Shi Xiaoyang, Zhang Kai, Wang Pengxu, Kan Quane, Yang Junpeng, Wang Limin, Yuan Huijuan
Department of Endocrinology and Metabolism, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China.
Department of Adult ICU, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Arch Med Sci. 2019 Oct 30;16(3):538-544. doi: 10.5114/aoms.2019.89218. eCollection 2020.
The aim of the study was to evaluate the association of masked uncontrolled hypertension (MUCH) and prevalence of cardiovascular disease in treated hypertensive patients.
Patients' demographics and prior medical histories were collected. Fasting venous blood was drawn for evaluation of serum creatinine level, which was used to calculate glomerular filtration rate (GFR). Clinic blood pressure (BP) and 24 h ambulatory blood pressure monitoring (ABPM) measurements were performed. Based on the clinic BP and 24 h ABPM results, patients were divided into MUCH and non-masked hypertension groups.
Compared to patients without masked hypertension, MUCH patients were older (62.4 ±11.2 vs. 59.7 ±10.4 years, < 0.05), more likely to be male (66.9% vs. 63.4%), had diabetes (33.9% vs. 29.6%), longer hypertension duration (12.4 ±5.3 vs. 9.5 ±4.5 years, < 0.05), lower GFR (79.5 ±11.6 vs. 82.4 ±10.3 ml/min/1.73 m, < 0.05), treated with β-blocker (39.0% vs. 32.7%, < 0.05) and required more antihypertensive medications (2.7 ±0.5 vs. 2.2 ±0.3, < 0.05). MUCH patients have higher cardiovascular disease prevalence than that without masked hypertension (30.1% vs. 23.4%, < 0.05). After adjustment for covariates, MUCH was still independently associated with higher cardiovascular disease prevalence with odds ratio 1.38 (95% confidence interval 1.17-1.62, < 0.05).
The MUCH is independently associated with prevalent cardiovascular disease in treated hypertensive patients. Future studies are needed to evaluate whether correction of MUCH can improve patients' outcomes.
本研究的目的是评估接受治疗的高血压患者中隐匿性未控制高血压（MUCH）与心血管疾病患病率之间的关联。
收集患者的人口统计学资料和既往病史。采集空腹静脉血以评估血清肌酐水平，用于计算肾小球滤过率（GFR）。进行诊室血压（BP）和24小时动态血压监测（ABPM）测量。根据诊室血压和24小时ABPM结果，将患者分为MUCH组和非隐匿性高血压组。
与无隐匿性高血压的患者相比，MUCH患者年龄更大（62.4±11.2岁对59.7±10.4岁，P<0.05），男性比例更高（66.9%对63.4%），患有糖尿病（33.9%对29.6%），高血压病程更长（12.4±5.3年对9.5±4.5年，P<0.05），GFR更低（79.5±11.6对82.4±10.3ml/min/1.73m²，P<0.05），接受β受体阻滞剂治疗（39.0%对32.7%，P<0.05），且需要更多的降压药物（2.7±0.5对2.2±0.3，P<0.05）。MUCH患者的心血管疾病患病率高于无隐匿性高血压的患者（30.1%对23.4%，P<0.05）。在对协变量进行调整后，MUCH仍与较高的心血管疾病患病率独立相关，比值比为1.38（95%置信区间为1.17-1.62，P<0.05）。
MUCH与接受治疗的高血压患者中普遍存在的心血管疾病独立相关。未来需要进行研究以评估纠正MUCH是否能改善患者的预后。
