ホワイトコートと持続的な軽度の高血圧における心血管的アウトカム: 10年間の追跡調査研究
R S Khattar1, R Senior, A Lahiri
1Department of Cardiovascular Medicine, Northwick Park, and St Mark's Hospital NHS Trust and Institute for Medical Research, Harrow, Middlesex, UK.
Circulation
|November 3, 1998
まとめ
ホワイトコートの高血圧は,持続的な軽度の高血圧よりも心血管疾患のリスクが低い. この研究では,ホワイトコートの高血圧患者は,事件が少なく,臓器の損傷が少ないことを発見しました.
科学分野:
- 心臓病学 心臓病学
- 高血圧の研究 高血圧の研究
- 予防医学は,予防的な医療です.
背景:
- 高血圧は,心血管疾患 (CVD) の主要な危険因子です.
- ホワイトコート高血圧と持続高血圧の区別は,リスク評価において極めて重要です.
- 以前の研究は,ホワイトコート高血圧の長期的予後について矛盾する結果をもたらしました.
研究 の 目的:
- ホワイトコートの高血圧と持続的な軽度の高血圧に関連した心血管疾患のリスクを比較するために.
- 高血圧の臨床患者の心血管疾患の予測要因を特定する.
主な方法:
- 479人の臨床シストリック血圧上昇 (140-180 mm Hg) の患者は,24時間通院式血圧モニタリングを受けました.
- 患者は,心血管疾患について平均9.1年間追跡された.
- サブグループ分析には,臓器損傷を評価するために,エコーカルディオグラフィーと頸動脈超音波が含まれていました.
主要な成果:
- ホワイトコート高血圧 (臨床高血圧,常 ambulatory BP) は126人の患者に診断されました.
- ホワイトコートの高血圧患者は,持続した高血圧患者と比較して,より若く,CVDイベントの発生率が著しく低下していました (100患者年当たり1.32対2.56イベント).
- ホワイトコートの高血圧は,心血管疾患の発生率の減少 (HR,0.29;P=0.04) の独立した予測因子であり,左心室および頸動脈縮の減少が観察されました.
結論:
- ホワイトコートの高血圧は,持続的な軽度の高血圧と比較して比較的良性的な予後に関連しています.
- これらの発見は,ホワイトコート高血圧に対するより積極的な管理アプローチを支持します.
- さらなる研究により,異なる高血圧フェノタイプに対する最適なモニタリングと治療戦略を明確にすることができます.
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