Sasak Gulsah, Ecder Sabahat Alisir
Department of Nephrology, S.B Medeniyet University Goztepe Educational and Research Hospital, Istanbul, Turkey.
Department of Nephrology, S.B Medeniyet University Faculty of Medicine, Istanbul, Turkey.
Transplant Proc. 2019 Sep;51(7):2355-2357. doi: 10.1016/j.transproceed.2019.01.175. Epub 2019 Aug 8.
The diagnosis of arterial hypertension has traditionally been based on measurements of blood pressure (BP) in the clinic. However, home or ambulatory BP monitoring (ABPM) is reported to correlate better with target organ damage than clinic BP readings. The other potential advantage of out-of-clinic BP measurement is the detection of both white-coat hypertension (WCHT) and masked hypertension (MHT). Studies have suggested that MHT have an increased risk of cardiovascular disease (CVD). We aimed to investigate the prevalence of MHT and to evaluate risk factors by ABPM in our renal transplant recipients. One hundred twenty-ninety patients who were followed up in our nephrology clinic were included in the study. The prevalence of MHT was 17%. In logistic regression analysis, we investigated factors associated with MHT. In a model with age, sex, smoking, presence of Diabetes mellitus (DM) and blood glucose, estimated glomerular filtration rate (eGFR), donor type, body mass index, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), we found that WHR (r: 18.61, P: .007) and smoking (r: 2.79, P: .011) were related with MHT. MHT was related to target organ damage and cardiovascular disease. The diagnosis and treatment of MHT are important. These findings suggesting that patients with high WC and smokers should be investigated with ABPM to diagnose masked hypertension. This approach may reduce adverse cardiovascular outcomes after transplantation.
传统上，动脉高血压的诊断是基于临床测量的血压（BP）。然而，据报道，家庭或动态血压监测（ABPM）与靶器官损害的相关性比诊所血压读数更好。门诊外血压测量的另一个潜在优势是能够检测白大衣高血压（WCHT）和隐匿性高血压（MHT）。研究表明，MHT患者患心血管疾病（CVD）的风险增加。我们旨在调查肾移植受者中MHT的患病率，并通过ABPM评估危险因素。本研究纳入了在我们肾脏病诊所接受随访的129名患者。MHT的患病率为17%。在逻辑回归分析中，我们调查了与MHT相关的因素。在一个包含年龄、性别、吸烟、糖尿病（DM）的存在和血糖、估计肾小球滤过率（eGFR）、供体类型、体重指数、腰围（WC）、腰臀比（WHR）和腰高比（WHtR）的模型中，我们发现WHR（r：18.61，P：.007）和吸烟（r：2.79，P：.011）与MHT相关。MHT与靶器官损害和心血管疾病有关。MHT的诊断和治疗很重要。这些发现表明，WC高的患者和吸烟者应通过ABPM进行检查以诊断隐匿性高血压。这种方法可能会减少移植后的不良心血管结局。
