Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences.
Center of Medical Image Science and Visualization.
J Hypertens. 2023 Jul 1;41(7):1084-1091. doi: 10.1097/HJH.0000000000003431. Epub 2023 Apr 3.
Masked hypertension is associated with cardiovascular disease (CVD). However, previous large studies have not used the same device to measure office and home blood pressure (BP) and adhered to current home BP measurement recommendations of the European Society of Hypertension. We aimed to characterize masked hypertension and explore its relation to manifestations of CVD.
A randomly selected cohort of 5057 participants aged 50-64 years from the Swedish CardioPulmonary BioImage Study (SCAPIS) was evaluated with office and home BP using the semi-automatic Omron M10-IT oscillometric device. Additional analyses included pulse wave velocity (PWV) and coronary artery calcium score (CACS).
Of participants, 4122 did not have current antihypertensive treatment, and were thus included in our analyses. Of these, 2634 (63.9%) had sustained normotension, and 172 (4.2%) had masked hypertension. Participants with masked hypertension vs. sustained normotension were more often men (66.9 vs. 46.2%, P < 0.001). Those with masked hypertension had higher mean PWV [9.3 (95% confidence interval, 95% CI 9.1-9.5) vs. 8.3 (95% CI 8.2-8.4) m/s, P < 0.001] and odds ratio for CACS at least 100 [1.65 (95% CI 1.02-2.68), P = 0.040]. These associations were similar in a posthoc analysis of masked hypertension and sustained normotension, matched for age, sex and systolic office BP.
Masked hypertension was associated with markers of CVD. This suggests that home BP is a better predictor of risk, even when the recordings are performed with the same measurement device, in a population-based setting with randomized recruitment.
隐匿性高血压与心血管疾病（CVD）有关。然而，以前的大型研究并未使用相同的设备来测量诊室血压和家庭血压（BP），也未遵守欧洲高血压学会（ESH）目前的家庭 BP 测量建议。我们旨在描述隐匿性高血压，并探讨其与 CVD 表现的关系。
从瑞典心肺生物影像研究（SCAPIS）中随机选择了 5057 名年龄在 50-64 岁的参与者进行评估，使用半自动欧姆龙 M10-IT 示波法测量诊室和家庭血压。其他分析包括脉搏波速度（PWV）和冠状动脉钙评分（CACS）。
在未接受当前降压治疗的 5057 名参与者中，有 4122 名参与者被纳入我们的分析。在这些参与者中，2634 名（63.9%）为持续性正常血压，172 名（4.2%）为隐匿性高血压。与持续性正常血压相比，隐匿性高血压患者更多为男性（66.9% vs. 46.2%，P < 0.001）。隐匿性高血压患者的平均 PWV 更高[9.3（95%置信区间，95%CI 9.1-9.5） vs. 8.3（95%CI 8.2-8.4）m/s，P < 0.001]，且冠状动脉钙评分至少为 100 的比值比为 1.65（95%CI 1.02-2.68），P = 0.040。在对年龄、性别和诊室收缩压匹配的隐匿性高血压和持续性正常血压的posthoc 分析中，这些相关性相似。
隐匿性高血压与 CVD 标志物有关。这表明，即使在基于人群的随机招募中，使用相同的测量设备进行家庭 BP 测量，其也是更好的风险预测指标。
