Cardiology Division, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
J Hum Hypertens. 2013 May;27(5):328-34. doi: 10.1038/jhh.2012.39. Epub 2012 Sep 13.
The objective of this study was to use a nationwide epidemiological survey to investigate the factors that affect within-visit blood pressure (BP) variability. We analyzed the Korean National Health and Nutrition Examination Survey (KNHNES) data for 2005 (n=5488). We examined three within-visit BP variability parameters that include the following: the alarm reaction (AR), defined as the first BP reading minus the third BP reading; the BP discrepancy, defined as the maximal BP reading minus the minimal BP reading (ΔBPmax); and the s.d. (BPSD). Age, fasting glucose, eGFR, total cholesterol, LDL cholesterol, and the metabolic syndrome (MetS) score were the relevant factors that affected the systolic AR, ΔSBPmax and SBPSD. Multiple linear regression models revealed that age (P<0.0001), the office systolic BP (SBP) level (P<0.0001), the MetS score (P<0.0001), the female gender (P=0.007) and the eGFR (P=0.049) were independently associated with the systolic AR, whereas age (P<0.0001), the office SBP level (P<0.0001), and the female gender (P=0.024 and 0.022) were independently associated with ΔSBPmax and SBPSD, respectively. Within-visit BP variability, especially the variability associated with the SBP, was significantly associated with increased age, female gender and cardiovascular risk factors, such as hypertension, low eGFR and adverse glucose and lipid profiles. In addition, increased age, female gender, the eGFR and the MetS score were independently relevant factors that affected the systolic AR. Systolic within-visit BP variability and systolic AR are associated with cardiovascular risk factors.
本研究旨在通过全国性的流行病学调查,研究影响就诊内血压(BP)变异性的因素。我们分析了 2005 年韩国国家健康和营养检查调查(KNHNES)的数据(n=5488)。我们检查了三个就诊内 BP 变异性参数,包括以下内容:警报反应(AR),定义为第一次血压读数减去第三次血压读数;BP 差值,定义为最大 BP 读数减去最小 BP 读数(ΔBPmax);和标准差(BPSD)。年龄、空腹血糖、肾小球滤过率(eGFR)、总胆固醇、低密度脂蛋白胆固醇和代谢综合征(MetS)评分是影响收缩压 AR、ΔSBPmax 和 SBPSD 的相关因素。多元线性回归模型显示,年龄(P<0.0001)、诊室收缩压(SBP)水平(P<0.0001)、MetS 评分(P<0.0001)、女性性别(P=0.007)和 eGFR(P=0.049)与收缩压 AR 独立相关,而年龄(P<0.0001)、诊室 SBP 水平(P<0.0001)和女性性别(P=0.024 和 0.022)与ΔSBPmax 和 SBPSD 分别独立相关。就诊内 BP 变异性,特别是与 SBP 相关的变异性,与年龄增加、女性性别以及心血管危险因素(如高血压、低 eGFR 和不良血糖和血脂谱)显著相关。此外,年龄增加、女性性别、eGFR 和 MetS 评分是独立相关的影响收缩压 AR 的因素。收缩压就诊内 BP 变异性和收缩压 AR 与心血管危险因素相关。