subclinical target organ damage in hypertension.
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高血压亚临床靶器官损伤的下降状态和晨峰之间可能存在有趣的联系。
DOI：
10.1111/jch.13637
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Wakui H.
中科院分区：
文献类型：
--
作者：
Tamura K;Waki K;Kawai Y;Ueda E;Ishii T;Wakui H.
高血压在世界范围内非常普遍，是中风（如脑梗死、脑出血和蛛网膜下腔出血）、心脏病（如冠状动脉疾病、心脏肥厚和心力衰竭）、肾脏疾病（如肾硬化和终末期肾脏疾病）和大血管疾病（如主动脉夹层和外周动脉疾病）的主要原因。因此，降压治疗的主要目的是向所有医务工作者提供标准的管理策略和证据，以便为临床医生/从业人员在日常实践中最常遇到的高血压患者提供适当的治疗，通过控制血压来预防脑/心/肾高血压并发症的发生/进展。关于血压测量方法，越来越多的证据支持“临床外”血压，特别是门诊血压，对于高血压的正确诊断和血压控制的评估是重要的。2‐4动态血压监测不仅可以获取24小时血压水平的关键信息，还可以获取日常活动过程中发生的血压变化。积累的证据表明，动态血压，另一种估计临床外血压的方法，比临床血压更能预测未来心血管事件，据报道，夜间动态血压比白天血压更能预测未来心血管事件。据报道，家庭血压比临床血压更能预测未来心血管事件，最近开发了几种能够自动测量夜间血压的家庭血压装置。特别是，inCKD患者夜间高血压的患病率很高，并随着疾病进展而增加，据报道，夜间高血压与蛋白尿的恶化有关，并且进一步肾脏恶化和未来心血管事件的风险增加。因此，测量夜间血压水平和降低夜间血压对于抑制肾脏恶化和心血管并发症是很重要的。13,14此外，家庭血压测量设备的最新发展能够将家庭血压读数存储在云数据库中，不仅允许参与者，还允许实验者通过自动信息/通信技术（ICT）设置夜间血压测量的时间，从而为夜间家庭血压测量提供精确的时间表，8用于糖尿病患者的血糖控制。15
Hypertension is highly prevalent worldwide and is a major cause of strokes (such as cerebral infarction, cerebral hemorrhage, and sub‐arachnoid hemorrhage), heart diseases (such as coronary artery dis‐ease, cardiac hypertrophy, and heart failure), kidney diseases (such as nephrosclerosis and end‐stage kidney disease), and macrovascu‐lar diseases (such as aortic dissection and peripheral artery disease). Therefore, the primary aim of the anti‐hypertensive treatment is to present standard management strategies and evidence to all medical workers to provide appropriate treatment to patients with hyperten‐sion most frequently encountered by clinicians/practitioners in daily practice for the prevention of the onset/progression of hypertension complications in the brain/heart/kidney by blood pressure control. 1 Concerning the method of BP measurements, accumulating ev‐idence supports that the “out‐of‐clinic” BP, particularly the ambula‐tory BP profile, is important for a proper diagnosis of hypertension and estimation of BP control. 2‐4 Ambulatory BP monitoring allows the acquisition of critical information not only at the level of the 24‐hour BP but also the BP variations that occur in the course of daily activities. Accumulated evidence has showed that ambulatory BP, another measure to estimate out‐of‐clinic BP, is a superior predic‐tor of future cardiovascular events than clinic BP, and ambulatory nighttime BP is reportedly shown to be a superior predictor of future cardiovascular events than daytime BP. 5 Home BP is also report‐edly a better predictor of future cardiovascular events than clinic BP, and recent several home BP devices are capable of measuring automatically nocturnal BP have been developed. 6‐8 Particularly, inCKD patients the prevalence of nocturnal hypertension is high and increases with disease progression, 9 and nocturnal hypertension is reportedly associated with the worsening of albuminuria10, 11 and the increased risks of further renal deterioration and future cardiovas‐cular events. 12 Thus, it should be important to measure nighttime BP level and to reduce nighttime BP, in order to inhibit renal dete‐rioration and cardiovascular complication. 13, 14 Furthermore, recent development in the devices for home BP measurement enables to store home BP readings in a cloud database and can permit not only participants but also experimenters to set the timing of nocturnal BP measurement via automatic information/communication tech‐nology (ICT), resulting in a precise schedule for the measurement of nocturnal home BP, 8 as performed for glycemic control of diabetic patients. 15