诊室和动态血压关系的可重复性和治疗效果。

IF 6.9 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Hypertension Pub Date : 2025-01-01 Epub Date: 2024-11-14 DOI:10.1161/HYPERTENSIONAHA.124.23549
Giuseppe Mancia, Rita Facchetti, Fosca Quarti-Trevano, Guido Grassi
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引用次数: 0

摘要

背景:在缺乏基于结果的动态血压(BP)数据的情况下,高血压指南提供了与试验验证的诊室血压值相对应的 24 小时平均血压值。数据显示的是未接受治疗和接受治疗的患者的血压值,但未接受治疗和接受治疗的高血压患者的相应动态血压值是否相似,以及在治疗期间每年测量的血压值是否具有可重复性,目前尚无定论:在 ELSA(欧洲拉西地平动脉粥样硬化研究)和 PHYLLIS(意大利斑块性高血压降脂研究)试验的 2397 名患者中,我们以办公室收缩压为自变量,根据线性回归模型计算了基线和 3 年治疗期间每年的办公室血压与 24 小时血压的关系。计算了与临床上重要的诊室血压值(高血压分级、治疗阈值和目标值)相对应的 24 小时血压值,并将其与指南提供的值进行了比较:结果:办公室 24 小时收缩压或舒张压始终呈显著的线性关系,但皮尔逊相关系数有限(从未大于 0.44)。与指南提供的相应值相比,24 小时血压显示出质与量的差异;例如,当诊室血压处于高血压和低血压治疗目标范围时,24 小时血压分别大大低于和高于指南相应值:结论:在接受治疗的高血压患者中,诊室/24 小时血压线性回归的斜率在一段时间内是可重复的。结论:在接受过治疗的高血压患者中,诊室血压/24 小时血压线性回归的斜率随时间推移具有可重复性,但在未接受过治疗的患者中,斜率则更陡峭,这表明如果在这两种情况下分别估算诊室血压值对应的非卧床血压值信息,会更加准确。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reproducibility and Treatment Effect on Office and Ambulatory Pressure Relation.

Background: In the absence of outcome-based ambulatory blood pressure (BP) trails hypertension guidelines provide 24-hour mean BP values corresponding to trial-validated office BP values. Data are shown for untreated and treated patients together, but whether corresponding ambulatory values are similar in untreated and treated hypertensives and reproducible at yearly measurements during treatment is undefined.

Methods: In 2397 patients of the ELSA (European Lacidipine Study on Atherosclerosis) and PHYLLIS (Plaque Hypertension Lipid-Lowering Italian Study) trials, we calculated the office and 24-hour BP relationship according to the linear regression model, with office systolic BP as the independent variable, at baseline and yearly during a 3-year treatment. Twenty-four hour BP values corresponding to clinically important office BP values (hypertension grading and treatment thresholds and targets) were calculated and compared with those provided by guidelines.

Results: Office and 24-hour systolic BP or diastolic BP always exhibited a significant linear relationship, with, however, limited Pearson correlation coefficients (never >0.44).The slopes of the relationship were superimposable between different years of treatment but always significantly less steep than the slope seen in untreated individuals. Compared with the guideline-provided corresponding values, 24-hour BP showed qualitative and quantitative differences; for example, it was considerably lower and higher than the guideline-corresponding values when office BP was in the high hypertension and low treatment target ranges, respectively.

Conclusions: In treated patients with hypertension the slope of the office and 24-hour BP linear regression is reproducible over time. However, the slopes are steeper in untreated individuals, indicating that information on ambulatory BP values corresponding to office BP values can be more accurate if separately estimated in these 2 conditions.

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来源期刊
Hypertension
Hypertension 医学-外周血管病
CiteScore
15.90
自引率
4.80%
发文量
1006
审稿时长
1 months
期刊介绍: Hypertension presents top-tier articles on high blood pressure in each monthly release. These articles delve into basic science, clinical treatment, and prevention of hypertension and associated cardiovascular, metabolic, and renal conditions. Renowned for their lasting significance, these papers contribute to advancing our understanding and management of hypertension-related issues.
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