Hulsen Hans T, Nijdam Marie-Elise, Bos Willem-Jan, Uiterwaal Cuno S, Oren Anath, Grobbee Diederick E, Bots Michiel
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
J Hypertens. 2006 Jun;24(6):1027-32. doi: 10.1097/01.hjh.0000226191.36558.9c.
To investigate the prevalence and determinants of spurious systolic hypertension (SSH) in a population-based sample of young adults and estimate their 20-year risk of coronary heart disease.
Seven hundred and fifty young adults (352 men and 398 women), aged 26-31 years, from the Atherosclerosis Risk in Young Adults study were studied. Blood pressure levels were measured twice and central (aortic) pressures were derived by applanation tonometry on the radial artery using a generalized transfer function. SSH was defined as brachial systolic blood pressure (SBP) > or = 140 mmHg, brachial diastolic blood pressure (DBP) < 90 mmHg, and central SBP < 124 mmHg for men and < 120 mmHg for women. The Framingham risk score was calculated. Analysis of variance models were used to compare SSH individuals with normotensive and hypertensive males for cardiovascular risk factors.
SSH was diagnosed in 57 men (16.1%; 95% confidence interval, 12.3-20.0) versus only three women (8%; 95% confidence interval, 0-1.6). The female population was excluded from further analysis. Compared with normotensive males, SSH individuals were heavier (88.7 versus 81.8 kg, P < 0.05) had a higher body mass index (25.8 versus 24.2 kg/m, P < 0.01) and significantly higher brachial and central SBP, DBP, pulse pressure, and mean arterial pressure. They had significantly higher pulse pressure amplification. Twenty-year Framingham risk scores based on DBP did not differ significantly between SSH subjects and normotensive individuals (2.72 versus 2.10%, respectively).
SSH is predominantly found among young adult men. Apart from weight and body mass index, no other cardiovascular risk factors differed significantly between subjects with SSH and normotension or hypertension. When calculating the 20-year risk of coronary heart disease based on brachial DBP, SSH individuals were at intermediate risk between normotensive and hypertensive participants, but differences were not statistically significant.
在一个基于人群的年轻成年人样本中调查假性收缩期高血压（SSH）的患病率及决定因素，并评估他们20年患冠心病的风险。
对来自“年轻成年人动脉粥样硬化风险”研究的750名年龄在26至31岁的年轻成年人（352名男性和398名女性）进行了研究。测量两次血压水平，并使用广义传递函数通过对桡动脉进行压平式眼压测量得出中心（主动脉）压。SSH定义为：男性肱动脉收缩压（SBP）≥140 mmHg，肱动脉舒张压（DBP）<90 mmHg，中心SBP<124 mmHg；女性肱动脉收缩压≥140 mmHg，肱动脉舒张压<90 mmHg，中心SBP<120 mmHg。计算弗雷明汉风险评分。使用方差分析模型比较SSH个体与血压正常和高血压男性的心血管危险因素。
57名男性被诊断为SSH（16.1%；95%置信区间，12.3 - 20.0），而只有3名女性被诊断为SSH（0.8%；95%置信区间，0 - 1.6）。女性人群被排除在进一步分析之外。与血压正常的男性相比，SSH个体体重更重（88.7对81.8 kg，P<0.05），体重指数更高（25.8对24.2 kg/m²，P<0.01），肱动脉和中心SBP、DBP、脉压和平均动脉压显著更高。他们的脉压放大显著更高。基于DBP的20年弗雷明汉风险评分在SSH受试者和血压正常个体之间无显著差异（分别为2.72%和2.10%）。
SSH主要在年轻成年男性中发现。除体重和体重指数外，SSH受试者与血压正常或高血压受试者之间的其他心血管危险因素无显著差异。基于肱动脉DBP计算20年冠心病风险时，SSH个体处于血压正常和高血压参与者之间的中等风险，但差异无统计学意义。
