Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Am J Hypertens. 2013 Jun;26(6):808-15. doi: 10.1093/ajh/hpt021. Epub 2013 Feb 27.
In a prior study of patients with diabetes, diastolic function was similarly impaired in masked hypertension (MHT) and sustained hypertension (SHT). We evaluated whether MHT is associated with impaired diastolic function compared with SHT and sustained normotension (NT) in the general population.
From February 2005 to December 2010, 798 participants without a history of cardiovascular disease or treated hypertension, were enrolled in the Masked Hypertension Study. Participants underwent clinic blood pressure (CBP) and 24-hour ambulatory blood pressure (ABP) measurements. A 2-dimensional Doppler echocardiogram was performed to evaluate diastolic function,s cardiac structure, volume, and systolic function. The 9 CBPs obtained across 3 clinic visits and awake ABP measurements were averaged. Clinic hypertension was defined as systolic/diastolic blood pressure (SBP/DBP) ≥ 140/90 mmHg. Ambulatory hypertension was defined as awake SBP/DBP ≥ 135/85mm Hg. MHT was defined as having ambulatory but not clinic hypertension. White-coat hypertensives (n = 8) were excluded from the analysis.
Of the 790 participants, 116 (14.7%) participants had MHT, 37 (4.7%) participants had SHT, and 637 (80.6%) participants had NT. After age, sex, race/ethnicity, and body mass index adjustment, compared with NT, E'-velocities were significantly lower in MHT (P < 0.01) and SHT (P < 0.05), and E/E' ratios were significantly higher MHT (P < 0.05) and SHT (P < 0.05). These associations were independent of left ventricular mass. Diastolic function parameters did not significantly differ between MHT and SHT.
Diastolic function was impaired in MHT compared with NT independent of changes in left ventricular mass.
在一项针对糖尿病患者的研究中，隐匿性高血压（MHT）和持续性高血压（SHT）同样存在舒张功能障碍。我们评估了在一般人群中，与持续性正常血压（NT）相比，MHT 是否与舒张功能障碍相关。
从 2005 年 2 月至 2010 年 12 月，共有 798 名无心血管疾病或高血压病史的参与者参加了隐匿性高血压研究。参与者接受了诊所血压（CBP）和 24 小时动态血压（ABP）测量。进行二维多普勒超声心动图评估舒张功能、心脏结构、容积和收缩功能。在 3 次诊所就诊期间获得的 9 次 CBP 和清醒时 ABP 测量值的平均值。诊所高血压定义为收缩压/舒张压（SBP/DBP）≥140/90mmHg。动态高血压定义为清醒时 SBP/DBP≥135/85mmHg。MHT 定义为存在动态但无诊所高血压。（n=8）白大衣高血压患者被排除在分析之外。
在 790 名参与者中，116 名（14.7%）参与者患有 MHT，37 名（4.7%）参与者患有 SHT，637 名（80.6%）参与者患有 NT。在校正年龄、性别、种族/民族和体重指数后，与 NT 相比，MHT（P＜0.01）和 SHT（P＜0.05）的 E'速度明显较低，而 MHT（P＜0.05）和 SHT（P＜0.05）的 E/E'比值明显较高。这些关联独立于左心室质量。MHT 和 SHT 之间舒张功能参数无显著差异。
与 NT 相比，MHT 存在舒张功能障碍，与左心室质量变化无关。
