Lindroos Annika S, Johansson Jouni K, Puukka Pauli J, Kantola Ilkka, Salomaa Veikko, Juhanoja Eeva P, Sivén Sam S E, Jousilahti Pekka, Jula Antti M, Niiranen Teemu J
aDivision of Medicine, Turku University Hospital bDepartment of Health, National Institute for Health and Welfare, Turku cDepartment of Health, National Institute for Health and Welfare, Helsinki dDepartment of Medicine, University of Turku, Turku, Finland eThe Framingham Heart Study, Framingham, Massachusetts, USA.
J Hypertens. 2016 Sep;34(9):1730-7. doi: 10.1097/HJH.0000000000000995.
The aim of this study was to test the agreement between night-time home and night-time ambulatory blood pressure (BP) and to compare their associations with hypertensive end-organ damage for the first time in the general population.
A population sample of 248 participants underwent measurements for night-time home BP (three measurements on two nights with a timer-equipped home device), night-time ambulatory BP, pulse wave velocity (PWV), carotid intima-media thickness (IMT) and echocardiographic left ventricular mass index (LVMI).
No significant or systematic differences were observed between mean night-time ambulatory and home BPs (systolic/diastolic difference: 0.7 ± 7.6/0.2 ± 6.0 mmHg, P = 0.16/0.64). All night-time home and ambulatory BPs were positively correlated with PWV, IMT and LVMI (P < 0.01 for all). No significant differences in Pearson's correlations between end-organ damage and night-time home or ambulatory BP were observed (P ≥ 0.11 for all comparisons using Dunn and Clark's Z), except for a slightly stronger correlation between PWV and ambulatory SBP than for home SBP (r = 0.57 vs. 0.50, P = 0.03). The adjusted R of all multivariable-adjusted models for PWV, IMT or LVMI that included night-time home or ambulatory SBP/DBP were within 2/1%.
Our study demonstrates that night-time home and ambulatory measurements produce similar BP values that have comparable associations with end-organ damage in the general population even when a clinically feasible measurement protocol is used for measuring night-time home BP. In the future, night-time home BP measurement may offer a feasible and easily accessible alternative to ambulatory monitoring for the measurement of night-time BP.
本研究旨在测试夜间家庭血压与夜间动态血压之间的一致性,并首次在普通人群中比较它们与高血压靶器官损害的相关性。
对248名参与者的人群样本进行了夜间家庭血压测量(使用配备定时器的家用设备在两个晚上进行三次测量)、夜间动态血压、脉搏波速度(PWV)、颈动脉内膜中层厚度(IMT)和超声心动图左心室质量指数(LVMI)的测量。
夜间动态血压平均值与家庭血压平均值之间未观察到显著或系统性差异(收缩压/舒张压差值:0.7±7.6/0.2±6.0 mmHg,P = 0.16/0.64)。所有夜间家庭血压和动态血压均与PWV、IMT和LVMI呈正相关(所有P<0.01)。在靶器官损害与夜间家庭血压或动态血压之间的Pearson相关性方面,未观察到显著差异(使用Dunn和Clark's Z进行的所有比较中P≥0.11),除了PWV与动态收缩压之间的相关性略强于家庭收缩压(r = 0.57对0.50,P = 0.03)。纳入夜间家庭或动态收缩压/舒张压的所有PWV、IMT或LVMI多变量调整模型的调整R在2/1%以内。
我们的研究表明,即使使用临床可行的测量方案来测量夜间家庭血压,夜间家庭测量和动态测量产生的血压值相似,并在普通人群中与靶器官损害具有可比的相关性。未来,夜间家庭血压测量可能为夜间血压测量提供一种可行且易于获得的动态监测替代方法。