吸烟和超重与隐蔽性未控制高血压相关:高血压最佳治疗(HOT)亚研究

IF 2.3 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Blood Pressure Pub Date : 2021-02-01 Epub Date: 2020-07-07 DOI:10.1080/08037051.2020.1787815

Magnus Holanger, Sverre E Kjeldsen, Kenneth Jamerson, Stevo Julius

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引用次数: 9

摘要

目的:高血压最佳治疗(HOT)研究对18790例50-80岁患者的目标办公室舒张压(BP)≤80、≤85或≤90 mmHg与心血管发病率和死亡率的关系进行了研究。家庭血压亚组研究招募了926名患者，目的是澄清办公室中血压目标组的分离是否在办公室外的环境中普遍存在。本研究旨在确定表征隐性非控制高血压(MUCH)和白大衣非控制高血压(WUCH)的变量。材料和方法:次级研究参与者在办公室测血压时，在家中测血压。正常或高血压的临界值在家中设置为≥135/85 mmHg，在办公室设置为≥140/90 mmHg。我们以家庭和办公室BP组合为因变量，采用多元和逐步多元逻辑回归分析数据。结果:WUCH与较低的体重指数(BMI)(比值比(OR) 0.92, 95%可信区间(ci) 0.88-0.96, p p = 0.0025)、较低的基线心率(OR 0.98, 95% ci 0.97-0.99, p = 0.03)和较高的BMI (OR 1.03, ci 1.00-1.06, p = 0.04)相关。当使用≥140/90 mmHg作为临界值时，MUCH仍与吸烟相关(OR 2.76, 95% ci 1.76-4.35, p p = 0.009)，而WUCH与较低的BMI相关(OR 0.93, 95% ci 0.90-0.97, p = 0.0005)。结论:我们的数据支持“逆转或掩盖”治疗但未控制的高血压(MUCH)是常见的，约占接受治疗的高血压患者的25%。这种实体(MUCH)与当前吸烟和超重密切相关，而不受控制的白大褂(办公室)高血压(WUCH)与较低的BMI相关。

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Smoking and overweight associated with masked uncontrolled hypertension: a Hypertension Optimal Treatment (HOT) Sub-Study.

Purpose: The Hypertension Optimal Treatment (HOT) Study investigated the relationship between target office diastolic blood pressure (BP) ≤80, ≤85 or ≤90 mmHg and cardiovascular morbidity and mortality in 18,790 patients aged 50-80 years. The home BP sub-study enrolled 926 patients and the aim was to clarify whether the separation into the BP target groups in the office prevailed in the out-of-office setting. The present study aimed to identify variables that characterised masked uncontrolled hypertension (MUCH) and white coat uncontrolled hypertension (WUCH).

Material and methods: The sub-study participants took their home BP when office BP had been up titrated. The cut-off for normal or high BP was set to ≥135/85 mmHg at home and ≥140/90 mmHg in the office. We analysed data by using multivariate and stepwise multivariate logistic regression with home and office BP combinations as the dependent variables.

Results: WUCH was associated with lower body mass index (BMI) (odds ratio (OR) 0.92, 95% confident intervals (CIs) 0.88-0.96, p < 0.001). MUCH was associated with smoking (OR 1.89, 95% CIs 1.25-2.86, p = 0.0025) and with lower baseline heart rate (OR 0.98, 95% CIs 0.97-0.99, p = 0.03) and higher BMI (OR 1.03, CIs 1.00-1.06, p = 0.04). MUCH remained associated with smoking (OR 2.76, 95% CIs 1.76-4.35, p < 0.0001) also when using ≥140/90 mmHg as the cut-off for both home and office BP. MUCH was also associated with higher BMI (OR 1.05, 95% CIs 1.01-1.09, p = 0.009) while WUCH was associated with lower BMI (OR 0.93, 95% CIs 0.90-0.97, p = 0.0005) when using ≥140/90 mmHg as a cut-off.

Conclusion: Our data support that 'reversed or masked' treated but uncontrolled hypertension (MUCH) is common and constitutes about 25% of treated hypertensive patients. This entity (MUCH) is rather strongly associated with current smoking and overweight while uncontrolled white coat (office) hypertension (WUCH) is associated with lower BMI.

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来源期刊

Blood Pressure 医学-外周血管病

CiteScore

3.00

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： For outstanding coverage of the latest advances in hypertension research, turn to Blood Pressure, a primary source for authoritative and timely information on all aspects of hypertension research and management. Features include: • Physiology and pathophysiology of blood pressure regulation • Primary and secondary hypertension • Cerebrovascular and cardiovascular complications of hypertension • Detection, treatment and follow-up of hypertension • Non pharmacological and pharmacological management • Large outcome trials in hypertension.