Saeed Sahrai, Waje-Andreassen Ulrike, Fromm Annette, Øygarden Halvor, Naess Halvor, Gerdts Eva
Departments of aHeart Disease bNeurology, Haukeland University Hospital Departments of cClinical Science dClinical Medicine, University of Bergen, Bergen, Norway.
Blood Press Monit. 2016 Aug;21(4):244-50. doi: 10.1097/MBP.0000000000000190.
Masked hypertension (MHT) is characterized by normal clinic blood pressure (BP), but elevated ambulatory BP has been associated with a higher prevalence of cardiovascular organ damage.
We assessed the prevalence and characteristics of MHT in 298 ischemic stroke patients aged 15-60 years. High-normal office BP was considered present if systolic BP was 130-139 mmHg and/or diastolic BP was 85-89 mmHg. Arterial damage was defined as increased pulse wave velocity measured by applanation tonometry and/or mean common carotid intima-media thickness more than 0.9 mm measured by ultrasound.
MHT was found in 12% of patients. In multivariable logistic regression analysis, MHT patients were characterized by higher BMI [odds ratio (OR) 1.09; 95% confidence interval (CI) 1.03-1.16], high-normal office BP (OR 2.30; 95% CI 1.26-4.21), and higher serum triglycerides (OR 1.32; 95% CI 1.01-1.47, all P<0.05) in the total study population. Compared with normotensive patients, MHT was characterized by a higher prevalence of high-normal office BP (OR 2.05; 95% CI 1.08-3.90), obesity (OR 2.67; 95% CI 1.31-5.47), and arterial damage (OR 2.87; 95% CI 1.46-5.66, all P<0.05). Compared with patients with sustained hypertension, MHT was associated with a lower prevalence of arterial damage (OR 0.48; 95% CI 0.23-0.99, P=0.05) despite a higher prevalence of high-normal office BP and comparable ambulatory BP values.
Among young and middle-aged ischemic stroke patients, MHT was found in 12% and associated with high-normal office BP, obesity, and more prevalent arterial damage compared with normotensive patients, underscoring the importance of identification of MHT in these patients.
隐匿性高血压（MHT）的特征为诊所血压（BP）正常，但动态血压升高与心血管器官损害的较高患病率相关。
我们评估了298例年龄在15至60岁的缺血性中风患者中MHT的患病率和特征。如果收缩压为130 - 139 mmHg和/或舒张压为85 - 89 mmHg，则认为存在高正常诊室血压。动脉损伤定义为通过压平式眼压测量法测得的脉搏波速度增加和/或通过超声测得的颈总动脉平均内膜中层厚度超过0.9 mm。
12%的患者存在MHT。在多变量逻辑回归分析中，在整个研究人群中，MHT患者的特征为较高的体重指数[比值比（OR）1.09；95%置信区间（CI）1.03 - 1.16]、高正常诊室血压（OR 2.30；95% CI 1.26 - 4.21）和较高的血清甘油三酯（OR 1.32；95% CI 1.01 - 1.47，所有P<0.05）。与血压正常的患者相比，MHT的特征为高正常诊室血压的患病率较高（OR 2.05；95% CI 1.08 - 3.90）、肥胖（OR 2.67；95% CI 1.31 - 5.47）和动脉损伤（OR 2.87；95% CI 1.46 - 5.66，所有P<0.05）。与持续性高血压患者相比，尽管MHT患者高正常诊室血压的患病率较高且动态血压值相当，但MHT与动脉损伤的患病率较低相关（OR 0.48；95% CI 0.23 - 0.99，P = 0.05）。
在中青年缺血性中风患者中，12%的患者存在MHT，与血压正常的患者相比，MHT与高正常诊室血压、肥胖和更普遍的动脉损伤相关，突出了在这些患者中识别MHT的重要性。
