Significance of White-Coat Hypertension in Older Persons With Isolated Systolic Hypertension A Meta-Analysis Using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Population

被引：156

作者：

Franklin, Stanley S. ^{[2
]}

Thijs, Lutgarde ^{[1
]}

Hansen, Tine W. ^{[3
]}

Li, Yan ^{[4
,5
]}

Boggia, Jose ^{[6
,7
]}

Kikuya, Masahiro ^{[8
]}

Bjoerklund-Bodegard, Kristina ^{[9
]}

Ohkubo, Takayoshi ^{[8
]}

Jeppesen, Jorgen ^{[10
]}

Torp-Pedersen, Christian ^{[10
]}

Dolan, Eamon ^{[11
]}

Kuznetsova, Tatiana ^{[1
]}

Stolarz-Skrzypek, Katarzyna ^{[12
]}

Tikhonoff, Valerie ^{[13
]}

Malyutina, Sofia ^{[14
]}

Casiglia, Edoardo ^{[13
]}

Nikitin, Yuri ^{[14
]}

Lind, Lars ^{[9
]}

Sandoya, Edgardo ^{[15
]}

Kawecka-Jaszcz, Kalina ^{[12
]}

Imai, Yutaka ^{[8
]}

Wang, Jiguang ^{[4
,5
]}

Ibsen, Hans ^{[16
,17
]}

O'Brien, Eoin ^{[18
]}

Staessen, Jan A. ^{[1
,19
]}

机构：

[1] Univ Louvain, Lab Hypertens, Studies Coordinating Ctr, Dept Cardiovasc Sci,Div Hypertens & Cardiaovasc R, B-3000 Louvain, Belgium

[2] Univ Calif Irvine, Sch Med, Div Cardiol, Irvine, CA USA

[3] Univ Copenhagen Hosp, Rigshosp, Dept Clin Physiol, Nucl Med & PET, DK-2100 Copenhagen, Denmark

[4] Shanghai Jiao Tong Univ, Sch Med, Shanghai Inst Hypertenson, Ctr Epidemiol Studies & Clin Trials,Ruijin Hosp, Shanghai 200030, Peoples R China

[5] Shanghai Jiao Tong Univ, Sch Med, Shanghai Inst Hypertenson, Ctr Vasc Evaluat,Ruijin Hosp, Shanghai 200030, Peoples R China

[6] Univ Republica, Hosp Clin, Dept Fisiopatol, Montevideo, Uruguay

[7] Univ Republica, Hosp Clin, Ctr Nefrol, Montevideo, Uruguay

[8] Tohoku Univ, Grad Sch Pharmaceut Sci & Med, Sendai, Miyagi 980, Japan

[9] Uppsala Univ, Dept Publ Hlth & Caring Sci, Sect Geriatr, Uppsala, Sweden

[10] Univ Copenhagen Hosp, DK-2100 Copenhagen, Denmark

[11] Addenbrookes Hosp, Cambridge Univ Hosp, Cambridge, England

[12] Jagiellonian Univ, Coll Med, Dept Cardiol & Hypertens 1, Krakow, Poland

[13] Univ Padua, Dept Clin & Expt Med, Padua, Italy

[14] Inst Internal Med, Novosibirsk, Russia

[15] Asociac Espanola Primera Socorros Mutuos, Montevideo, Uruguay

[16] Aarhus Univ, Holbak Hosp, Holbaek, Denmark

[17] Holbak Hosp, Div Cardiol, Holbaek, Denmark

[18] Univ Coll Dublin, Conway Inst Biomol & Biomed Res, Dublin 2, Ireland

[19] Maastricht Univ, Dept Epidemiol, Maastricht, Netherlands

来源：

HYPERTENSION | 2012年 / 59卷 / 03期

基金：

欧洲研究理事会; 中国国家自然科学基金;

关键词：

isolated systolic hypertension; ambulatory blood pressure; white-coat hypertension; white-coat effect; cardiovascular disease; epidemiology; PROGNOSTIC-SIGNIFICANCE; PULSE PRESSURE; RISK; HOME; MORTALITY; TERM; PREDICTOR; MORBIDITY; NORMALITY; DISEASE;

D O I：

10.1161/HYPERTENSIONAHA.111.180653

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

The significance of white-coat hypertension in older persons with isolated systolic hypertension remains poorly understood. We analyzed subjects from the population-based 11-country International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes database who had daytime ambulatory blood pressure (BP; ABP) and conventional BP (CBP) measurements. After excluding persons with diastolic hypertension by CBP (>= 90 mm Hg) or by daytime ABP (>= 85 mm Hg), a history of cardiovascular disease, and persons<18 years of age, the present analysis totaled 7295 persons, of whom 1593 had isolated systolic hypertension. During a median follow-up of 10.6 years, there was a total of 655 fatal and nonfatal cardiovascular events. The analyses were stratified by treatment status. In untreated subjects, those with white-coat hypertension (CBP >= 140/<90 mm Hg and ABP<135/<85 mm Hg) and subjects with normal BP (CBP<140/<90 mm Hg and ABP<135/<85 mm Hg) were at similar risk (adjusted hazard rate: 1.17 [95% CI: 0.87-1.57]; P=0.29). Furthermore, in treated subjects with isolated systolic hypertension, the cardiovascular risk was similar in elevated conventional and normal daytime systolic BP as compared with those with normal conventional and normal daytime BPs (adjusted hazard rate: 1.10 [95% CI: 0.79-1.53]; P = 0.57). However, both treated isolated systolic hypertension subjects with white-coat hypertension (adjusted hazard rate: 2.00; [95% CI: 1.43-2.79]; P<0.0001) and treated subjects with normal BP (adjusted hazard rate: 1.98 [95% CI: 1.49-2.62]; P<0.0001) were at higher risk as compared with untreated normotensive subjects. In conclusion, subjects with sustained hypertension who have their ABP normalized on antihypertensive therapy but with residual white-coat effect by CBP measurement have an entity that we have termed, "treated normalized hypertension." Therefore, one should be cautious in applying the term "white-coat hypertension" to persons receiving antihypertensive treatment. (Hypertension. 2012; 59: 564-571.). Online Data Supplement

引用

页码：564 / U96

页数：17

共 39 条

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