National Health Research Institutes, Miaoli, Taiwan.
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
J Clin Hypertens (Greenwich). 2021 Mar;23(3):656-664. doi: 10.1111/jch.14105. Epub 2020 Dec 22.
We aimed to investigate the association between isolated systolic hypertension (ISH) and central blood pressure (BP) in a nationally representative population, with a focus on the young and middle-aged adults (<50 years old). A total of 2029 adults without taking antihypertensive medications, aged ≥ 19 years old, participated in the 2013-2016 National Nutrition and Health Survey in Taiwan. Central and brachial BP were simultaneously measured using a cuff-based stand-alone central blood pressure monitor purporting to measure invasive central BP (type II device). Central hypertension was defined by central systolic (SBP)/diastolic BP (DBP) ≥130 or 90 mm Hg, and ISH was defined by brachial SBP ≥ 140 and DBP < 90 mm Hg. Overall, the prevalence rates of ISH, isolated diastolic hypertension (IDH, brachial SBP < 140 and DBP ≥ 90 mmHg), and systolic/diastolic hypertension (SDH, brachial SBP ≥ 140 and DBP ≥ 90 mmHg) were 6.51%, 1.92%, and 4.34%, respectively. ISH subjects had significantly higher central pulse pressure (PP) (62.8 ± 9.7 mm Hg for age < 50 years and 72.4 ± 13.5 mmHg for age ≥ 50 years) than those subjects with either IDH (44.7 ± 10.7 and 44.9 ± 10.6 mmHg) or SDH (55.2 ± 14.0 and 62.6 ± 17.1 mmHg). All ISH adults had central hypertension, and a higher prevalence of central obesity than the normotensives (80.95% vs. 26.15%, for age < 50 years; and 63.96% vs. 43.37% for age ≥ 50 years). All untreated subjects with ISH, whether younger or older, had central hypertension and had significantly higher central PP than those with IDH or SDH. Central obesity was one of the major characteristics of ISH, especially in the young- and middle-aged adults.
我们旨在研究孤立性收缩期高血压（ISH）与中心血压（BP）在全国代表性人群中的关联，重点关注年轻和中年成年人（<50 岁）。共有 2029 名未服用抗高血压药物、年龄≥19 岁的成年人参加了 2013-2016 年台湾全国营养与健康调查。使用基于袖带的独立中心血压监测仪（声称测量侵入性中心血压的 II 型设备）同时测量中心和肱动脉血压。中心高血压定义为中心收缩压（SBP）/舒张压（DBP）≥130 或 90mmHg，ISH 定义为肱动脉 SBP≥140 和 DBP<90mmHg。总体而言，ISH、孤立性舒张期高血压（IDH，肱动脉 SBP<140 和 DBP≥90mmHg）和收缩期/舒张期高血压（SDH，肱动脉 SBP≥140 和 DBP≥90mmHg）的患病率分别为 6.51%、1.92%和 4.34%。ISH 患者的中心脉搏压（PP）明显高于 IDH 患者（年龄<50 岁时为 62.8±9.7mmHg，年龄≥50 岁时为 72.4±13.5mmHg）和 SDH 患者（年龄<50 岁时为 55.2±14.0mmHg，年龄≥50 岁时为 62.6±17.1mmHg）。所有 ISH 成年人都有中心高血压，并且中心肥胖的患病率高于血压正常者（年龄<50 岁时为 80.95% vs. 26.15%；年龄≥50 岁时为 63.96% vs. 43.37%）。所有未经治疗的 ISH 患者，无论年龄大小，均有中心高血压，且中心 PP 明显高于 IDH 或 SDH 患者。中心肥胖是 ISH 的主要特征之一，尤其是在年轻和中年成年人中。
