综合治疗白大衣高血压疗效观察

Efficacy observation of white coat hypertension with comprehensive therapy

目的通过对综合治疗白大衣高血压(WCH)患者166例的疗效观察,探讨合理干预治疗WCH的必要性和安全性。方法将166例合并靶器官功能损害或代谢异常的WCH患者随机分成药物加生活方式干预的综合治疗组84例和对照组82例,综合治疗组给予口服美托洛尔缓释片加运动、戒烟、低盐低脂饮食、减肥等生活方式干预治疗,对照组不进行药物和生活干预等任何治疗措施,观察两组患者血压进展和靶器官功能损害情况。结果 2年后综合治疗组发展为持续性高血压患者的例数明显低于对照组(P<0.01),体重指数(BMI)、血脂(TC、TG)和肌酐(Cre)的控制明显优于对照组(P<0.01),而室间隔(IST)和左室后壁厚度(LVPWT)的控制也优于对照组(P<0.05)。结论 WCH在合并靶器官功能损害或代谢异常时进行综合治疗能控制血压进展和靶器官功能损害,值得医患重视和临床推广。

Objective To investigate the necessity and safety of rational intervention treatment for white coat hypertension（WCH） through efficacy observation of WCH 166 cases with comprehensive therapy.Methods One hundred and fifty-six WCH cases accompanied with functional damage of target organs or abnormality of metabolism were randomly assigned into comprehensive treatment group（n = 84） with drug and life style interventions and control group（n = 82）.Subjects in the comprehensive treatment group were administrated with metoprolol sustained-release tablets and intervened with life style such as exercise,smoking cessation,diet with low salt and low fat and weight loss and so on.No treatment strategy was performed in the control group.The progress of blood pressure and functional damage of target organs were observed between the two groups.Results The number of cases developing into consistent hypertension in the comprehensive therapy group after 2 years were obviously lower than that of control group（P 0.01） while the control of BMI,TC,TG and Cre were significantly better than control group.Meanwhile the control of IST and LVPWT were better than control group（P 0.05）.Conclusion Comprehensive treatment may control the progress of blood pressure and functional damage of target organs in WCH accompanied with functional damage or metabolism abnormality,which may be worth of being promoted in clinical practice and notified by doctors and patients.