Amar J, Bieler L, Salvador M, Chamontin B
Service de médecine interne et d'hypertension artérielle, CHU, Purpan, Toulouse.
Arch Mal Coeur Vaiss. 1997 Aug;90(8):1075-8.
Recent epidemiological studies have reported an association between carotid intima media thickness (IMT), ambulatory blood pressure (ABP) and absolute cardiovascular risk. To study the relation between white coat effect and vascular changes in hypertensives (HT), 57 essential HT (office blood pressure (OBP) 152.2 +/- 19.5/93.7 +/- 12.4 mmHg) were recruited (46.4 +/- 11.8 years old, 49 men). After antihypertensive drugs withdrawal, an ABP was performed (Spacelabs 90207). The right common carotid artery IMT 3 cm proximal to the bifurcation was examined by ultrasonography. IMT (0.59 +/- 0.09 mm; Software lotec system) were measured by a reader blinded to the ABP data. White coat hypertension (WCH) was defined by a mean day-time ambulatory BP (d-ABP) lower than the 90th percentile of the distribution of daytime ABP of a normotensive population reported by Verdecchia et al. (131/86 mmHg in women and 136/87 mmHg in men). [table: see text] White coat hypertension was found in 8 from 57 (14%) subjects. IMT was significantly increased in ambulatory HT when compared with white coat HT while age, sex ratio, OBP, smoking status were not different. In stepwise regression age and systolic d-ABP were the only determinants of IMT (p < 0.05). In our hypertensive population. ABP appears more closely related to IMT than OBP and IMT in sustained is greater than in white coat hypertensive.
近期的流行病学研究报告了颈动脉内膜中层厚度（IMT）、动态血压（ABP）与绝对心血管风险之间的关联。为研究高血压患者（HT）的白大衣效应与血管变化之间的关系，招募了57例原发性高血压患者（诊室血压（OBP）为152.2±19.5/93.7±12.4 mmHg）（年龄46.4±11.8岁，男性49例）。停用抗高血压药物后，进行动态血压监测（使用Spacelabs 90207）。通过超声检查右侧颈总动脉分叉近端3 cm处的IMT。由对ABP数据不知情的一名阅片者测量IMT（0.59±0.09 mm；使用Lotec软件系统）。白大衣高血压（WCH）的定义为日间动态平均血压（d-ABP）低于Verdecchia等人报告的正常血压人群日间ABP分布的第90百分位数（女性为131/86 mmHg，男性为136/87 mmHg）。[见表：原文]57例受试者中有8例（14%）被发现患有白大衣高血压。与白大衣高血压患者相比，动态高血压患者的IMT显著增加，而年龄、性别比例、OBP、吸烟状况无差异。在逐步回归分析中，年龄和收缩期d-ABP是IMT的唯一决定因素（p<0.05）。在我们的高血压人群中，ABP似乎比OBP与IMT的关系更密切，持续性高血压患者的IMT大于白大衣高血压患者。
