Dai Xixi, Wang Haiya, Fang Ningyuan
Department of Geriatrics, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Medicine (Baltimore). 2017 Dec;96(48):e8386. doi: 10.1097/MD.0000000000008386.
Pseudohypertension (PHT) can cause adverse effects in the elderly owing to administration of antihypertension therapy. The present study aimed to determine the prevalence of PHT in the elderly and associated risk factors to investigate a noninvasive method of detection of PHT.
We recruited 151 patients (age ≥60 years) who underwent coronary angiography. Demographic and clinical data were collected from the patients. During coronary angiography, intrabrachial arterial pressure and indirect blood pressure were measured. Brachial-ankle pulse wave velocity (ba-PWV) was measured within 2 weeks after coronary angiography.
Based on the differences between the direct and indirect pressure measurements, the patients were divided into a PHT group (n = 87) and a non-PHT group (n = 64). The prevalence of PHT was 57.6%, and the development of PHT was significantly associated with older age. Serum creatinine level and creatinine clearance rate were significantly higher in the non-PHT group than in the PHT group (P < .05). In addition, the PHT group had significantly higher ba-PWV and pulse pressure (PP) than the non-PHT group (P < .05). Receiver-operating characteristic curve analysis revealed that ba-PWV (AUC = 0.783) and PP (AUC = 0.791) showed a relatively good diagnostic performance for PHT.
PHT was present in most of the elderly who had indications for coronary angiography and associated with age and renal function. The data from the present study also suggested that both PP and ba-PWV could be used to positively predict PHT.
假性高血压(PHT)可因抗高血压治疗而对老年人产生不良影响。本研究旨在确定老年人中PHT的患病率及相关危险因素,以探索一种检测PHT的非侵入性方法。
我们招募了151例接受冠状动脉造影的患者(年龄≥60岁)。收集患者的人口统计学和临床数据。在冠状动脉造影期间,测量肱动脉内压和间接血压。在冠状动脉造影后2周内测量臂踝脉搏波速度(ba-PWV)。
根据直接和间接压力测量的差异,将患者分为PHT组(n = 87)和非PHT组(n = 64)。PHT的患病率为57.6%,PHT的发生与年龄较大显著相关。非PHT组的血清肌酐水平和肌酐清除率显著高于PHT组(P < 0.05)。此外,PHT组的ba-PWV和脉压(PP)显著高于非PHT组(P < 0.05)。受试者工作特征曲线分析显示,ba-PWV(AUC = 0.783)和PP(AUC = 0.791)对PHT具有相对较好的诊断性能。
大多数有冠状动脉造影指征的老年人存在PHT,且与年龄和肾功能有关。本研究数据还表明,PP和ba-PWV均可用于阳性预测PHT。