Ting-Tse Lin, MD Lecturer, Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital Hsin-Chu Branch; and Institute of Biomedical Engineering, National Chiao-Tung University, Hsinchu, Taiwan. Jimmy Jyh-Ming Juang, MD, PhD Associate Professor, Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei. Jen-Kuang Lee, MD, PhD Lecturer, Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei. Chia-Ti Tsai, MD, PhD Professor, Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei. Chen-Huan Chen, MD, PhD Professor, Division of Cardiology, Department of Medical Education, Taipei Veterans General Hospital, Taiwan. Wen-Chung Yu, MD, PhD Associate Professor, Department of Medicine, National Taiwan University Hospital; and Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. Hao-min Cheng, MD, PhD Associate Professor, Department of Medicine, National Taiwan University Hospital; and Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. Yen-Wen Wu, MD, PhD Professor, Cardiology Division of Cardiovascular Medical Center and Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Yu-Wei Chiu, MD Assistant Professor, Department of Computer Science and Engineering, Yuan Ze University, Taiwan. Chi-Tai Kuo, MD, PhD Professor, Cardiovascular Department, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Jin-Jer Chen, MD, PhD Professor, China Medical University Hospital, Taichung, Taiwan. Zhih-Cherng Chen, MD Associate Professor, Chi Mei Medical Center, Tainan, Taiwan. Wei-Ting Chang, MD Assistant Professor, Chi Mei Medical Center, Tainan, Taiwan. Ping-Yen Liu, MD, PhD Professor, Division of Cardiology, Internal Medicine, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. Po-wei Chen, MD Attending Physician, Division of Cardiology, Internal Medicine, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. Hsueh-Wei Yen, MD Lecturer, Division of Cardiology, Kaohsiung Medical University Hospital, Taiwan. Ying-Chih Chen, MD Attending Physician, Division of Cardiology, Kaohsiung Medical University Hospital, Taiwan. Wei-Kung Tseng, MD, PhD Assistant Professor, Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan. Fu-Tien Chiang, MD, PhD Professor, Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei. Cho-Kai Wu, MD, PhD Associate Professor, Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei.
J Cardiovasc Nurs. 2019 Mar/Apr;34(2):106-114. doi: 10.1097/JCN.0000000000000515.
To evaluate whether home or ambulatory blood pressure (BP) monitoring was associated with preclinical hypertensive cardiovascular target organ damage (TOD).
We enrolled participants with prehypertension and stage 1 hypertension from 11 medical centers within the Taiwan hypertension-associated cardiac disease consortium. Recordings of clinical BP measurement, ambulatory BP monitoring for 24 hours, and home BP monitoring during morning and evening were made. The measured parameters of target organ damage included left ventricular mass index (LVMI), left atrial volume index (LAVI), and carotid-femoral pulse wave velocity (PWV).
Data were collected from 561 study participants (mean age, 65.0 ± 10.8 years; men, 61.3%). Morning and evening home BP values were slightly higher than the daytime and nighttime ABP values (difference for systolic morning-daytime/evening-nighttime, 7.3 ± 14.2/11.3 ± 18.5 mm Hg, P < .001; for diastolic, 5.4 ± 9.4/7.3 ± 12.1, P < .001). Daytime ambulatory (r = 0.114), nighttime ambulatory (r = 0.130), morning home (r = 0.310), and evening home (r = 0.220) systolic BPs (SBPs) were all associated with LVMI (all P < .05). The correlation coefficient was significantly greater for the relationship between daytime home SBP and LVMI than for the relationship between ambulatory SBP and LVMI (P < .01). The goodness of fit of the association between SBP and LVMI improved by adding home daytime SBP to the other SBPs (P < .001). Similar findings were observed for LAVI, but not for PWV.
These findings indicate that morning SBP assessed by home monitoring appears to be a better predictor than other BP measures to determine preclinical hypertensive cardiovascular damage in patients with early-stage hypertension.
评估家庭或动态血压（BP）监测与临床前高血压心血管靶器官损伤（TOD）的关系。
我们从台湾高血压相关心脏病学联盟的 11 个医疗中心招募了高血压前期和 1 期高血压患者。记录临床 BP 测量、24 小时动态 BP 监测和早晚家庭 BP 监测。靶器官损伤的测量参数包括左心室质量指数（LVMI）、左心房容积指数（LAVI）和颈动脉-股动脉脉搏波速度（PWV）。
共纳入 561 例研究参与者（平均年龄 65.0 ± 10.8 岁；男性 61.3%）。早晚家庭 BP 值略高于日间和夜间 ABPM 值（收缩压差异为：晨-日间/晚-夜间，7.3 ± 14.2/11.3 ± 18.5mmHg，P<.001；舒张压差异为：5.4 ± 9.4/7.3 ± 12.1，P<.001）。日间动态（r=0.114）、夜间动态（r=0.130）、晨起家庭（r=0.310）和晚归家庭（r=0.220）SBP 与 LVMI 均相关（均 P<.05）。与日间家庭 SBP 与 LVMI 的关系相比，日间动态 SBP 与 LVMI 的相关系数更大（P<.01）。将家庭日间 SBP 加入其他 SBP 后，SBP 与 LVMI 的相关性的拟合度更好（P<.001）。LAVI 也有类似的发现，但 PWV 没有。
这些发现表明，通过家庭监测评估的晨起 SBP 似乎比其他 BP 测量指标更能预测早期高血压患者的临床前高血压心血管损伤。
