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真实世界家庭血压测量模式与老年高血压患者血压变异性的关系:一项基于社区的血压变异性研究。

Association between real-world home blood pressure measurement patterns and blood pressure variability among older individuals with hypertension: A community-based blood pressure variability study.

机构信息

Institute of Biomedical Informatics, National Yang Ming University, Taipei, Taiwan.

Department of Family Medicine, Taipei City Hospital RenAi Branch, Taipei, Taiwan.

出版信息

J Clin Hypertens (Greenwich). 2021 Mar;23(3):628-637. doi: 10.1111/jch.14134. Epub 2020 Dec 18.

Abstract

Home blood pressure (BP) monitoring is a useful tool for hypertension management. BP variability (BPV) has been associated with an increased risk of cardiovascular events. However, little is known about the correlation between BPV and different measurement patterns of long-term home BP monitoring. This longitudinal cohort study aimed to assess the associations between dynamic BP measurement patterns and BPV. A total of 1128 participants (mean age, 77.4 ± 9.3 years; male, 51%) with 23 269 behavior measuring units were included. We used sliding window sampling to classify the home BP data with a regular 6-month interval into units in a sliding manner until the data are not continuous. Three measurement patterns (stable frequent [SF], stable infrequent [SI], and unstable [US]) were assessed based on the home BP data obtained within the first 3 months of the study, and the data in the subsequent 3 months were used to assess the BPV of that unit. We used linear mixed-effects model to assess the association between BP measurement patterns and BPV with adjustment for possible confounding factors including average BP. Average real variability and coefficient variability were used as measures of the BPV. No significant differences were observed in average BP between the SF, SI, and US patterns. However, BPV in the SF group was significantly lower than that in the US and SI groups (all p-values < .05). The BPV in SI and US groups was not significantly different. A stable and frequent BP measuring pattern was independently associated with a lower BPV.

摘要

家庭血压(BP)监测是高血压管理的有用工具。BP 变异性(BPV)与心血管事件风险增加相关。然而,对于 BPV 与长期家庭 BP 监测的不同测量模式之间的相关性知之甚少。这项纵向队列研究旨在评估动态 BP 测量模式与 BPV 之间的相关性。共纳入 1128 名参与者(平均年龄 77.4±9.3 岁;男性 51%),共 23269 个行为测量单位。我们使用滑动窗口采样,以 6 个月的常规间隔将家庭 BP 数据分类为滑动单元,直到数据不连续。根据研究开始前 3 个月内获得的家庭 BP 数据,评估了三种测量模式(稳定频繁[SF]、稳定不频繁[SI]和不稳定[US]),并使用随后 3 个月的数据评估该单元的 BPV。我们使用线性混合效应模型来评估 BP 测量模式与 BPV 之间的关联,调整可能的混杂因素,包括平均 BP。平均真实变异性和系数变异性均用于衡量 BPV。SF、SI 和 US 模式之间的平均 BP 无显著差异。然而,SF 组的 BPV 明显低于 US 和 SI 组(均 p 值<.05)。SI 和 US 组的 BPV 无显著差异。稳定且频繁的 BP 测量模式与较低的 BPV 独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79ff/8029514/a6d0fe40d04d/JCH-23-628-g004.jpg

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