Aparicio Lucas S, Barochiner Jessica, Cuffaro Paula E, Alfie José, Rada Marcelo A, Morales Margarita S, Galarza Carlos R, Marín Marcos J, Waisman Gabriel D
Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1181ACH Buenos Aires, Argentina.
Int J Hypertens. 2014;2014:569259. doi: 10.1155/2014/569259. Epub 2014 Dec 14.
Background. The morning home blood pressure (BP) rise is a significant asymptomatic target organ damage predictor in hypertensives. Our aim was to evaluate determinants of home-based morning-evening difference (MEdiff) in Argentine patients. Methods. Treated hypertensive patients aged ≥18 years participated in a cross-sectional study, after performing home morning and evening BP measurement. MEdiff was morning minus evening home average results. Variables identified as relevant predictors were entered into a multivariable linear regression analysis model. Results. Three hundred sixty-seven medicated hypertensives were included. Mean age was 66.2 (14.5), BMI 28.1 (4.5), total cholesterol 4.89 (1.0) mmol/L, 65.9% women, 11.7% smokers, and 10.6% diabetics. Mean MEdiff was 1.1 (12.5) mmHg systolic and 2.3 (6.1) mmHg diastolic, respectively. Mean self-recorded BP was 131.5 (14.1) mmHg systolic and 73.8 (7.6) mmHg diastolic, respectively. Mean morning and evening home BPs were 133.1 (16.5) versus 132 (15.7) systolic and 75.8 (8.4) versus 73.5 (8.2) diastolic, respectively. Significant beta-coefficient values were found in systolic MEdiff for age and smoking and in diastolic MEdiff for age, smoking, total cholesterol, and calcium-channel blockers. Conclusions. In a cohort of Argentine medicated patients, older age, smoking, total cholesterol, and use of calcium channel blockers were independent determinants of home-based MEdiff.
背景。早晨家庭血压升高是高血压患者无症状靶器官损害的重要预测指标。我们的目的是评估阿根廷患者家庭早晚血压差值（MEdiff）的决定因素。方法。年龄≥18岁的接受治疗的高血压患者在进行家庭早晚血压测量后参与一项横断面研究。MEdiff为早晨家庭平均血压结果减去晚上家庭平均血压结果。将确定为相关预测因素的变量纳入多变量线性回归分析模型。结果。纳入367例接受药物治疗的高血压患者。平均年龄为66.2（14.5）岁，体重指数为28.1（4.5），总胆固醇为4.89（1.0）mmol/L，女性占65.9%，吸烟者占11.7%，糖尿病患者占10.6%。收缩压平均MEdiff为1.1（12.5）mmHg，舒张压平均MEdiff为2.3（6.1）mmHg。平均自我记录血压收缩压为131.5（14.1）mmHg，舒张压为73.8（7.6）mmHg。早晨和晚上家庭血压平均收缩压分别为133.1（16.5）与132（15.7）mmHg，舒张压分别为75.8（8.4）与73.5（8.2）mmHg。在收缩压MEdiff方面，年龄和吸烟有显著的β系数值；在舒张压MEdiff方面，年龄、吸烟、总胆固醇和钙通道阻滞剂有显著的β系数值。结论。在一组阿根廷接受药物治疗的患者中，年龄较大、吸烟、总胆固醇和使用钙通道阻滞剂是家庭MEdiff的独立决定因素。
