Norton Gavin R, Maseko Muzi, Libhaber Elena, Libhaber Carlos D, Majane Olebogeng H I, Dessein Patrick, Sareli Pinhas, Woodiwiss Angela J
Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.
J Hypertens. 2008 Dec;26(12):2279-87. doi: 10.1097/HJH.0b013e328311f296.
We sought to determine whether prehypertension (BP = 120-139/80-89 mmHg) is associated with target organ changes independent of confounders.
In 771 participants from a population sample of African ancestry, approximately 46% of whom had hypertension, and approximately 30% prehypertension, organ damage was assessed from echocardiography (left ventricular mass indexed to height2.7, the mean of posterior and septal wall thickness and early-to-late transmitral velocity), 24-h urine samples (urinary albumin-to-creatinine ratio), serum creatinine concentrations, and carotid-femoral pulse wave velocity. Ambulatory blood pressure values that met with prespecified quality control criteria were available in 539 participants.
A greater proportion of hypertensives (P < 0.0001) but not prehypertensives had elevated 24-h blood pressure values as compared with participants with optimal blood pressure values. Before adjustment for confounders, hypertension was associated with all target organ changes (P < 0.0001), and after adjustment, an independent association was noted between hypertension and all target organ changes (P < 0.05-0.005) except albumin-to-creatinine ratio or serum creatinine concentrations. Before adjustment, prehypertension was associated with left ventricular mass indexed to height2.7, mean wall thickness, pulse wave velocity, and early-to-late transmitral velocity (P < 0.05-0.001), but not with other target organ changes. After adjustment, however, prehypertension was not independently associated with target organ changes. Other factors independently associated with target organ changes were age (all target organs), waist circumference (left ventricular mass indexed to height2.7 and early-to-late transmitral velocity) and diabetes mellitus (albumin-to-creatinine ratio and pulse wave velocity). Interactions between prehypertension and any of the alternative risk factors were not independent predictors of target organ changes.
Although associated with it, prehypertension is not an independent predictor of organ damage in young-to-middle-aged persons of African ancestry.
我们试图确定高血压前期（血压=120 - 139/80 - 89 mmHg）是否与独立于混杂因素的靶器官改变相关。
在771名非洲裔人群样本参与者中，约46%患有高血压，约30%为高血压前期，通过超声心动图（左心室质量指数与身高2.7的比值、后壁和室间隔厚度均值以及二尖瓣舒张早期与晚期流速比值）、24小时尿液样本（尿白蛋白与肌酐比值）、血清肌酐浓度和颈股脉搏波速度评估器官损害。539名参与者可获得符合预先设定质量控制标准的动态血压值。
与血压最佳值的参与者相比，高血压患者中24小时血压值升高的比例更高（P < 0.0001），但高血压前期患者并非如此。在调整混杂因素之前，高血压与所有靶器官改变相关（P < 0.0001），调整后，除白蛋白与肌酐比值或血清肌酐浓度外，高血压与所有靶器官改变之间存在独立关联（P < 0.05 - 0.005）。调整前，高血压前期与左心室质量指数与身高2.7的比值、平均壁厚度、脉搏波速度和二尖瓣舒张早期与晚期流速比值相关（P < 0.05 - 0.001），但与其他靶器官改变无关。然而，调整后，高血压前期与靶器官改变无独立关联。与靶器官改变独立相关的其他因素包括年龄（所有靶器官）、腰围（左心室质量指数与身高2.7的比值和二尖瓣舒张早期与晚期流速比值）和糖尿病（白蛋白与肌酐比值和脉搏波速度）。高血压前期与任何其他危险因素之间的相互作用并非靶器官改变的独立预测因素。
尽管高血压前期与之相关，但在非洲裔中青年人群中，高血压前期并非器官损害的独立预测因素。
