Third Department of Internal Medicine, Hypertension-24h ABPM ESH Center of Excellence, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Cardiology, 424 General Military Hospital, Thessaloniki, Greece.
J Clin Hypertens (Greenwich). 2020 May;22(5):802-811. doi: 10.1111/jch.13876. Epub 2020 May 1.
Arterial damage of large arteries, addressed as c-f PWV, is recognized as independent predictor for future cardiovascular disease. The aim of this study was to systematically investigate the association of the four hypertension phenotypes with carotid-femoral pulse wave velocity (c-f PWV), in untreated patients. PubMed and Cochrane Library were searched to identify studies comparing c-f PWV levels between normotensives, sustained hypertensives, white-coat hypertensives (WCH), and masked hypertensives (MH). Meta-analysis was performed to compare the difference c-f PWV levels between these groups. Newcastle-Ottawa quality assessment scale for cross-sectional studies was used to assess study quality. MH and WCH patients had significantly increased c-f PWV values compared to the normotensive groups (d = 0.96 m/s, 95% CI: 0.49-1.42; I2 = 85%, P < .01 for MH and d = 0.85 m/s, 95% CI: 0.48-1.22; I2 = 89%, for WCH). Moreover, the sustained hypertensive population was found to have significantly increased values of c-f PWV compared to MH (d = -0.70 m/s, 95% CI: -0.87 to -0.54; I2 = 12%, P = .33) but not compared to WCH population (d = -0.75 m/s, 95% CI: -1.52-0.02; I = 96%,). Finally, there was no significant difference between MH and WCH population (d = 0.06 m/s, 95% CI: -1.04 to 1.15; I = 96%,). MH and WCH population may have increased values of c-f PWV compared to the normotensive group. These results demonstrate that these phenotypes are not clinically innocent, in the untreated population.
大动脉的动脉损伤，被定义为 c-f PWV，被认为是未来心血管疾病的独立预测因子。本研究旨在系统地研究四种高血压表型与颈股脉搏波速度（c-f PWV）的关系，研究对象为未经治疗的患者。使用 PubMed 和 Cochrane Library 搜索比较正常血压者、持续性高血压者、白大衣高血压（WCH）者和隐蔽性高血压（MH）者之间 c-f PWV 水平差异的研究。采用 Meta 分析比较这些组之间 c-f PWV 水平的差异。使用纽卡斯尔-渥太华质量评估量表对横断面研究进行质量评估。与正常血压组相比，MH 和 WCH 患者的 c-f PWV 值显著升高（d=0.96m/s，95%CI：0.49-1.42；I2=85%，P<.01；d=0.85m/s，95%CI：0.48-1.22；I2=89%，WCH）。此外，与 MH 相比，持续性高血压患者的 c-f PWV 值显著升高（d=-0.70m/s，95%CI：-0.87 至-0.54；I2=12%，P=0.33），但与 WCH 相比则无显著差异（d=-0.75m/s，95%CI：-1.52 至 0.02；I2=96%）。最后，MH 和 WCH 之间无显著差异（d=0.06m/s，95%CI：-1.04 至 1.15；I2=96%）。与正常血压组相比，MH 和 WCH 患者的 c-f PWV 值可能升高。这些结果表明，在未经治疗的人群中，这些表型并非临床无害。
