Polónia Jorge, Madede Tavares, Silva José A, Mesquita-Bastos José, Damasceno Albertino
aDepartment of Medicine and Cintesis, Faculty of Medicine, Porto University, Porto bHypertension Unit, Hospital Pedro Hispano EPE, ULS Matosinhos cDepartment of Cardiology, Hospital Infante D Pedro, EPE, Health School, Aveiro University, Aveiro, Portugal dDepartment of Cardiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
Blood Press Monit. 2014 Aug;19(4):192-8. doi: 10.1097/MBP.0000000000000046.
The aim of this study was to compare the 24-h ambulatory blood pressure (ABP) profile in never-treated black hypertensive patients living in Africa, Mozambique (20-80 years), versus never-treated white hypertensive patients living in Europe.
ABP recordings of untreated black hypertensive patients and white hypertensive patients with 24-h ABP of 130/80 mmHg or more were retrospectively selected from two computerized database records of ABP and matched for age by decades, sex, and BMI.
Black hypertensive patients were n=548, 47 ± 12 years, 52% women, BMI=28.0 ± 8.2 kg/m(2), 7% smokers, 7% diabetics; white hypertensive patients were n=604, 47 ± 15 years, 52% women, BMI=27.4 ± 5.1 kg/m(2), 8.4% diabetics, and 18% smokers (P<0.02). Black hypertensive patients versus white hypertensive patients showed higher casual blood pressure (BP) 160/104 ± 19/14 versus 149/97 ± 18/12 mmHg, 24-h ABP 146/92 ± 16/13 versus 139/85 ± 11/10 mmHg, daytime ABP 150/95 ± 16/13 versus 143/88 ± 13/11 mmHg, night-time BP 139/84 ± 17/13 versus 130/78 ± 13/10 mmHg (all P<0.001) and lower night-time BP fall 8.3 ± 6.9 versus 10.1 ± 8.7% (P<0.02) and higher BP variability. Differences were still significant in all decades above 30 years of age and when calculations were carried out separately for both men and women. The average 24-h heart rate did not differ between groups.
Our data suggest that untreated black hypertensive patients systematically present higher clinic and ABP values and a lower night-time BP fall than untreated white hypertensive patients for all spectra of age distribution. This might be the reason for the worse cardiovascular prognosis described in black hypertensive patients compared with white hypertensive patients.
本研究旨在比较居住在非洲莫桑比克（20 - 80岁）未经治疗的黑人高血压患者与居住在欧洲未经治疗的白人高血压患者的24小时动态血压（ABP）情况。
从两个ABP计算机化数据库记录中回顾性选取未经治疗的黑人高血压患者和24小时ABP为130/80 mmHg或更高的白人高血压患者，并按年龄段、性别和BMI进行年龄匹配。
黑人高血压患者n = 548，年龄47 ± 12岁，女性占52%，BMI = 28.0 ± 8.2 kg/m²，吸烟者占7%，糖尿病患者占7%；白人高血压患者n = 604，年龄47 ± 15岁，女性占52%，BMI = 27.4 ± 5.1 kg/m²，糖尿病患者占8.4%，吸烟者占18%（P < 0.02）。黑人高血压患者与白人高血压患者相比，偶测血压（BP）更高，分别为160/104 ± 19/14 mmHg和149/97 ± 18/12 mmHg；24小时ABP分别为146/92 ± 16/13 mmHg和139/85 ± 11/10 mmHg；日间ABP分别为150/95 ± 16/13 mmHg和143/88 ± 13/11 mmHg；夜间血压分别为13 /84 ± 17/13 mmHg 和130/78 ± 13/10 mmHg（所有P < 0.001），夜间血压下降幅度更低，分别为8.3 ± 6.9%和10.1 ± 8.7%（P < 0.02），且血压变异性更高。在30岁以上的所有年龄段以及分别对男性和女性进行计算时，差异仍然显著。两组间的平均24小时心率无差异。
我们的数据表明，在所有年龄分布范围内，未经治疗的黑人高血压患者系统性地呈现出比未经治疗的白人高血压患者更高的诊室血压和ABP值以及更低的夜间血压下降幅度。这可能是黑人高血压患者与白人高血压患者相比心血管预后更差的原因。
