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尼日利亚一家三级医疗中心新诊断高血压患者中白大衣高血压的患病率及预测因素

Prevalence and Predictors of White Coat Hypertension among Newly-Diagnosed Hypertensive Patients in a Tertiary Health Centre in Nigeria.

作者信息

Dele-Ojo Bolade, Kolo Philip, Ogunmodede Ayodele, Bello Haleema, Katibi Ibraheem, Omotoso Ayodele, Dada Samuel

机构信息

Ekiti State University Ado Ekiti Ekiti State, Ado, Ekiti 360001, Nigeria.

University of Ilorin Teaching Hospital, Ilorin, Nigeria.

出版信息

Ethiop J Health Sci. 2019 Jul;29(4):431-438. doi: 10.4314/ejhs.v29i4.3.

Abstract

BACKGROUND

Failure to diagnose and adequately classify newly-diagnosed hypertensive patients may lead to non-recognition of White Coat Hypertension (WCH) and inappropriate use of antihypertensive medications. This study determined the prevalence and predictors of white coat hypertension among newly-diagnosed hypertensive patients in a tertiary health centre in Nigeria.

METHODS

One hundred and twenty newly-diagnosed hypertensive patients and 120 controls were recruited for the study. All the participants had 24-hour Ambulatory Blood Pressure Monitoring (ABPM) using an oscillometric device (CONTEC®). Data were analyzed using SPSS version 20.0.

RESULTS

Out of 120 patients, 52 were males and the mean age was 44.2 ± 9.7 years whereas of the 120 controls, 53 were males and the mean age was 44.0 ± 7.5 years. The mean body mass index of the patients, BMI (27.0 ± 4.5kg/m) was higher than control (24.1 ± 4.5kg/m), p-value <0.001. The prevalence of WCH was 36.7%. The mean age and BMI of those with WCH were 43.3 ± 11.4 years and 26.4 ± 4.5kg/m2 respectively. Females constituted a greater proportion (70.5%). In multivariate analysis, high level of education and being overweight or obese were significant determinants of WCH.

CONCLUSION

High prevalence of WCH existed among participants studied. High level of education and being obese were predictors of white coat hypertension. Hence, ambulatory blood pressure monitoring should be included as part of routine work-up for newly-diagnosed hypertensive patients in order to limit the number of those who may be committed to lifelong antihypertensive medications with its unwanted side effects.

摘要

背景

对新诊断的高血压患者未能进行诊断及恰当分类可能导致白大衣高血压(WCH)未被识别以及降压药物的不恰当使用。本研究确定了尼日利亚一家三级医疗中心新诊断的高血压患者中白大衣高血压的患病率及预测因素。

方法

招募了120名新诊断的高血压患者和120名对照者参与本研究。所有参与者均使用示波装置(CONTEC®)进行24小时动态血压监测(ABPM)。使用SPSS 20.0版对数据进行分析。

结果

120名患者中,52名为男性,平均年龄为44.2±9.7岁;而120名对照者中,53名为男性,平均年龄为44.0±7.5岁。患者的平均体重指数,即BMI(27.0±4.5kg/m)高于对照者(24.1±4.5kg/m),p值<0.001。白大衣高血压的患病率为36.7%。患有白大衣高血压者的平均年龄和BMI分别为43.3±11.4岁和26.4±4.5kg/m²。女性占比更大(70.5%)。在多变量分析中,高学历以及超重或肥胖是白大衣高血压的重要决定因素。

结论

在所研究的参与者中白大衣高血压患病率较高。高学历和肥胖是白大衣高血压的预测因素。因此,动态血压监测应纳入新诊断高血压患者的常规检查项目,以减少可能需终身服用有不良副作用的降压药物的人数。

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