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隐匿性高血压和白大衣高血压的流行病学:基于家庭的SKIPOGH研究

Epidemiology of masked and white-coat hypertension: the family-based SKIPOGH study.

作者信息

Alwan Heba, Pruijm Menno, Ponte Belen, Ackermann Daniel, Guessous Idris, Ehret Georg, Staessen Jan A, Asayama Kei, Vuistiner Philippe, Younes Sandrine Estoppey, Paccaud Fred, Wuerzner Grégoire, Pechere-Bertschi Antoinette, Mohaupt Markus, Vogt Bruno, Martin Pierre-Yves, Burnier Michel, Bochud Murielle

机构信息

Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland.

Service of Nephrology, University Hospital of Lausanne, Lausanne, Switzerland.

出版信息

PLoS One. 2014 Mar 24;9(3):e92522. doi: 10.1371/journal.pone.0092522. eCollection 2014.

Abstract

OBJECTIVE

We investigated factors associated with masked and white-coat hypertension in a Swiss population-based sample.

METHODS

The Swiss Kidney Project on Genes in Hypertension is a family-based cross-sectional study. Office and 24-hour ambulatory blood pressure were measured using validated devices. Masked hypertension was defined as office blood pressure<140/90 mmHg and daytime ambulatory blood pressure≥135/85 mmHg. White-coat hypertension was defined as office blood pressure≥140/90 mmHg and daytime ambulatory blood pressure<135/85 mmHg. Mixed-effect logistic regression was used to examine the relationship of masked and white-coat hypertension with associated factors, while taking familial correlations into account. High-normal office blood pressure was defined as systolic/diastolic blood pressure within the 130-139/85-89 mmHg range.

RESULTS

Among the 652 participants included in this analysis, 51% were female. Mean age (±SD) was 48 (±18) years. The proportion of participants with masked and white coat hypertension was respectively 15.8% and 2.6%. Masked hypertension was associated with age (odds ratio (OR) = 1.02, p = 0.012), high-normal office blood pressure (OR = 6.68, p<0.001), and obesity (OR = 3.63, p = 0.001). White-coat hypertension was significantly associated with age (OR = 1.07, p<0.001) but not with education, family history of hypertension, or physical activity.

CONCLUSIONS

Our findings suggest that physicians should consider ambulatory blood pressure monitoring for older individuals with high-normal office blood pressure and/or who are obese.

摘要

目的

我们在一个基于瑞士人群的样本中研究了与隐蔽性高血压和白大衣高血压相关的因素。

方法

瑞士高血压基因肾脏项目是一项基于家庭的横断面研究。使用经过验证的设备测量诊室血压和24小时动态血压。隐蔽性高血压定义为诊室血压<140/90 mmHg且日间动态血压≥135/85 mmHg。白大衣高血压定义为诊室血压≥140/90 mmHg且日间动态血压<135/85 mmHg。采用混合效应逻辑回归来检验隐蔽性高血压和白大衣高血压与相关因素之间的关系,同时考虑家族相关性。血压正常高值定义为收缩压/舒张压在130 - 139/85 - 89 mmHg范围内。

结果

在纳入本次分析的652名参与者中,51%为女性。平均年龄(±标准差)为48(±18)岁。隐蔽性高血压和白大衣高血压参与者的比例分别为15.8%和2.6%。隐蔽性高血压与年龄(优势比(OR)=1.02,p = 0.012)、血压正常高值(OR = 6.68,p<0.001)和肥胖(OR = 3.63,p = 0.001)相关。白大衣高血压与年龄显著相关(OR = 1.07,p<0.001),但与教育程度、高血压家族史或体育活动无关。

结论

我们的研究结果表明,医生应对诊室血压正常高值和/或肥胖的老年人考虑进行动态血压监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb4d/3963885/4bf68e3e0111/pone.0092522.g001.jpg

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