Department of Cardiology, Baskent University Hospital, Alanya Medical and Research Center, Alanya, Turkey.
Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Clin Exp Hypertens. 2021 Aug 18;43(6):579-585. doi: 10.1080/10641963.2021.1916946. Epub 2021 Apr 18.
Masked hypertension (MH) and non-dipping pattern are conditions associated with target organ damage and cardiovascular risk, which are frequently observed together. We aimed to show the relationship between the target organ damage observed in MH and the deterioration in the dipping pattern.
Patients who underwent ambulatory blood pressure monitoring (ABPM) and office blood pressure (BP) <140/90 mmHg were retrospectively screened. In ABPM data, those with daytime BP ≥135/85 mmHg and night BP ≥120/70 mmHg were included in the MH group, while the others were included in the normotensive group. The patients were grouped as dipper, non-dipper and reverse-dipper according to ABPM results. Left ventricular mass index (LVMI), glomerular filtration rate (GFR) and serum creatinine levels were used to determine target organ damage.
289 patients [mean age 46.6 ± 12.4 years, 136 (47.1%) males], 154 (53.3%) of whom had MH were included in our study. GFR value was found to be significantly lower, serum creatinine levels and LVMI were significantly higher in patients with MH compared to normotensives ( < .05, for all). When the subgroups were examined, it was found that this difference was associated with the disruption in the dipping pattern. In patients with MH, dipping pattern disruption without change in systolic BP was independently associated with an increase in LVMI ( < .05, for both).
Target organ damage seen in MH may be due to the deterioration of the dipping pattern.
隐匿性高血压（MH）和非杓型血压是与靶器官损伤和心血管风险相关的两种情况，这两种情况常同时出现。我们旨在显示 MH 中观察到的靶器官损伤与血压下降模式恶化之间的关系。
回顾性筛选接受动态血压监测（ABPM）和诊室血压（BP）<140/90mmHg的患者。在 ABPM 数据中，将日间 BP≥135/85mmHg 和夜间 BP≥120/70mmHg 的患者纳入 MH 组，而将其他患者纳入正常血压组。根据 ABPM 结果，将患者分为杓型、非杓型和反杓型。使用左心室质量指数（LVMI）、肾小球滤过率（GFR）和血清肌酐水平来确定靶器官损伤。
289 例患者[平均年龄 46.6±12.4 岁，136（47.1%）名男性]，其中 154 例（53.3%）患有 MH，纳入本研究。与正常血压者相比，MH 患者的 GFR 值明显较低，血清肌酐水平和 LVMI 明显较高（均<0.05）。在亚组检查中，发现这种差异与血压下降模式的破坏有关。在 MH 患者中，收缩压无变化而血压下降模式破坏与 LVMI 增加独立相关（均<0.05）。
MH 中观察到的靶器官损伤可能是由于血压下降模式恶化所致。
