Department of Cardiology, Dongguk University Ilsan Hospital, Goyang-si 10326, Gyeonggi-do, Republic of Korea.
College of Medicine, Dongguk University, Gyeongju-si 38066, Gyeongsangbuk-do, Republic of Korea.
Medicina (Kaunas). 2024 Sep 18;60(9):1522. doi: 10.3390/medicina60091522.
: We evaluated the prevalence and characteristics of isolated nighttime masked uncontrolled hypertension (IN-MUCH) in treated patients. : Participants aged 20 years or older who were on antihypertensive medication underwent three-day office blood pressure (BP) and 24 h ambulatory BP measurements. Hypertension phenotypes were classified as controlled hypertension (CH), isolated daytime masked uncontrolled hypertension (ID-MUCH), IN-MUCH, and daytime and nighttime masked uncontrolled hypertension (DN-MUCH). : Among 701 participants, 544 had valid BP data and controlled office BP (<140/90 mmHg). The prevalence of IN-MUCH was 34.9%, with a higher prevalence of men and drinkers than in those with CH. Patients with IN-MUCH had higher office systolic BP (SBP) and diastolic BP (DBP) than those with CH. The prevalence of IN-MUCH was 37.6%, 38.5%, and 27.9% in patients with optimal, normal, and high-normal office BP levels, respectively. Among IN-MUCH patients, 51.6% exhibited isolated uncontrolled DBP and 41.1% uncontrolled SBP and DBP. Younger age ( = 0.043), male sex ( = 0.033), and alcohol consumption ( = 0.011) were more prevalent in patients with isolated uncontrolled DBP than in those with uncontrolled SBP and DBP. Age and alcohol consumption were positively associated, whereas high-normal office BP exhibited a negative association with IN-MUCH. : The IN-MUCH was significantly more prevalent in patients with normal or optimal office BP, posing treatment challenges. Further investigation is needed to determine whether differentiation between isolated uncontrolled DBP and combined uncontrolled SBP and DBP is necessary for prognostic assessment of IN-MUCH.
我们评估了治疗患者中孤立夜间未控制的高血压（IN-MUCH）的患病率和特征。参与者年龄在 20 岁或以上，正在服用抗高血压药物，进行了三天的门诊血压（BP）和 24 小时动态血压测量。高血压表型分为控制的高血压（CH）、孤立日间未控制的高血压（ID-MUCH）、IN-MUCH、日间和夜间未控制的高血压（DN-MUCH）。在 701 名参与者中，544 名有有效的 BP 数据和控制的门诊 BP（<140/90mmHg）。IN-MUCH 的患病率为 34.9%，男性和饮酒者的患病率高于 CH 患者。IN-MUCH 患者的门诊收缩压（SBP）和舒张压（DBP）高于 CH 患者。在门诊 BP 水平为最佳、正常和高正常的患者中，IN-MUCH 的患病率分别为 37.6%、38.5%和 27.9%。在 IN-MUCH 患者中，51.6%的患者表现为孤立的未控制的 DBP，41.1%的患者表现为未控制的 SBP 和 DBP。年龄较小（=0.043）、男性（=0.033）和饮酒（=0.011）在孤立的未控制的 DBP 患者中比在未控制的 SBP 和 DBP 患者中更为常见。年龄和饮酒呈正相关，而高正常的门诊 BP 与 IN-MUCH 呈负相关。在门诊 BP 正常或最佳的患者中，IN-MUCH 的患病率显著更高，这对治疗构成了挑战。需要进一步研究，以确定在预后评估 IN-MUCH 时，是否需要区分孤立的未控制的 DBP 和联合的未控制的 SBP 和 DBP。
