Palatini Paolo, Reboldi Gianpaolo, Beilin Lawrence J, Casiglia Edoardo, Eguchi Kazuo, Imai Yutaka, Kario Kazuomi, Ohkubo Takayoshi, Pierdomenico Sante D, Schwartz Joseph E, Wing Lindon, Verdecchia Paolo
University of Padova, Padua, Italy.
University of Perugia, Perugia, Italy.
J Clin Hypertens (Greenwich). 2016 Feb;18(2):111-8. doi: 10.1111/jch.12700. Epub 2015 Oct 5.
The purpose of this study was to compare the predictive value of ambulatory blood pressure (BP) vs office BP for cardiovascular events during a 5.8-year follow-up period in the obese and nonobese participants of the Ambulatory Blood Pressure-International Study (n=10,817). Both ambulatory BP and office BP considered separately were predictive of cardiovascular events. However, in Cox models including both pressures, only ambulatory BP was associated with outcome. Among obese patients, the hazard ratios for a 10-mm Hg increase in 24-hour and office systolic BPs were 1.37 (95% confidence interval, 1.20-1.53) and 0.91 (95% confidence interval, 0.76-1.07), respectively. Among nonobese patients, the corresponding hazard ratios were 1.39 (95% confidence interval, 1.31-1.47) and 0.94 (95% confidence interval, 0.88-1.00) (P=not significant vs obese). Similar results were obtained for diastolic BP and for daytime and nighttime BPs. Ambulatory BP has similar predictive capacity in obese and nonobese patients, suggesting that ambulatory BP monitoring is a useful diagnostic tool for the assessment of obese individuals.
本研究的目的是在动态血压国际研究（n = 10817）的肥胖和非肥胖参与者中，比较动态血压（BP）与诊室血压对5.8年随访期内心血管事件的预测价值。单独考虑的动态血压和诊室血压均能预测心血管事件。然而，在包含这两种血压的Cox模型中，只有动态血压与结局相关。在肥胖患者中，24小时收缩压和诊室收缩压每升高10 mmHg的风险比分别为1.37（95%置信区间，1.20 - 1.53）和0.91（95%置信区间，0.76 - 1.07）。在非肥胖患者中，相应的风险比分别为1.39（95%置信区间，1.31 - 1.47）和0.94（95%置信区间，0.88 - 1.00）（与肥胖患者相比，P无显著性差异）。舒张压以及日间和夜间血压也得到了类似结果。动态血压在肥胖和非肥胖患者中具有相似的预测能力，这表明动态血压监测是评估肥胖个体的一种有用的诊断工具。
