二十五年来办公室和动态血压的变化：来自年轻人冠状动脉风险发展（CARDIA）研究的结果。

Twenty-Five-Year Changes in Office and Ambulatory Blood Pressure: Results From the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

机构信息

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.

Tulane University Translational Science Institute, New Orleans, Louisiana, USA.

出版信息

Am J Hypertens. 2021 May 22;34(5):494-503. doi: 10.1093/ajh/hpaa189.

DOI:10.1093/ajh/hpaa189

PMID:33201230

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8140654/

Abstract

BACKGROUND

Blood pressure (BP) measured in the office setting increases from early through later adulthood. However, it is unknown to what extent out-of-office BP derived via ambulatory BP monitoring (ABPM) increases over time, and which participant characteristics and risk factors might contribute to these increases.

METHODS

We assessed 25-year change in office- and ABPM-derived BP across sex, race, diabetes mellitus (DM), and body mass index (BMI) subgroups in the Coronary Artery Risk Development in Young Adults study using multivariable-adjusted linear mixed effects models.

RESULTS

We included 288 participants who underwent ABPM at the Year 5 Exam (mean [SD] age, 25.1 [3.7]; 45.8% men) and 455 participants who underwent ABPM at the Year 30 Exam (mean [SD] age, 49.5 [3.7]; 42.0% men). Office, daytime, and nighttime systolic BP (SBP) increased 12.8 (95% confidence interval [CI], 7.6-17.9), 14.7 (95% CI, 9.7-19.8), and 16.6 (95% CI, 11.4-21.8) mm Hg, respectively, over 25 years. Office SBP increased 6.5 (95% CI, 2.3-10.6) mm Hg more among black compared with white participants. Daytime SBP increased 6.3 (95% CI, 0.2-12.4) mm Hg more among participants with a BMI ≥25 vs. <25 kg/m2. Nighttime SBP increased 4.7 (95% CI, 0.5-8.9) mm Hg more among black compared with white participants, and 17.3 (95% CI, 7.2-27.4) mm Hg more among participants with vs. without DM.

CONCLUSIONS

Office- and ABPM-derived BP increased more from early through middle adulthood among black adults and participants with DM and BMI ≥25 kg/m2.

摘要

背景

从成年早期到后期，在诊室测量的血压（BP）会逐渐升高。然而，目前尚不清楚通过动态血压监测（ABPM）获得的诊室外 BP 在多大程度上随时间推移而增加，以及哪些参与者特征和危险因素可能导致这些增加。

方法

我们使用多变量调整线性混合效应模型，在冠状动脉风险发展在年轻人研究中，按性别、种族、糖尿病（DM）和体重指数（BMI）亚组评估 25 年期间诊室和 ABPM 衍生的 BP 变化。

结果

我们纳入了 288 名在第 5 年检查时进行 ABPM（平均[标准差]年龄 25.1[3.7]岁；45.8%为男性）和 455 名在第 30 年检查时进行 ABPM（平均[标准差]年龄 49.5[3.7]岁；42.0%为男性）的参与者。25 年间，诊室、白天和夜间收缩压（SBP）分别增加 12.8（95%置信区间[CI]：7.6-17.9）、14.7（95%CI：9.7-19.8）和 16.6（95%CI：11.4-21.8）mmHg。与白人相比，黑人参与者的诊室 SBP 增加了 6.5（95%CI：2.3-10.6）mmHg。与 BMI<25kg/m2 的参与者相比，BMI≥25kg/m2 的参与者白天 SBP 增加了 6.3（95%CI：0.2-12.4）mmHg。与白人相比，黑人参与者夜间 SBP 增加了 4.7（95%CI：0.5-8.9）mmHg，与无 DM 的参与者相比，有 DM 的参与者夜间 SBP 增加了 17.3（95%CI：7.2-27.4）mmHg。