白袍与持续轻度高血压的心血管结局:一项为期10年的随访研究
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
概括
白袍高血压比持续的轻度高血压带来更低的心血管疾病风险. 这项研究发现,白衣高血压患者经历的事件较少,器官损伤较少.
科学领域:
- 心脏病学 心脏病学
- 高血压研究 高血压研究
- 预防医学 预防医学
背景情况:
- 高血压是心血管疾病 (CVD) 的一个主要风险因素.
- 区分白衣高血压和持续高血压对于风险评估至关重要.
- 以前的研究对白袍高血压的长期预后产生了相互矛盾的结果.
研究的目的:
- 为了比较与白衣高血压相关的心血管疾病风险与持续轻度高血压.
- 确定高临床血压患者心血管事件的预测因素.
主要方法:
- 479名临床缩血压升高 (140-180毫米升) 的患者接受了24小时的门诊血压监测.
- 针对心血管事件,患者的平均随访时间为9.1年.
- 亚组分析包括心声学和带超声检查,以评估器官损伤.
主要成果:
- 在126名患者中诊断出白衣高血压 (高临床血压,正常的门诊血压).
- 与持续高血压患者相比,白衣高血压患者年轻,心血管疾病事件的发生率显著降低 (1.32对每100个患者年2.56事件),比持续高血压患者要低得多.
- 白衣高血压是较少心血管事件 (HR,0.29;P=0.04) 的独立预测因素,较少观察到左心室和大脑动脉缩.
结论:
- 与持续的轻度高血压相比,白衣高血压与相对良性的预后有关.
- 这些发现支持对白袍高血压的不那么激进的管理方法.
- 进一步的研究可能会澄清不同高血压表型的最佳监测和治疗策略.
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