不同定义的白衣高血压的预后影响
Paolo Verdecchia1, Stefano Coiro2, Claudia Bartolini2
1Associazione Umbra Cuore e Ipertensione and Division of Cardiology, Hospital S. Maria della Misericordia, Perugia, Italy.
American journal of hypertension
|July 24, 2025
概括
白袍高血压 (WCH) 携带低心血管风险,当被定义为24小时门诊血压 (ABP) 低于125/75 mmHg时. 较高的门增加了风险,突出了精确的WCH定义对患者结果的重要性.
科学领域:
- 心脏病学 心脏病学
- 高血压研究 高血压研究
- 临床流行病学临床流行病学
背景情况:
- 白袍高血压 (WCH) 研究结果的变化可能源于不同的诊断定义.
- 准确的WCH分类对于预测长期心血管风险至关重要.
研究的目的:
- 为了研究与WCH相关的长期心血管事件和死亡风险,使用不同的24小时门诊血压 (ABP) 值.
- 为了澄清不同WCH定义的预后影响.
主要方法:
- 从1986年开始,一项纵向研究跟踪了3,153名办公室高血压患者和457名正常血压对照者.
- 参与者接受了24小时的血压监测;WCH被定义为24小时平均血压<130/80 mmHg或<125/75 mmHg.
- 主要结局是主要心血管不良事件 (MACE) 和所有原因死亡率在平均10.4年的随访期间的复合.
主要成果:
- 与正常血压患者相比,WCH和24小时ABP<125/75 mmHg的个体没有增加MACE (HR 0.94) 或死亡 (HR 1.37) 的风险.
- 然而,以24小时血压<130/80毫米血压定义的WCH与明显更高的MACE风险 (HR 1.79) 和全因死亡率 (HR 1.82) 相关.
结论:
- 使用更严格的24小时血压值 (<125/75 mmHg) 定义WCH,可以确定患有心血管事件和死亡的长期风险较低的个体.
- 升高的24小时血压值甚至略高于<125/75 mmHg的值与心血管风险增加有关,这强调了精确诊断标准的临床意义.
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