Detection of carotid atherosclerosis in individuals with masked hypertension and white-coat hypertension by self-measured blood pressure at home: The Ohasama Study

被引:79
作者
Hara, Azusa
Ohkubo, Takayoshi
Kikuya, Masahiro
Shintani, Yoriko
Obara, Taku
Metoki, Hirohito
Inoue, Ryusuke
Asayama, Kei
Hashimoto, Takanao
Harasawa, Toshiya
Aono, Yoko
Otani, Harunori
Tanaka, Kazushi
Hashimoto, Junichiro
Totsune, Kazuhito
Hoshi, Haruhisa
Satoh, Hiroshi
Imai, Yutaka
机构
[1] Tohoku Univ, Grad Sch Pharmaceut Sci & Med, Dept Clin Pharmacol & Therapeut, Sendai, Miyagi 980, Japan
[2] Tohoku Univ, Grad Sch Pharmaceut Sci & Med, Dept Planning Drug Dev & Clin Evaluat, Sendai, Miyagi 980, Japan
[3] Tohoku Univ, Grad Sch Pharmaceut Sci & Med, Dept Environm Hlth Sci, Sendai, Miyagi 980, Japan
[4] Tohoku Univ, Century COE Program 21, Comprehens Res & Educ Ctr Planning Drug Dev & Cli, Sendai, Miyagi 980, Japan
关键词
home blood pressure; masked hypertension; white-coat hypertension; carotid atherosclerosis; general population;
D O I
10.1097/HJH.0b013e3280115bbf
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objective To investigate carotid atherosclerosis in individuals with masked hypertension (MHT) and white-coat hypertension (WCHT) in a general population. Methods Self-measurement of blood pressure at home (HBP) and casual blood pressure (CBP) measurements were recorded in 812 individuals aged at least 55 years (mean 66.4 years) from the general Japanese population. The intima-media thickness (IMT) of the near and far wall of both common carotid arteries was measured and averaged. The relationships between carotid atherosclerosis (IMT and plaque) and the four blood pressure groups (sustained normal blood pressure: HBP < 135/85 mmHg, CBP < 140/ 90 mmHg; WCHT: HBP < 135/85 mmHg, CBP < 140/ 90 mmHg; MHT: HBP < 135/85 mmHg, CBP < 140/ 90 mmHg; sustained hypertension: HBP >= 135/85 mmHg, CBP >= 140/90 mmHg) were examined using multivariate analysis adjusted for possible confounding factors. Results Adjusted IMT in individuals with sustained hypertension [0.77 mm; 95% confidence interval (Cl) 0.75 to 0.79 mm] and MHT (0.77 mm; 95% Cl 0.73 to 0.80 mm) was significantly greater than in those with sustained normal blood pressure (0.71 mm; 95% Cl 0.69 to 0.72 mm) and WCHT (0.72 mm; 95% Cl 0.71 to 0.74 mm) (P < 0.0001). The odds ratios for the presence of plaques in all four groups were similar to the trends in IMT. Conclusions Our findings imply that CBP measurements alone are insufficient to distinguish individuals at high risk of carotid atherosclerosis from those at low risk. However, these individuals do have distinct HBP measurements, suggesting that HBP measurement could become a valuable tool for predicting carotid atherosclerosis. J Hypertens 25:321 -327 (c) 2007 Lippincott Williams & Wilkins.
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收藏
页码:321 / 327
页数:7
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