腹膜透析患者家庭血压监测定义的隐蔽性高血压的患病率及危险因素分析

Prevalence and determinants of masked hypertension defined by home blood pressure monitoring in peritoneal dialysis patients

目的调查腹膜透析(peritoneal dialysis,PD)患者家庭血压监测定义的隐蔽性高血压的患病率并分析其相关危险因素。方法采用横断面研究的方法,收集2006年1月1日至2013年12月31日在中山大学附属第一医院PD中心开始行PD的患者的人口学、临床和生化检查资料。分析PD患者家庭血压监测定义的隐蔽性高血压的患病率和临床特点,并采用多因素Logistic回归分析法分析诊室血压正常PD患者发生隐蔽性高血压的危险因素。结果共纳入1425例PD患者,其中男性866例,年龄为(46.9±14.9)岁,体重指数为(21.6±3.1)kg/m2。PD患者中隐蔽性高血压患病率为31.9%,诊室血压正常的PD患者隐蔽性高血压患病率为57.5%。多因素Logistic回归分析结果显示,高体重指数(OR=1.057,95%CI 1.001~1.116,P=0.047)、合并糖尿病(OR=1.996,95%CI 1.160~3.433,P=0.013)、使用多种降压药(OR=1.336,95%CI 1.122~1.590,P=0.001)和高诊室血压(OR=1.785,95%CI 1.546~2.060,P<0.001)是诊室血压正常PD患者发生隐蔽性高血压的独立危险因素。结论PD患者隐蔽性高血压的患病率高,高体重指数、合并糖尿病、使用多种降压药、高诊室血压是诊室血压正常PD患者发生隐蔽性高血压的独立危险因素。

Objective To evaluate the prevalence of masked hypertension defined by home blood pressure monitoring in patients on peritoneal dialysis(PD)and examine its determinants.Methods The patients who performed PD in the First Affiliated Hospital of Sun Yat-sen University from January 1,2006 to December 31,2013 were recruited.Baseline demographic,clinical and biochemical examination data were collected to analyze the prevalence and clinical characteristics in patients with masked hypertension defined by home blood pressure monitoring.Multivariate logistic regression model was used to analyze the related risk factors of masked hypertension in PD patients with clinic normotension.Results There were 1425 patients(866 males)enrolled in this study,with age of(46.9±14.9)years and body mass index of(21.6±3.1)kg/m2.The prevalence of masked hypertension in PD patients was 31.9%,and the prevalence of masked hypertension in patients with clinic normotension was 57.5%.Multivariate logistic regression analysis showed that higher body mass index(OR=1.057,95%CI 1.001-1.116,P=0.047),incorporating diabetes mellitus(OR=1.996,95%CI 1.160-3.433,P=0.013),use of multiple antihypertensive drugs(OR=1.336,95%CI 1.122-1.590,P=0.001)and elevated office blood pressure(OR=1.785,95%CI 1.546-2.060,P<0.001)were independent risk factors of masked hypertension in PD patients with clinic normotension.Conclusions The prevalence of masked hypertension is high in PD patients.Higher body mass index,incorporating diabetes mellitus,use of multiple antihypertensive drugs and elevated office blood pressure are independent risk factors for masked hypertension in PD patients with clinic normotension.