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成人家庭血压监测与夜尿症

Home Blood Pressure Monitoring And Nocturia In Adults.

作者信息

Lazar Jason M, Posner Alexandra, Akbar Kamal, Tologonova Gulzhan, Monaghan Thomas, Murray Christopher, Weiss Jeffrey, Everaert Karel, DeBacker Tine, Helzner Elizabeth, Calixte Rose, Browne Rasheda, Goldman Sarah, Salciccioli Louis

机构信息

Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC 1199, 11203-2098, Brooklyn, NY, USA.

Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.

出版信息

J Community Health. 2023 Apr;48(2):238-244. doi: 10.1007/s10900-022-01171-8. Epub 2022 Nov 12.

DOI:10.1007/s10900-022-01171-8
PMID:36370256
Abstract

Although widely viewed as a urological condition, nocturia has been increasingly recognized to accompany various non-urological conditions such as hypertension and blood pressure (BP) elevation on office determination. Home BP monitoring (HBPM) has been shown superior to office-based readings and provides an opportunity to assess potential relationships between nocturia and novel indices derived from multiple BP recordings including BP load, BP variability, and arterial stiffness, which have prognostic significance. We retrospectively studied 103 home BP logs and nocturia frequencies provided by 61 stable cardiology patients ≥ 21 years without medication change. Nocturnal voids ranged from 0 to 5 voids per night, median: 1.5. Nocturia frequency was significantly correlated with home and office systolic BPs and with BP load, but not with diastolic BPs, BP variability or arterial stiffness. On Poisson regression analysis, the estimated prevalence ratio (PR) for home and office systolic BPs were 1.025 (CI: 1.01, 1.04; p < .001) and 1.01 (CI:1.00, 1.02; p = .019), indicating 2.5% and 1% increases in the risk of nocturia per mmHg increases in BP respectively. In conclusion, higher mean home and office systolic BPs are associated with self-reported nocturia frequency with stronger associations seen for home BP measurement. Nocturia frequency appears unrelated to mean home and office diastolic BPs. Nocturia may be related to BP load, (percentage of elevated BP values), but not to BP variability or arterial stiffness. Future prospective studies using HBPM are needed to confirm these findings and to contribute to the understanding of the elevated BP-nocturia link.

摘要

尽管夜尿症被广泛视为一种泌尿系统疾病,但人们越来越认识到它会伴随各种非泌尿系统疾病,如高血压以及在诊室测量时出现的血压升高。家庭血压监测(HBPM)已被证明优于诊室血压测量,并且提供了一个机会来评估夜尿症与从多次血压记录得出的新指标之间的潜在关系,这些指标包括血压负荷、血压变异性和动脉僵硬度,它们具有预后意义。我们回顾性研究了61名年龄≥21岁、病情稳定且未改变用药的心脏病患者提供的103份家庭血压记录和夜尿频率。夜间排尿次数为每晚0至5次,中位数为1.5次。夜尿频率与家庭和诊室收缩压以及血压负荷显著相关,但与舒张压、血压变异性或动脉僵硬度无关。在泊松回归分析中,家庭和诊室收缩压的估计患病率比(PR)分别为1.025(置信区间:1.01, 1.04;p <.001)和1.01(置信区间:1.00, 1.02;p =.019),表明血压每升高1 mmHg,夜尿症风险分别增加2.5%和1%。总之,较高的家庭和诊室平均收缩压与自我报告的夜尿频率相关,家庭血压测量的相关性更强。夜尿频率似乎与家庭和诊室平均舒张压无关。夜尿症可能与血压负荷(血压升高值的百分比)有关,但与血压变异性或动脉僵硬度无关。需要未来使用家庭血压监测的前瞻性研究来证实这些发现,并有助于理解血压升高与夜尿症之间的联系。

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De novo nocturia: A red flag for coronary heart disease patients.新发性夜尿症:冠心病患者的危险信号。
Prog Urol. 2022 Sep;32(11):756-762. doi: 10.1016/j.purol.2022.05.005. Epub 2022 Jun 27.
2
Systolic Blood Pressure Time in Target Range and Cardiovascular Outcomes in Patients With Hypertension.高血压患者的目标范围内收缩压时间与心血管结局。
J Am Coll Cardiol. 2021 Mar 16;77(10):1290-1299. doi: 10.1016/j.jacc.2021.01.014.
3
Nocturia and electrocardiographic abnormalities among patients at an inner-city cardiology clinic.
市中心心脏病学诊所患者的夜尿症和心电图异常。
Neurourol Urodyn. 2021 Jan;40(1):509-514. doi: 10.1002/nau.24590. Epub 2020 Dec 21.
4
Phenotyping the Association between Nocturia and Hypertension: A Systematic Review and Meta-Analysis.对夜间多尿与高血压相关性的表型分析:系统评价和荟萃分析。
J Urol. 2021 Jun;205(6):1577-1583. doi: 10.1097/JU.0000000000001433. Epub 2020 Oct 20.
5
Future Considerations in Nocturia and Nocturnal Polyuria.夜尿症和夜间多尿的未来考虑。
Urology. 2019 Nov;133S:34-42. doi: 10.1016/j.urology.2019.06.014. Epub 2019 Jun 22.
6
Proportion of US Adults Recommended Out-of-Clinic Blood Pressure Monitoring According to the 2017 Hypertension Clinical Practice Guidelines.根据 2017 年高血压临床实践指南,推荐美国成年人进行非诊所血压监测的比例。
Hypertension. 2019 Aug;74(2):399-406. doi: 10.1161/HYPERTENSIONAHA.119.12775. Epub 2019 Jun 24.
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Nocturia as an Unrecognized Symptom of Uncontrolled Hypertension in Black Men Aged 35 to 49 Years.35 至 49 岁黑人男性中未被识别的高血压未控的夜间多尿症状。
J Am Heart Assoc. 2019 Mar 5;8(5):e010794. doi: 10.1161/JAHA.118.010794.
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International Continence Society consensus on the diagnosis and treatment of nocturia.国际尿控协会关于夜尿症的诊断和治疗共识。
Neurourol Urodyn. 2019 Feb;38(2):478-498. doi: 10.1002/nau.23939. Epub 2019 Feb 19.
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Schedules for Self-monitoring Blood Pressure: A Systematic Review.自我监测血压的时间表:系统评价。
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Rationale for Ambulatory and Home Blood Pressure Monitoring Thresholds in the 2017 American College of Cardiology/American Heart Association Guideline.2017年美国心脏病学会/美国心脏协会指南中动态和家庭血压监测阈值的理论依据。
Hypertension. 2019 Jan;73(1):33-38. doi: 10.1161/HYPERTENSIONAHA.118.11946.