Freitas Dayana, Toneti Adrielle Naiara, Cesarino Evandro José, Desidério Vagner Luis, Pacca Sérgio de Figueiredo, Godoy Simone de, Mendes Isabel Amélia Costa, Marchi-Alves Leila Maria
University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil.
University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil.
J Vasc Nurs. 2014 Jun;32(2):38-45. doi: 10.1016/j.jvn.2013.09.002.
The aim in this study was to identify the cardiovascular risk in patients suffering from white coat hypertension (WCH) by determining the ankle brachial index (ABI) with an automatic oscillometric sphygmomanometer. The study was undertaken in a Brazilian city between August 2010 and June 2011. The study variables were age, ethnic origin, marital status, education level, profession, weight, height, waist circumference, arm and ankle blood pressure (BP), and ABI. Analysis of variance was used for repeated measures and Tukey's test for multiple comparisons of means. The linear relationship between systolic BP levels and ankle brachial indices was verified using Pearson's correlation coefficient. Results were expressed as mean values ± standard errors of means, and differences were considered statistically significant when P < .05. Study participants were 135 subjects, including 37% normotensive, 37% hypertensive (HT), and 26% WCH patients. WCH individuals revealed intermediate risk in the analysis of the clinical variables. Alterations compatible with peripheral obstructive arterial disease and arterial calcification were observed only in the HT and WCH groups. These findings lead to the premise that WCH should not be viewed as a benign condition. The measurement of the ABI should be considered in the clinical approach of patients and professionals should use it as an instrument for cardiovascular risk assessment in routine health care delivery.
本研究的目的是通过使用自动示波血压计测定踝臂指数（ABI），来确定白大衣高血压（WCH）患者的心血管风险。该研究于2010年8月至2011年6月在巴西一座城市进行。研究变量包括年龄、种族、婚姻状况、教育水平、职业、体重、身高、腰围、手臂和脚踝血压（BP）以及ABI。采用方差分析进行重复测量，并使用Tukey检验进行均值的多重比较。使用Pearson相关系数验证收缩压水平与踝臂指数之间的线性关系。结果以均值±均值标准误差表示，当P <.05时，差异被认为具有统计学意义。研究参与者为135名受试者，包括37%的血压正常者、37%的高血压患者（HT）和26%的WCH患者。在临床变量分析中，WCH个体显示出中等风险。仅在HT组和WCH组中观察到与外周阻塞性动脉疾病和动脉钙化相符的改变。这些发现得出这样一个前提，即不应将WCH视为一种良性病症。在患者的临床诊疗过程中应考虑测量ABI，并且专业人员应将其用作常规医疗保健中心血管风险评估的工具。
