Follow-up clinic and ambulatory blood pressure in untreated white-coat hypertensive patients (evaluation after 2-5 years).
Follow-up clinic and ambulatory blood pressure in untreated white-coat hypertensive patients (evaluation after 2-5 years).
复制标题
未经治疗的白大衣高血压患者的门诊随访和动态血压（2-5年后评估）。
作者：
J. Polónia;Alejandro Santos;G. Gama;F. Basto;Paulo Bettencourt;L. Martins
背景技术背景：门诊血压持续升高但动态血压正常的受试者[白大衣高血压患者（WCH）]是否有更高的进一步发展为动态高血压的倾向仍存在争议。方法：我们前瞻性地评估了3.5年（从26个月至59个月）36例未接受治疗的受试者的门诊和动态血压值的变化（17-65岁）（门诊血压> 140/90，清醒时动态血压< 132/84 mmHg，无任何其他主要心血管危险因素）和52名门诊和动态血压正常的受试者（门诊血压< 140/90 mmHg，清醒血压< 132/84 mmHg，24-61岁）。研究结果：两个人群的门诊血压、24小时血压和清醒血压值的平均值从基线到随访期结束没有差异。36例WCH受试者中有4例（11%）发生动态高血压，52例血压正常者中有3例（6%）发生动态高血压，如果定义为清醒血压>/= 140/90 mmHg，36例WCH受试者中有8例（22%）发生动态高血压，52例血压正常者中有8例（15%）发生动态高血压，如果定义为清醒血压>/= 132/84 mmHg，分别达到动态高血压的患者的基线清醒血压值在其各自组的血压分布的上五分位数内。结论：经过平均3.5年的随访，血压正常者和无其他心血管风险的WCH受试者以类似的方式转变为动态高血压。发生持续性高血压的小倾向可能影响初始动态血压值较高的患者。尽管不能排除WCH患者向持续性高血压的缓慢演变，但这些发现表明这种转变可能与血压正常者相似。
BACKGROUND: It is still under debate whether subjects with persistently elevated clinic blood pressure but normal ambulatory blood pressure, [white-coat hypertensives (WCH)] have a higher propensity for further development of ambulatory hypertension. METHODS: We prospectively evaluated for 3.5 years (from 26 up to 59 months) the transition of clinic and ambulatory blood pressure values in 36 untreated subjects (17-65 years) with WCH (clinic blood pressure > 140/90 and awake ambulatory blood pressure < 132/84 mmHg and without any other major cardiovascular risk factors) and of 52 clinic and ambulatory normotensive subjects (clinic blood pressure < 140/90 mmHg and awake blood pressure < 132/84 mmHg, 24-61 years). RESULTS: Average values of clinic blood pressure, 24 h blood pressure and awake blood pressure values did not differ from baseline to the end of the follow-up period in both populations. Development of ambulatory hypertension occurred in four out of 36 (11%) subjects with WCH and in three out of 52 (6%) normotensives if defined by awake blood pressure >/= 140/90 mmHg and in eight out of 36 (22%) subjects with WCH and in eight out of 52 (15%) normotensives if defined by awake blood pressure >/= 132/84 mmHg, respectively. Patients who reached ambulatory hypertension had baseline awake blood pressure values within the upper quintile of distribution of blood pressure in their respective group. CONCLUSION: After an average of 3.5 years of follow-up, a transition to ambulatory hypertension occurred in a similar way in normotensives and subjects with WCH without any other cardiovascular risk. A small propensity for the development of sustained hypertension may affect patients with higher initial ambulatory blood pressure values. Although a slow evolution towards sustained hypertension cannot be excluded in subjects with WCH, these findings suggest that this transition might be similar to that in normotensive subjects.