Skladany Lubomir, Adamcova Selcanova Svetlana, Liptak Lukas, Dedinska Ivana
Bratisl Lek Listy. 2024;125(9):564-571. doi: 10.4149/BLL_2024_88.
One of the most prevalent influenceable risk factors for poor cardiovascular outcome is arterial hypertension.This is a prospective analysis of liver transplant recipients in which 24-hour blood pressure (BP) measurement was performed. The primary aim was to identify post-LT (liver transplantation) patients without a history of arterial hypertension who meet the criteria for arterial hypertension using 24-hour BP monitoring. Secondary objectives were to determine how many patients with known treated arterial hypertension had suboptimal BP control. The group included 88 patients (men, 52.3%, history of arterial hypertension group: n=56, no history of arterial hypertension group: n=32) with an average age at the time of measurement of 62.4 years±11. The average time since LT at the time of measurement was 45.2 months. De novo arterial hypertension using 24-hour BP monitoring was diagnosed in 28%. Hypertonic changes in the fundus oculi were confirmed as predictor for suboptimally controlled hypertension [OR 5,1265, p=0.0279]. On the other hand, male sex [OR 3.1840, p=0.0311], together with age [OR 1.3347, p=0.0153] and waist circumference [OR 4.3490, p=0.0418] predicted the need of intensification of antihypertensive treatment. Male sex, age and waist circumference should increase the index of suspicion and lead to zoom-in on a possibility of poorly controlled blood pressure. Where automated blood pressure monitoring is unavailable, regular examination of the fundus could serve as an available surrogate marker of suboptimally controlled arterial hypertension (Tab.6, Fig. 1, Ref. 36). Text in PDF www.elis.sk Keywords: liver transplantation, arterial hypertension, automated blood pressure monitoring.
心血管不良预后最常见的可干预风险因素之一是动脉高血压。这是一项对肝移植受者进行的前瞻性分析,其中进行了24小时血压(BP)测量。主要目的是使用24小时血压监测识别无动脉高血压病史但符合动脉高血压标准的肝移植后(LT)患者。次要目标是确定已知接受治疗的动脉高血压患者中有多少血压控制不理想。该组包括88名患者(男性占52.3%,有动脉高血压病史组:n = 56,无动脉高血压病史组:n = 32),测量时的平均年龄为62.4岁±11岁。测量时距肝移植的平均时间为45.2个月。使用24小时血压监测诊断出28%的患者新发动脉高血压。眼底的高血压变化被确认为高血压控制不佳的预测指标[比值比5.1265,p = 0.0279]。另一方面,男性[比值比3.1840,p = 0.0311]、年龄[比值比1.3347,p = 0.0153]和腰围[比值比4.3490,p = 0.0418]预测了强化降压治疗的必要性。男性、年龄和腰围应增加怀疑指数,并导致关注血压控制不佳的可能性。在无法进行自动血压监测的情况下,定期眼底检查可作为动脉高血压控制不佳的可用替代指标(表6,图1,参考文献36)。www.elis.sk上的PDF文本关键词:肝移植、动脉高血压、自动血压监测