白大衣高血压中的亚临床器官损害：胱抑素C的潜在作用。
Subclinical Organ Damage in White-Coat Hypertension: The Possible Role of Cystatin C.
作者信息
Androulakis Emmanuel, Papageorgiou Nikolaos, Lioudaki Eirini, Chatzistamatiou Evaggelos, Zacharia Effimia, Kallikazaros Ioannis, Tousoulis Dimitris
机构信息
Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK.
Barts Heart Centre, St Bartholomew's Hospital, London, UK.
出版信息
J Clin Hypertens (Greenwich). 2017 Feb;19(2):190-197. doi: 10.1111/jch.12882. Epub 2016 Jul 21.
The authors investigated the relationship of white-coat hypertension (WCH) with subclinical organ damage and potential relevant mechanisms. A total of 386 untreated patients were enrolled and divided into 204 patients with WCH and 183 with normotension. Flow-mediated dilation (FMD), pulse wave velocity (PWV), intima-media thickness, left ventricular mass index (LVMI), and cystatin C levels were measured. All tests were two-sided, and a P value <.05 was considered statistically significant. The WCH group exhibited higher LVMI and PWV values, decreased E/A ratio and FMD values, and increased prevalence for left ventricular hypertrophy compared with controls (P<.001 for all). Cystatin C was significantly higher in the WCH group compared with controls (P=.035) and was positively associated with LVMI (P<.05 for both). The presence of WCH is associated with more pronounced subclinical organ damage compared with normotension. Cystatin C may play a significant role and therefore warrants further investigation.
作者研究了白大衣高血压（WCH）与亚临床器官损害及潜在相关机制之间的关系。共纳入386例未经治疗的患者，分为204例白大衣高血压患者和183例血压正常者。测量了血流介导的血管舒张功能（FMD）、脉搏波速度（PWV）、内膜中层厚度、左心室质量指数（LVMI）和胱抑素C水平。所有检验均为双侧检验，P值<0.05被认为具有统计学意义。与对照组相比，白大衣高血压组的LVMI和PWV值更高，E/A比值和FMD值降低，左心室肥厚的患病率增加（所有P值均<0.001）。与对照组相比，白大衣高血压组的胱抑素C显著更高（P = 0.035），且与LVMI呈正相关（两者P值均<0.05）。与血压正常相比，白大衣高血压的存在与更明显的亚临床器官损害相关。胱抑素C可能起重要作用，因此值得进一步研究。
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