Discrepancy between screening blood pressure and ambulatory blood pressure: A community-based study in Ohasama

被引:15
作者
Aihara, A
Imai, Y
Sekino, M
Kato, J
Ito, S
Ohkubo, T
Tsuji, I
Satoh, H
Hisamichi, S
Nagai, K
机构
[1] Tohoku Univ, Sch Med, Dept Med, Sendai, Miyagi 9808574, Japan
[2] Tohoku Univ, Sch Med, Dept Publ Hlth, Sendai, Miyagi 9808574, Japan
[3] Tohoku Univ, Sch Med, Dept Environm Hlth Sci, Sendai, Miyagi 9808574, Japan
[4] Ohasama Prefectural Hosp, Ohasama, Iwate, Japan
来源
HYPERTENSION RESEARCH-CLINICAL AND EXPERIMENTAL | 1998年 / 21卷 / 02期
关键词
screening blood pressure; ambulatory blood pressure; white coat effect; blood pressure variability; pulse rate;
D O I
10.1291/hypres.21.127
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
We investigated factors underlying discrepancy between screening blood pressure and daytime ambulatory blood pressure(the difference) in a community-based population in northeastern Japan. Screening and ambulatory pressures were measured in 706 untreated subjects aged 20 yr or older. We analyzed the effects of age and blood pressure on the difference and then performed multivariate stepwise linear regression analysis using the difference as the dependent variable. The systolic difference positively correlated with age in men. Women in their 40s exhibited a large difference, disturbing the linear relationship between the difference and age. The difference positively correlated with the screening pressure in men and women. A positive difference (screening pressure > ambulatory pressure) was observed at screening pressures above 130/75 mmHg. The difference inversely correlated with the ambulatory pressure. Multivariate analysis demonstrated that body mass index and male sex were positively associated with the systolic and diastolic blood pressure differences. The daytime pulse rate was negatively associated with the systolic difference, and the standard deviation of daytime diastolic ambulatory blood pressure was positively associated with the diastolic difference. The diastolic difference in subjects with isolated systolic hypertension based on the screening pressure was significantly smaller than that in subjects with systolic/diastolic hypertension. The difference in subjects with isolated systolic hypertension based on ambulatory pressure was significantly higher than that in systolic/diastolic hypertension. When white-coat (isolated screening) hypertension was defined as a screening systolic pressure greater than or equal to 140 mmHg, a diastolic pressure greater than or equal to 90 mmHg, or both, and a 24-h ambulatory pressure <136/87 mmHg in men and <131/86 mmHg in women, white-coat (isolated screening) hypertension was present in 79 (56.8%) of 139 subjects with screening hypertension. The results confirm that the discrepancy between screening and ambulatory blood pressure is due to a variety of factors, including age, sex, blood pressure levels, and baroreflex function. Our results indicate that screening blood pressure in elderly hypertensive patients should be evaluated carefully.
引用
收藏
页码:127 / 136
页数:10
相关论文
共 48 条
[1]  
[Anonymous], 1991, AMBULATORY MONITORIN
[2]  
ARMITAGE P, 1996, CLIN SCI, V3, P325
[3]   MECHANISMS CONCERNED WITH BLOOD-PRESSURE VARIABILITY THROUGHOUT THE DAY [J].
CONWAY, J ;
BOON, N ;
JONES, JV ;
SLEIGHT, P .
CLINICAL AND EXPERIMENTAL HYPERTENSION PART A-THEORY AND PRACTICE, 1985, 7 (2-3) :153-157
[4]   AMBULATORY BLOOD-PRESSURE RECORDINGS - REPRODUCIBILITY AND UNPREDICTABILITY [J].
DESCOMBES, BJ ;
PORCHET, M ;
WAEBER, B ;
BRUNNER, HR .
HYPERTENSION, 1984, 6 (01) :110-114
[5]   LEFT-VENTRICULAR HYPERTROPHY IN PATIENTS WITH HYPERTENSION - IMPORTANCE OF BLOOD-PRESSURE RESPONSE TO REGULARLY RECURRING STRESS [J].
DEVEREUX, RB ;
PICKERING, TG ;
HARSHFIELD, GA ;
KLEINERT, HD ;
DENBY, L ;
CLARK, L ;
PREGIBON, D ;
JASON, M ;
KLEINER, B ;
BORER, JS ;
LARAGH, JH .
CIRCULATION, 1983, 68 (03) :470-476
[6]   THE USE OF SHORT-TERM AMBULATORY BLOOD-PRESSURE MONITORING IN DIFFERING FORMS OF HYPERTENSION [J].
DRAYER, JIM ;
WEBER, MA ;
DEYOUNG, JL .
CLINICAL AND EXPERIMENTAL HYPERTENSION PART A-THEORY AND PRACTICE, 1983, 5 (10) :1597-1610
[7]  
FLORAS JS, 1981, LANCET, V2, P107
[8]  
FLORAS JS, 1982, HYPERTENSIVE CARDIOV, P104
[9]  
FOTHERBY MD, 1994, J HUM HYPERTENS, V8, P107
[10]  
GIFFORD RW, 1993, ARCH INTERN MED, V153, P154