全球高血压诊所转诊的14143例患者中根据诊所血压和动态血压定义的高血压类型。来自ARTEMIS研究的数据。
Hypertension types defined by clinic and ambulatory blood pressure in 14 143 patients referred to hypertension clinics worldwide. Data from the ARTEMIS study.
作者信息
Omboni Stefano, Aristizabal Dagnovar, De la Sierra Alejandro, Dolan Eamon, Head Geoffrey, Kahan Thomas, Kantola Ilkka, Kario Kazuomi, Kawecka-Jaszcz Kalina, Malan Leoné, Narkiewicz Krzysztof, Octavio José A, Ohkubo Takayoshi, Palatini Paolo, Siègelovà Jarmila, Silva Eglé, Stergiou George, Zhang Yuqing, Mancia Giuseppe, Parati Gianfranco
机构信息
aItalian Institute of Telemedicine, Varese, Italy bSicor Clinical and Research Center, Medellín, Colombia cDepartment of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona, Barcelona, Spain dConnolly Hospital, Dublin, Ireland eBaker IDI Heart and Diabetes Institute, Melbourne, Australia fDepartment of Cardiology, Danderyd University Hospital, Stockholm, Sweden gTurku University Hospital, Turku, Finland hDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan iDepartment of Cardiology, Interventional Elektrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland jHypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa kDepartment of Hypertension and Diabetology, Hypertension Unit, Medical University of Gdańsk, Gdańsk, Poland lExperimental Cardiology, Tropical Medicine Institute, Central University, Caracas, Venezuela mDepartment of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan nVascular Medicine, Department of Medicine, University of Padova, Padova, Italy oDepartment of Physiotherapy pDepartment of Sport Medicine and Rehabilitation, Medical Faculty, Masaryk University qSt. Anne's University Hospital in Brno, Brno, Czech Republic rInstituto de Investigacion y estudio de Enfermedades Cardiovasculares, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela sThird University Department of Medicine, Hypertension Center, Sotiria Hospital, Athens, Greece tDivisions of Hypertension and Biometrics, FuWai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, China uDepartment of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano vDepartment of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
出版信息
J Hypertens. 2016 Nov;34(11):2187-98. doi: 10.1097/HJH.0000000000001074.
OBJECTIVE
The Ambulatory blood pressure Registry TEleMonitoring of hypertension and cardiovascular rISk project was designed to set up an international registry including clinic blood pressure (CBP) and ambulatory blood pressure (ABP) measurements in patients attending hypertension clinics in all five continents, aiming to assess different daily life hypertension types.
METHODS
Cross-sectional ABP, CBP and demographic data, medical history and cardiovascular risk profile were provided from existing databases by hypertension clinics. Hypertension types were evaluated considering CBP (≥140/90 mmHg) and 24-h ABP (≥130/80 mmHg).
RESULTS
Overall, 14 143 patients from 27 countries across all five continents were analyzed (Europe 73%, Africa 3%, America 9%, Asia 14% and Australia 2%). Mean age was 57 ± 14 years, men 51%, treated for hypertension 46%, cardiovascular disease 14%, people with diabetes 14%, dyslipidemia 33% and smokers 19%. The prevalence of hypertension was higher by CBP than by ABP monitoring (72 vs. 60%, P < 0.0001). Sustained hypertension (elevated CBP and ABP) was detected in 49% of patients. White-coat hypertension (WCH, elevated CBP with normal ABP) was more common than masked hypertension (elevated ABP with normal CBP) (23 vs. 10%; P < 0.0001). Sustained hypertension was more common in Europe and America and in elderly, men, obese patients with cardiovascular comorbidities. WCH was less common in Australia, America and Africa, and more common in elderly, obese women. Masked hypertension was more common in Asia and in men with diabetes. Smoking was a determinant for sustained hypertension and masked hypertension.
CONCLUSION
Our analysis showed an unbalanced distribution of WCH and masked hypertension patterns among different continents, suggesting an interplay of genetic and environmental factors, and likely also different healthcare administrative and practice patterns.
目的
动态血压注册远程监测高血压与心血管风险项目旨在建立一个国际注册库，纳入来自五大洲高血压诊所患者的诊室血压（CBP）和动态血压（ABP）测量值，旨在评估不同的日常生活高血压类型。
方法
高血压诊所从现有数据库中提供横断面ABP、CBP以及人口统计学数据、病史和心血管风险概况。根据CBP（≥140/90 mmHg）和24小时ABP（≥130/80 mmHg）评估高血压类型。
结果
总体而言，对来自五大洲27个国家的14143例患者进行了分析（欧洲73%，非洲3%，美洲9%，亚洲14%，澳大利亚2%）。平均年龄为57±14岁，男性占51%，接受高血压治疗的占46%，患有心血管疾病的占14%，患有糖尿病的占14%，血脂异常的占33%，吸烟者占19%。通过CBP监测得出的高血压患病率高于ABP监测（72%对60%，P<0.0001）。在49%的患者中检测到持续性高血压（CBP和ABP均升高）。白大衣高血压（WCH，CBP升高而ABP正常）比隐匿性高血压（ABP升高而CBP正常）更常见（23%对10%；P<0.0001）。持续性高血压在欧洲和美洲以及老年人、男性、患有心血管合并症的肥胖患者中更常见。WCH在澳大利亚、美洲和非洲较少见，在老年人、肥胖女性中更常见。隐匿性高血压在亚洲以及患有糖尿病的男性中更常见。吸烟是持续性高血压和隐匿性高血压的一个决定因素。
结论
我们的分析表明，WCH和隐匿性高血压模式在不同大洲之间分布不均衡，提示遗传和环境因素之间存在相互作用，也可能存在不同的医疗管理和实践模式。
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