Guagnano M T, Pace-Palitti V, Murri R, Marchione L, Merlitti D, Sensi S
Institute of Internal Medicine, University of Chieti, Italy.
J Hum Hypertens. 1996 Sep;10(9):619-24.
Until now the different epidemiological studies performed have yielded widely different results in terms of the prevalence of hypertension in obese patients. This is mainly due to methodological errors in blood pressure (BP) measurements, including such false positives as white-coat or cuff hypertension, and more recently, to the different distribution in the study population of obese subjects at risk of hypertension (android obesity type). In 803 obese outpatient women (body mass index range: 28-45) randomly selected and subdivided into younger and older groups, and into android and gynaecoid, the casual BP was measured in the morning with a large size cuff. In addition, in 82 obese outpatients casual BP was measured simultaneously with the large and a standard size cuff. Another group of 94 patients was submitted to 24-h ambulatory blood pressure monitoring (ABPM). The aim was to observed if the use of inappropriate cuffs, or the incidence of white-coat hypertension and the prevalence of obese subjects at risk of hypertension, may contribute considerably to overestimating the prevalence of hypertension in obesity. The hypertension prevalence rate was 37.6% for the entire study group. The prevalence rate was 26.2% in women with gynaecoid type of obesity and 47.1% in android obese subjects. We could conclude that the use of inappropriate cuffs, office or white-coat hypertension and the prevalence of obese subjects at risk of hypertension, may contribute considerably to overestimating the prevalence of hypertension in obesity. The number of hypertensive subjects in younger obese subjects with gynaecoid fat distribution is similar to non-obese subjects who are age-adjusted, but our data confirm that the prevalence of hypertension in android type of obesity is significantly higher than in non-obese subjects.
到目前为止，所进行的不同流行病学研究在肥胖患者高血压患病率方面得出了大不相同的结果。这主要是由于血压测量中的方法学错误，包括白大褂高血压或袖带高血压等假阳性情况，以及最近研究人群中具有高血压风险的肥胖受试者（男性型肥胖）分布不同。在随机选取并细分为年轻组和老年组、男性型和女性型的803名肥胖门诊女性（体重指数范围：28 - 45）中，早晨使用大号袖带测量偶测血压。此外，在82名肥胖门诊患者中同时使用大号袖带和标准尺寸袖带测量偶测血压。另一组94名患者接受了24小时动态血压监测（ABPM）。目的是观察使用不合适的袖带、白大褂高血压的发生率以及具有高血压风险的肥胖受试者的患病率是否可能在很大程度上导致高估肥胖人群中的高血压患病率。整个研究组的高血压患病率为37.6%。女性型肥胖女性的患病率为26.2%，男性型肥胖受试者的患病率为47.1%。我们可以得出结论，使用不合适的袖带、诊室或白大褂高血压以及具有高血压风险的肥胖受试者的患病率可能在很大程度上导致高估肥胖人群中的高血压患病率。年轻且具有女性型脂肪分布的肥胖受试者中的高血压患者数量与年龄调整后的非肥胖受试者相似，但我们的数据证实男性型肥胖中的高血压患病率显著高于非肥胖受试者。
