Fabbian Fabio, Tonelli Laura, De Giorgi Alfredo, Cappadona Rosaria, Pasin Mauro, Manfredini Roberto
Department of Medical Sciences, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara.
General Hospital of Ferrara, Ferrara, Italy.
Blood Press Monit. 2019 Jun;24(3):120-122. doi: 10.1097/MBP.0000000000000375.
Ambulatory blood pressure monitoring (ABPM) is now considered by current guidelines to be a reliable method of measurement for the diagnosis and assessment of hypertension. The aim of this study was to relate the short-term outcomes, comorbidity and ABPM findings determined from evaluating an everyday clinical cohort of hypertensive patients. A prospective study was carried out that included hypertensive patients who had undergone 24-h ABPM from January 2016 to November 2017. The following parameters were recorded in the database: age, sex, current antihypertensive treatment and documented history of comorbidities. New episodes of myocardial infarction and stroke requiring hospitalization during follow-up obtained from electronic medical records were considered to be major adverse cardiovascular events (MACE) and were our main outcome measures. To estimate the risk of MACE, a Cox multivariate analysis was carried out. We analysed 1521 ABPM values and recorded 33 MACE during a follow-up of 518±120 days; 15 patients suffered a myocardial infarction and 18 patients had a stroke. The mean age of the patients was 59.9±14.2 years, and 49.4% were men. Night-time systolic blood pressure (BP), mean BP and pulse pressure were higher in patients who suffered a MACE. Age [hazard ratio (HR): 1.031, 95% confidence interval (CI): 1.002-1.060; P=0.036], night-time BP (HR: 1.018, 95% CI: 1.001-1.037; P=0.044) and diabetes mellitus (HR: 2.393, 95% CI: 1.053-5.436; P=0.037) were associated independently with MACE. We conclude that night-time BP is an important parameter to evaluate in aged patients with diabetes as a predictor of MACE.
动态血压监测（ABPM）目前被现行指南视为诊断和评估高血压的可靠测量方法。本研究的目的是探讨评估高血压患者日常临床队列所确定的短期结局、合并症与ABPM结果之间的关系。开展了一项前瞻性研究，纳入了2016年1月至2017年11月期间接受24小时ABPM的高血压患者。数据库中记录了以下参数：年龄、性别、当前的降压治疗以及合并症的记录病史。从电子病历中获取的随访期间需要住院治疗的心肌梗死和中风新发病例被视为主要不良心血管事件（MACE），是我们的主要结局指标。为了评估MACE的风险，进行了Cox多变量分析。我们分析了1521个ABPM值，并在518±120天的随访期间记录了33例MACE；15例患者发生心肌梗死，18例患者发生中风。患者的平均年龄为59.9±14.2岁，男性占49.4%。发生MACE的患者夜间收缩压（BP）、平均BP和脉压较高。年龄[风险比（HR）：1.031，95%置信区间（CI）：1.002 - 1.060；P = 0.036]、夜间BP（HR：1.018，95% CI：1.001 - 1.037；P = 0.044）和糖尿病（HR：2.393，95% CI：1.053 - 5.436；P = 0.037）与MACE独立相关。我们得出结论，夜间BP是评估老年糖尿病患者MACE预测指标的一个重要参数。
