摘要
背景:隐性高血压(MH)的患病率远非可以忽略的,在某些研究中甚至达到了40%。SHEAF(老年人在家中自测血压的评价与随访)研究和其他研究清楚地表明,
CONTEXT:Prevalence of masked hypertension(MH) is far from negligible reaching 40%in some studies. The SHEAF study(Self measurement of blood pressure at Home in the Elderly:Assessment and Follow-Up) and others clearly showed that masked hypertension(MH) as detected by home blood pressure measurement(HBPM) is associated with poor cardiovascular prognosis. OBJECTIVE:Systematic HBPM to detect MH is not yet routine. The aim of this work is to better define the clinical profile of masked hypertensives within a population with controlled office blood pressure(BP) and the factors associated with a higher prevalence of MH. MATERIALS AND METHODS:BP was measured at the clinic by the doctor and at home by the patient himself. Risk factors for MH were analysed in a cohort of 1150 treated hypertensive patients over the age of 60(mean age 70±6.5,48.9%men) with controlled office BP(SBP< 140 mmHg and DBP< 90 mmHg). RESULTS:463 patients(40%) were masked hypertensives(SBP≥135 mmHg or DBP≥85 mmHg at home). Three parameters were associated with MH(odds ratio OR):office SBP(OR=1.110),male gender(OR=2.214) and age(OR=1.031). Decision trees showed a 130 mmHg SBP was an efficient threshold to propose HBPM with a higher probability to detect MH. Subsequent variables were male gender and age over 70 in males. CONCLUSION:To detect masked hypertension,it would be logical to first of all select patients whose office SBP is between 130 and 140 mmHg.
