未经治疗的原发性高血压患者血压昼夜波动规律的可重复性：性别和年龄的影响
Reproducibility of dipping/nondipping pattern in untreated essential hypertensive patients: impact of sex and age.
作者信息
Cuspidi Cesare, Meani Stefano, Valerio Cristiana, Sala Carla, Fusi Veronica, Masaidi Meilikemu, Zanchetti Alberto, Mancia Giuseppe
机构信息
Department of Clinical Medicine, Prevention and Applied Biotechnologies, University of Milano-Bicocca, Milan, Italy.
出版信息
Blood Press Monit. 2007 Apr;12(2):101-6. doi: 10.1097/MBP.0b013e32809efa51.
OBJECTIVE
We aimed to evaluate the intrasubject short-term reproducibility of nocturnal blood pressure patterns (dipping/nondipping) in essential hypertensive patients in relation to age (<50 and > or =50 years) and sex.
METHODS
A total of 619 never-treated essential grade 1 and 2 hypertensive patients (383 men, 236 women) underwent the following procedures: (1) repeated clinic blood pressure measurements, (2) routine examinations, (3) ambulatory blood pressure monitoring over two 24-h periods within 4 weeks. Dipping pattern was defined as a 10%, or more, reduction in average systolic blood pressure/ diastolic blood pressure at night compared to daytime values.
RESULTS
Of the 407 patients showing a dipping pattern during the first ambulatory blood pressure monitoring period, 329 (80.1%) had the same pattern during the second ambulatory blood pressure monitoring recording. Of the 212 patients with a nondipping pattern during the first ambulatory blood pressure monitoring period, 140 (65.9%) confirmed the same pattern during the second ambulatory blood pressure monitoring period. Overall, 149 patients (24.1%) changed their initial nocturnal pattern at the second ambulatory blood pressure monitoring recording, without significant age and sex-related differences. Lower reproducibility rates of the nondipping as compared to the dipping pattern were found in the whole population as well as in men regardless of age and in younger but not in older women.
CONCLUSIONS
These findings indicate that nocturnal blood pressure patterns have a limited short-term reproducibility in the whole study population as well as in different age and sex subgroups. As variability of nocturnal blood pressure patterns is not predicted by easy available clinical data, such as sex and age, a reliable classification of patients according to circadian blood pressure patterns should be obtained by repeating ambulatory blood pressure monitoring.
目的
我们旨在评估原发性高血压患者夜间血压模式（勺型/非勺型）在个体内的短期可重复性，并探讨其与年龄（<50岁和≥50岁）及性别的关系。
方法
共有619例未经治疗的原发性1级和2级高血压患者（383例男性，236例女性）接受了以下检查：（1）重复测量诊室血压；（2）进行常规检查；（3）在4周内分两个24小时时段进行动态血压监测。勺型模式定义为夜间平均收缩压/舒张压较白天值降低10%或更多。
结果
在第一个动态血压监测期呈现勺型模式的407例患者中，329例（80.1%）在第二个动态血压监测记录中保持相同模式。在第一个动态血压监测期呈现非勺型模式的212例患者中，140例（65.9%）在第二个动态血压监测期确认了相同模式。总体而言，149例患者（24.1%）在第二个动态血压监测记录时改变了其初始夜间模式，且无明显的年龄和性别差异。在总体人群、无论年龄的男性以及年轻女性而非老年女性中，发现非勺型模式的可重复性率低于勺型模式。
结论
这些发现表明，夜间血压模式在整个研究人群以及不同年龄和性别亚组中的短期可重复性有限。由于夜间血压模式的变异性无法通过诸如性别和年龄等易于获取的临床数据来预测，因此应通过重复动态血压监测来获得根据昼夜血压模式对患者进行的可靠分类。
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