Cardiovascular Event Risks Associated With Masked Nocturnal Hypertension Defined by Home Blood Pressure Monitoring in the J-HOP Nocturnal Blood Pressure Study
Cardiovascular Event Risks Associated With Masked Nocturnal Hypertension Defined by Home Blood Pressure Monitoring in the J-HOP Nocturnal Blood Pressure Study
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DOI：
10.1161/hypertensionaha.120.14790
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发表时间：
2020-07-01
期刊：
影响因子：
8.3
通讯作者：
Kario, Kazuomi
中科院分区：
文献类型：
--
作者：
Fujiwara, Takeshi;Hoshide, Satoshi;Kario, Kazuomi
没有关于心血管疾病（CVD）事件风险与通过家庭血压（BP）监测定义的隐瞒性夜间高血压之间的潜在关联的信息。我们试图在普通人群中检验这种关联。为此，我们使用了J-HOP（日本晨间手术-家庭血压）夜间血压研究的数据，该研究招募了2745名高心血管风险参与者（平均[SD]年龄63.6[10.4]岁，48.7%为男性，82.7%服用降压药）。夜间家庭血压（HBP）在2:00、3:00和4:00测量，使用经过验证的自动化HBP设备连续14天。夜间血压测量平均值（SD）为17.1（13.5）。血压控制（夜间血压= 135/85 mm Hg）的比例分别为31.7%、7.9%、26.7%和33.7%。在中位7.6年的随访期间（19519人年），发生了162例CVD事件。隐匿性夜间高血压和持续性高血压患者CVD事件的累积发生率高于血压控制组。Cox模型的结果表明，隐性夜间高血压（校正风险比1.57 [95% CI, 1.00-2.46]）和持续高血压（校正风险比1.97 [95% CI, 1.26-3.06]）与CVD事件风险增加相关。通过HBP监测定义的隐匿性夜间高血压患者未来心血管事件的风险较高。
There is no information regarding the potential association between cardiovascular disease (CVD) event risks and masked nocturnal hypertension defined by home blood pressure (BP) monitoring. We sought to examine this association in a general practice population. For this purpose, we used data from the J-HOP (Japan Morning Surge-Home Blood Pressure) Nocturnal BP Study, which recruited 2745 high-cardiovascular-risk participants (mean [SD] age, 63.6 [10.4] years; 48.7% men; 82.7% on antihypertensive medications). Nocturnal home BPs (HBPs) were measured at 2:00, 3:00, and 4:00AMusing a validated, automated HBP device for 14 consecutive days. The average (SD) of nocturnal HBP measures was 17.1 (13.5). The percentages of participants with controlled BP (nocturnal HBP = 135/85 mm Hg) were 31.7%, 7.9%, 26.7%, and 33.7%, respectively. During a median 7.6-year follow-up (19 519 person-years), 162 CVD events occurred. The cumulative incidence of CVD events was higher in those with masked nocturnal hypertension and sustained hypertension than in the controlled BP group. Results from Cox models suggested that masked nocturnal hypertension (adjusted hazard ratio, 1.57 [95% CI, 1.00-2.46]) and sustained hypertension (adjusted hazard ratio, 1.97 [95% CI, 1.26-3.06]) were associated with increased risk of CVD events. Participants with masked nocturnal hypertension defined by HBP monitoring are at high risk of future CVD events.