de la Sierra Alejandro, Vinyoles Ernest, Banegas José R, Parati Gianfranco, de la Cruz Juan J, Gorostidi Manuel, Segura Julián, Ruilope Luis M
Department of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona, Barcelona, Spain.
CAP la Mina, University of Barcelona, Barcelona, Spain.
J Clin Hypertens (Greenwich). 2016 Sep;18(9):927-33. doi: 10.1111/jch.12792. Epub 2016 Feb 18.
The authors aimed to assess the reproducibility of normotension and white-coat, masked, and sustained hypertension in 839 untreated patients who underwent two separate assessments (median, 3; interquartile range, 0-13 months) by both office and ambulatory blood pressure (BP) monitoring (ABPM). The proportion of patients falling into the same category in the two assessments was: 52% normotension and 55% white-coat, 47% masked, and 82% sustained hypertension. The most frequent switch was to sustained hypertension (26% of white-coat and 33% of masked hypertension). No clinical factors predicted the change in category, except for higher office diastolic BP in patients with masked hypertension who developed sustained hypertension, compared with those who remained with masked hypertension (84±4 mm Hg vs 80±5 mm Hg; P=.006). The reproducibility of hypertension phenotypes was highly dependent on the time between assessments. The authors conclude that white-coat and masked hypertension phenotypes are only reproducible in the short-term, while they frequently shift towards sustained hypertension in the long-term.
作者旨在评估839例未经治疗的患者中正常血压、白大衣高血压、隐匿性高血压和持续性高血压的再现性，这些患者通过诊室血压和动态血压监测（ABPM）接受了两次独立评估（中位数为3个月；四分位间距为0 - 13个月）。在两次评估中处于同一类别的患者比例分别为：正常血压52%、白大衣高血压55%、隐匿性高血压47%、持续性高血压82%。最常见的转变是转变为持续性高血压（白大衣高血压患者中有26%，隐匿性高血压患者中有33%）。除了与仍为隐匿性高血压的患者相比，发展为持续性高血压的隐匿性高血压患者的诊室舒张压更高（84±4 mmHg对80±5 mmHg；P = 0.006）外，没有临床因素能够预测类别变化。高血压表型的再现性高度依赖于两次评估之间的时间。作者得出结论，白大衣高血压和隐匿性高血压表型仅在短期内具有再现性，而长期来看它们经常转变为持续性高血压。
