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血压变异性是否影响高血压前期患者的高血压发展?

Does Blood Pressure Variability Affect Hypertension Development in Prehypertensive Patients?

机构信息

Department of Nephrology, Tekirdağ Namık Kemal University, School of Medicine, Tekirdağ, Turkey.

Department of Nephrology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.

出版信息

Am J Hypertens. 2022 Jan 5;35(1):73-78. doi: 10.1093/ajh/hpab125.

DOI:10.1093/ajh/hpab125
PMID:34351385
Abstract

BACKGROUND

Blood pressure variability (BPV) is associated with end organ damage and cardiovascular outcomes in hypertensive patients. Prehypertensive patients frequently develop hypertension (HT). The purpose of the present study was to evaluate the effect of BPV on the development of HT.

METHODS

Two hundred and seven prehypertensive patients from the Cappadocia cohort were monitored over 2 years, and 24-hour ambulatory blood pressure monitoring (ABPM), office BP, and home BP measurements were subsequently performed at 4- to 6-month intervals. BPV was calculated as average real variability (ARV) from 24-h ABPM data, home BP, and office BP measurements at first visit. The relationship was evaluated between baseline ARV and the development of HT.

RESULTS

HT was diagnosed in 25.60% of subjects. Baseline 24-hour ABPM systolic blood pressure (SBP)ARV and diastolic blood pressure (DBP)ARV and home SBPARV were significantly higher in patients who developed HT than the other patients (P 0.006, 0.001 and 0.006, respectively). Baseline 24-hour ABPM SBPARV and home SBPARV exceeding the 90th percentile were identified as parameters affecting development of HT at logistic regression analysis.

CONCLUSION

In conclusion, our prospective observational cohort study showed that short-term BPV in particular can predict the development of HT in the prehypertensive population.

摘要

背景

血压变异性(BPV)与高血压患者的靶器官损害和心血管结局相关。高血压前期患者常发展为高血压(HT)。本研究旨在评估 BPV 对 HT 发展的影响。

方法

对来自卡帕多西亚队列的 207 例高血压前期患者进行了 2 年的监测,随后在 4-6 个月的间隔内进行了 24 小时动态血压监测(ABPM)、诊室血压和家庭血压测量。BPV 作为 24 小时 ABPM 数据、家庭血压和首次就诊时诊室血压测量的平均真实变异性(ARV)进行计算。评估基线 ARV 与 HT 发展之间的关系。

结果

25.60%的患者被诊断为 HT。与其他患者相比,发生 HT 的患者的基线 24 小时 ABPM 收缩压(SBP)ARV、舒张压(DBP)ARV 和家庭 SBPARV 明显更高(P 0.006、0.001 和 0.006,分别)。逻辑回归分析显示,基线 24 小时 ABPM SBPARV 和家庭 SBPARV 超过第 90 百分位是影响 HT 发展的参数。

结论

总之,我们的前瞻性观察性队列研究表明,短期 BPV 可预测高血压前期人群中 HT 的发生。

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