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Non-invasive Assessment of Microvascular and Endothelial Function
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平均每日血压,而不是办公室血压,决定了高血压患者的心脏功能
W B White1, P Schulman, E J McCabe
1Section of Hypertension, University of Connecticut School of Medicine, Farmington 06032.
JAMA
|February 10, 1989
概括
办公室高血压,或仅在医生的办公室血压升高,似乎不会导致心脏病. 门诊血压监测是预测高血压患者心脏损伤的关键.
科学领域:
- 心脏病学 心脏病学
- 高血压研究 高血压研究
- 诊断医学 诊断医学
背景情况:
- 高血压是心脏病的重要危险因素.
- 办公室和办公室外血压读数之间的差异可能会使诊断复杂化.
- 评估隔离办公室高血压患者的心脏状况需要进一步调查.
研究的目的:
- 为了调查高血压患者的心脏病的存在,有不同的血压测量.
- 将办公室高血压患者的心脏结构和功能与白天高血压和正常血压患者进行比较.
- 确定不同血压测量方法对心脏末端器官损伤的预测值.
主要方法:
- 对三组年龄相匹配的患者进行前性研究:办公室高血压患者,正常血压患者和白天高血压患者.
- 根据休 (办公室) 和清醒的门诊血压读数进行分类.
- 评估心脏参数,包括左心房指数,左心室质量指数,左心室填充率和喷射率.
主要成果:
- 与白天高血压患者相比,办公室高血压患者的左心房和左心室质量指数明显较低.
- 办公室高血压患者的心脏功能 (填充率,喷射率) 与正常血压患者相似,并且优于白天高血压患者.
- 在办公室高血压患者和正常血压患者之间没有观察到心脏大小和功能的显著差异.
结论:
- 仅在医生办公室内血压升高与心脏大小和功能相关,与正常血压个体相比.
- 门诊血压监测,反映平均每日血压,是心脏末端器官损伤的更可靠的预测指标,而不是仅仅是办公室读数.
- 准确的高血压诊断和风险分层应该包括室外血压测量.
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