Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín.
Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina.
J Hypertens. 2020 Mar;38(3):434-440. doi: 10.1097/HJH.0000000000002278.
To estimate the prevalence of isolated nocturnal hypertension (INH) and its relationships with office blood pressure (BP) categories defined by 2018 ESC/ESH guidelines.
We conducted a prospective cohort study in consecutive patients referred to perform an ambulatory blood pressure monitoring (ABPM) for diagnosis or therapeutic purposes. Office BP measurements and ABPM were performed in the same visit. The cohort was divided according to office BP in optimal, normal, high-normal and hypertension. The prevalence and adjusted risk for combined daytime and nocturnal hypertension and INH were estimated for each category.
We evaluated 1344 individuals, 59.3% women (51 ± 14 years old) and 40.7% men (52 ± 15 years old). 61.5% of the individuals had nocturnal hypertension, 12.9% INH and 48.7% combined daytime and nocturnal hypertension. Prevalence of combined daytime and nocturnal hypertension increased through office BP categories (P < 0.001). Conversely, prevalence of INH was lower in individuals with hypertension than in normotensives (7.4 vs. 17.2%, P < 0.001) and similar between nonhypertensive office BP categories, 16.6, 15 and 19.4% for optimal, normal and high-normal BP, respectively (P < 0.399). In individuals with office BP values less than 140/90 mmHg, the prevalence of masked hypertension phenotypes were 8.6, 17.2 and 30.2% for daytime, INH and combined daytime and nocturnal hypertension, respectively. Adjusted risk for combined daytime and nocturnal hypertension increased significantly through office BP categories; conversely, the risk for INH was similar in all nonhypertensive office BP categories.
Nocturnal hypertension was the more prevalent phenotype of masked hypertension and more than one-third of the individuals with nocturnal hypertension had INH. The risk for INH was not related to nonhypertensive office BP categories.
评估孤立性夜间高血压（INH）的患病率及其与 2018 年 ESC/ESH 指南定义的诊室血压（BP）分类的关系。
我们对连续就诊行动态血压监测（ABPM）以诊断或治疗的患者进行了前瞻性队列研究。在同一就诊时进行诊室 BP 测量和 ABPM。根据诊室 BP 将队列分为最佳、正常、高正常和高血压。估计每个类别中白天和夜间高血压以及 INH 的联合患病率和调整后的风险。
我们评估了 1344 名个体，其中 59.3%为女性（51±14 岁），40.7%为男性（52±15 岁）。61.5%的个体存在夜间高血压，12.9%为 INH，48.7%为白天和夜间高血压联合。通过诊室 BP 类别，白天和夜间高血压的联合患病率逐渐增加（P<0.001）。相反，高血压患者中 INH 的患病率低于血压正常者（7.4%比 17.2%，P<0.001），而非高血压的诊室 BP 类别中，最佳、正常和高正常 BP 者分别为 16.6%、15%和 19.4%（P<0.399）。在诊室 BP 值<140/90mmHg 的个体中，日间、INH 和白天和夜间高血压联合的隐匿性高血压表型的患病率分别为 8.6%、17.2%和 30.2%。通过诊室 BP 类别，白天和夜间高血压联合的调整风险显著增加；相反，INH 的风险在所有非高血压的诊室 BP 类别中相似。
夜间高血压是隐匿性高血压更常见的表型，超过三分之一的夜间高血压患者有 INH。INH 的风险与非高血压的诊室 BP 类别无关。
