Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Stroke. 2013 Jun;44(6):1512-7. doi: 10.1161/STROKEAHA.111.000704. Epub 2013 May 2.
On the basis of combined measurements of clinic blood pressure (CBP) and home blood pressure (HBP), blood pressure status can be divided into normotension, white-coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). Despite the clear impact of MHT and SHT on clinical and subclinical arterial disease, uncertainty about the influence of WCHT remains. The objective of this study was to investigate the associations of WCHT, MHT, and SHT with carotid atherosclerosis in a general population.
This is a cross-sectional survey of 2915 community-dwelling Japanese aged ≥ 40 years. Normotension was defined as CBP<140/90 and HBP<135/85 mm Hg; WCHT, CBP ≥ 140/90 and HBP<135/85 mm Hg; MHT, CBP<140/90 and HBP ≥ 135/85 mm Hg; and SHT, CBP ≥ 140/90 and HBP ≥ 135/85 mm Hg. Mean intima-media thickness of carotid arteries was measured using a computer-automated system, and carotid stenosis was defined as diameter stenosis ≥ 30%.
There were 1374 subjects (47.1%) with normotension, 200 (6.9%) with WCHT, 639 (21.9%) with MHT, and 702 (24.1%) with SHT. The geometric average of mean intima-media thickness was significantly higher among subjects with WCHT (0.73 mm), MHT (0.77 mm), and SHT (0.77 mm) than those with normotension (0.67 mm; all P<0.001 versus normotension). Compared with normotension, all types of hypertension were also associated with increased likelihood of carotid stenosis (age- and sex-adjusted odds ratio, 2.36 [95% confidence interval, 1.27-4.37] for WCHT, 1.95 [1.25-3.03] for MHT, and 3.02 [2.01-4.54] for SHT). These associations remained significant even after adjustment for other cardiovascular risk factors.
WCHT, as well as MHT, and SHT were associated with carotid atherosclerosis in a general Japanese population.
基于诊所血压（CBP）和家庭血压（HBP）的联合测量，血压状况可分为正常血压、白大衣高血压（WCHT）、隐蔽性高血压（MHT）和持续性高血压（SHT）。尽管 MHT 和 SHT 明显影响临床和亚临床动脉疾病，但 WCHT 的影响仍不确定。本研究的目的是在一般人群中研究 WCHT、MHT 和 SHT 与颈动脉粥样硬化的关系。
这是一项对 2915 名年龄≥40 岁的社区居民的横断面调查。正常血压定义为 CBP<140/90 和 HBP<135/85mmHg；WCHT，CBP≥140/90 和 HBP<135/85mmHg；MHT，CBP<140/90 和 HBP≥135/85mmHg；SHT，CBP≥140/90 和 HBP≥135/85mmHg。使用计算机自动系统测量颈动脉内膜中层厚度，颈动脉狭窄定义为直径狭窄≥30%。
1374 名受试者（47.1%）血压正常，200 名（6.9%）患有 WCHT，639 名（21.9%）患有 MHT，702 名（24.1%）患有 SHT。WCHT（0.73mm）、MHT（0.77mm）和 SHT（0.77mm）受试者的平均内膜中层厚度几何平均值明显高于血压正常受试者（0.67mm；所有 P<0.001 与正常血压相比）。与正常血压相比，所有类型的高血压也与颈动脉狭窄的可能性增加相关（年龄和性别调整后的优势比，WCHT 为 2.36（95%置信区间，1.27-4.37），MHT 为 1.95（1.25-3.03），SHT 为 3.02（2.01-4.54））。即使在调整其他心血管危险因素后，这些关联仍然显著。
WCHT 以及 MHT 和 SHT 与日本一般人群的颈动脉粥样硬化有关。
