隐匿性高血压患者的代谢危险因素和靶器官损害是否比白大衣高血压患者更常见？
Are metabolic risk factors and target organ damage more frequent in masked hypertension than in white coat hypertension?
机构信息
Chonnam National University Hospital, Gwangju, Korea.
出版信息
Clin Exp Hypertens. 2010;32(7):480-5. doi: 10.3109/10641963.2010.496517.
Patients with masked hypertension (MH) tend to have a higher risk than those with white-coat hypertension (WCH). Therefore, we evaluated the characteristics of MH and WCH in Korean patients receiving medical treatment for hypertension. We enrolled 1019 outpatients (56 ± 10 y, 488 males) with diagnosed hypertension who had not changed oral anti-hypertensive medication for 6 months. Clinic blood pressure (CBP) was checked by a nurse and doctor twice per visit. Home BP (HBP) was checked every morning and evening for 1 week. In the MH patients, mean CBP was 130/80 mmHg, whereas HBP was 137/86 mmHg. In the WCH patients, mean CBP was 149/86 mmHg by physician and 143/85 mmHg by nurse and mean HBP was 124/75 mmHg. Age and gender did not differ between the groups. Waist and hip circumferences and the level of fasting glucose were higher in patients with MH than in patients with WCH (p = 0.008, 0.016, 0.009, respectively). Metabolic risk factors were more frequent in patients with WCH, MH, and uncontrolled hypertension than in patients with controlled hypertension. The incidence of metabolic risk factors, however, did not differ between patients with WCH and MH. Heart damage was more frequent in MH than in WCH (p = 0.03). The incidence of metabolic risk factors did not differ between patients with WCH and those with MH. Target organ damage was more closely related to MH than to WCH. Home BP measurement was a useful tool for discriminating WCH and MH in patients with hypertension.
患有“ masked hypertension（隐蔽性高血压）”的患者比“white-coat hypertension（白大衣性高血压）”患者的风险更高。因此，我们评估了在接受高血压治疗的韩国患者中，“masked hypertension（隐蔽性高血压）”和“white-coat hypertension（白大衣性高血压）”的特征。我们纳入了 1019 名未改变口服抗高血压药物治疗 6 个月的门诊高血压患者（56±10 岁，488 名男性）。每次就诊时由护士和医生检查两次诊室血压（CBP）。家庭血压（HBP）每天早晚检查 1 周。在“masked hypertension（隐蔽性高血压）”患者中，平均 CBP 为 130/80mmHg，而 HBP 为 137/86mmHg。在“white-coat hypertension（白大衣性高血压）”患者中，医生测量的 CBP 平均值为 149/86mmHg，护士测量的 CBP 平均值为 143/85mmHg，HBP 平均值为 124/75mmHg。两组患者的年龄和性别无差异。与“white-coat hypertension（白大衣性高血压）”患者相比，“masked hypertension（隐蔽性高血压）”患者的腰围和臀围以及空腹血糖水平更高（p=0.008、0.016、0.009）。与“controlled hypertension（血压控制良好）”患者相比，“white-coat hypertension（白大衣性高血压）”、“masked hypertension（隐蔽性高血压）”和“uncontrolled hypertension（血压控制不良）”患者的代谢危险因素更常见。然而，“white-coat hypertension（白大衣性高血压）”和“masked hypertension（隐蔽性高血压）”患者之间的代谢危险因素发生率没有差异。与“white-coat hypertension（白大衣性高血压）”相比，“masked hypertension（隐蔽性高血压）”患者心脏损伤更常见（p=0.03）。“white-coat hypertension（白大衣性高血压）”和“masked hypertension（隐蔽性高血压）”患者的代谢危险因素发生率无差异。与“white-coat hypertension（白大衣性高血压）”相比，目标器官损伤与“masked hypertension（隐蔽性高血压）”更密切相关。家庭血压测量是区分高血压患者“white-coat hypertension（白大衣性高血压）”和“masked hypertension（隐蔽性高血压）”的有用工具。
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