In this paper, we evaluate the difference between the first and second measurements of blood pressure (BP) when BP is measured twice using the results of 17,775 medical checkups. The two measurements for both systolic...In this paper, we evaluate the difference between the first and second measurements of blood pressure (BP) when BP is measured twice using the results of 17,775 medical checkups. The two measurements for both systolic BP (SBP) and the diastolic BP (DBP) fluctuated a large amount even though they were measured at a short interval. The first measurements were 6.7 and 2.4 mmHg higher than the second ones for SBP and DBP, suggesting a white coat effect. Then, the factors that might affect the differences between the two measurements were analyzed by the regression models. For both SBP and DBP, the difference increased as the first measurement increased. Age, gender, BMI and alcohol consumption were other important factors affecting the difference. In the case of a typical male individual, the typical criteria for hypertension of 140/90, 160/100 and 180/110 mmHg criteria in the first measurement would correspond to 135/86, 150/94 and 165/102 mmHg in the second measurement. The necessity of developing accurate and cost-efficient BP measurement methods is strongly suggested.展开更多
Background Hypertension is the main risk factor for cardiovascular diseases, affecting more than half the elderly population. It is essential to know if they have proper control of hypertension. The aim of this study ...Background Hypertension is the main risk factor for cardiovascular diseases, affecting more than half the elderly population. It is essential to know if they have proper control of hypertension. The aim of this study was to identify the associated factors to masked uncon- trolled hypertension and false uncontrolled hypertension in older patients. Methods Two-hundred seventy-three individuals （70.1±6.7 years-old） had blood pressure （BP） measured at the office and by ambulatory BP monitoring （ABPM）, with the definition of controlled group （C）, individuals with high office BP and adequate ABPM, called white-coat effect group （WCE）, uncontrolled （UC）, and subjects with ap- propriate office BP and elevated ABPM denominated masked effect group （ME）. Age, body mass index, diabetes, pulse pressure （PP） and BP dipping during sleep were evaluated （Kruskal-Wallis test and logistic regression models）. Results Age was higher in UC than in C and ME （P 〈 0.01）, and 24-h ABPM PP was lower in C （48± 7 mmHg） and WCE （51±6 mmHg） than in UC （67±12 mmHg） and ME （59±8 mmHg） （P 〈 0.01）. Sleep systolic BP dipping was lower in ME than in C （P = 0.03）. Female gender was associated with a greater chance of being of ME group, which showed a higher PP and lower BP dipping during sleep. Conclusions In older individuals, office BP measure- ments did not allow the detection of associated factors that would permit to differentiate WCE from UC group and C from ME group. ABPM favored the identification of a higher PP and a lower BP dipping during sleep in the masked effect and uncontrolled groups.展开更多
目的探讨氟哌噻吨美利曲辛片对白大衣高血压患者白大衣效应及血压昼夜节律的影响。方法前瞻性选取120例白大衣高血压患者,进行汉密尔顿焦虑量表(HAMA)评分,HAMA总分>7分者共77例,然后将其按随机数字表法分为两组:治疗组39例,使用氟...目的探讨氟哌噻吨美利曲辛片对白大衣高血压患者白大衣效应及血压昼夜节律的影响。方法前瞻性选取120例白大衣高血压患者,进行汉密尔顿焦虑量表(HAMA)评分,HAMA总分>7分者共77例,然后将其按随机数字表法分为两组:治疗组39例,使用氟哌噻吨美利曲辛片,对照组38例,使用安慰剂。比较两组治疗前后动态血压监测各指标、诊室血压(CBP)值、白大衣效应(WCE)值、血压昼夜节律的变化。结果(1)治疗组治疗后白昼动态平均血压dSBP、dDBP略有上升(均为P<0.05),夜间动态平均血压nSBP、nDBP略有下降(均为P<0.05),24 h动态平均血压24 h SBP、24 h DBP无明显变化(均为P>0.05),对照组动态血压各指标均无明显变化(均为P>0.05),两组组间比较差异无统计学意义(均为P>0.05)。(2)治疗组治疗后CBP较治疗前有明显下降(均为P<0.01),对照组无明显变化(均为P>0.05),两组组间比较有统计学意义(均为P<0.01)。治疗组治疗后WCE值较治疗前均明显缩小(均为P<0.01),对照组无明显变化(均为P>0.05),两组组间比较差异有统计学意义(均为P<0.01)。(3)治疗组患者治疗后杓型血压昼夜节律的发生率明显升高(P=0.006),对照组无明显变化(P=1.0),两组组间比较差异有统计学意义(P=0.031)。结论氟哌噻吨美利曲辛片能明显降低伴有焦虑的白大衣高血压患者WCE值,改善血压昼夜节律,可作为此类患者的一种较好的用药选择。展开更多
目的探讨动态血压监测中存在的第1小时白大衣现象及其影响。方法选择2004—2005年门诊和病房住院的患者共626例(其中男性369例,女性257例)年龄范围13～90岁,平均年龄为(55.0±13.7)岁。所有观察对象测量诊室血压,在上午8:30—9:29...目的探讨动态血压监测中存在的第1小时白大衣现象及其影响。方法选择2004—2005年门诊和病房住院的患者共626例(其中男性369例,女性257例)年龄范围13～90岁,平均年龄为(55.0±13.7)岁。所有观察对象测量诊室血压,在上午8:30—9:29之间开始监测24小时动态血压,将此期间检测的3次血压平均值作为第1小时血压。结果所有观察对象第1小时的平均收缩压和舒张压显著高于23 h、白天、夜间和最后1 H 的平均水平(P<0.01),在不同年龄、性别组人群中也同样存在此种现象。女性中自大衣现象显著高于男性[第1小时平均血压-白天平均血压:女性:(9.5±13.4/6.0±7.8)mm Hg(1 mm Hg=0.133 kPa);男性:(5.5±11.9/4.2±7.8)mm Hg,P<0.01],而各年龄组间差异无统计学意义。结论动态血压监测中,普遍存在着明显的第1小时内血压升高的现象,建议在临床上判断血压水平和诊断中,删除第1小时的记录数据,以便更加准确客观地反映患者的真实血压水平,在临床药物疗效观察评价及科学研究中尤其重要。展开更多
文摘In this paper, we evaluate the difference between the first and second measurements of blood pressure (BP) when BP is measured twice using the results of 17,775 medical checkups. The two measurements for both systolic BP (SBP) and the diastolic BP (DBP) fluctuated a large amount even though they were measured at a short interval. The first measurements were 6.7 and 2.4 mmHg higher than the second ones for SBP and DBP, suggesting a white coat effect. Then, the factors that might affect the differences between the two measurements were analyzed by the regression models. For both SBP and DBP, the difference increased as the first measurement increased. Age, gender, BMI and alcohol consumption were other important factors affecting the difference. In the case of a typical male individual, the typical criteria for hypertension of 140/90, 160/100 and 180/110 mmHg criteria in the first measurement would correspond to 135/86, 150/94 and 165/102 mmHg in the second measurement. The necessity of developing accurate and cost-efficient BP measurement methods is strongly suggested.
文摘Background Hypertension is the main risk factor for cardiovascular diseases, affecting more than half the elderly population. It is essential to know if they have proper control of hypertension. The aim of this study was to identify the associated factors to masked uncon- trolled hypertension and false uncontrolled hypertension in older patients. Methods Two-hundred seventy-three individuals （70.1±6.7 years-old） had blood pressure （BP） measured at the office and by ambulatory BP monitoring （ABPM）, with the definition of controlled group （C）, individuals with high office BP and adequate ABPM, called white-coat effect group （WCE）, uncontrolled （UC）, and subjects with ap- propriate office BP and elevated ABPM denominated masked effect group （ME）. Age, body mass index, diabetes, pulse pressure （PP） and BP dipping during sleep were evaluated （Kruskal-Wallis test and logistic regression models）. Results Age was higher in UC than in C and ME （P 〈 0.01）, and 24-h ABPM PP was lower in C （48± 7 mmHg） and WCE （51±6 mmHg） than in UC （67±12 mmHg） and ME （59±8 mmHg） （P 〈 0.01）. Sleep systolic BP dipping was lower in ME than in C （P = 0.03）. Female gender was associated with a greater chance of being of ME group, which showed a higher PP and lower BP dipping during sleep. Conclusions In older individuals, office BP measure- ments did not allow the detection of associated factors that would permit to differentiate WCE from UC group and C from ME group. ABPM favored the identification of a higher PP and a lower BP dipping during sleep in the masked effect and uncontrolled groups.
文摘目的探讨氟哌噻吨美利曲辛片对白大衣高血压患者白大衣效应及血压昼夜节律的影响。方法前瞻性选取120例白大衣高血压患者,进行汉密尔顿焦虑量表(HAMA)评分,HAMA总分>7分者共77例,然后将其按随机数字表法分为两组:治疗组39例,使用氟哌噻吨美利曲辛片,对照组38例,使用安慰剂。比较两组治疗前后动态血压监测各指标、诊室血压(CBP)值、白大衣效应(WCE)值、血压昼夜节律的变化。结果(1)治疗组治疗后白昼动态平均血压dSBP、dDBP略有上升(均为P<0.05),夜间动态平均血压nSBP、nDBP略有下降(均为P<0.05),24 h动态平均血压24 h SBP、24 h DBP无明显变化(均为P>0.05),对照组动态血压各指标均无明显变化(均为P>0.05),两组组间比较差异无统计学意义(均为P>0.05)。(2)治疗组治疗后CBP较治疗前有明显下降(均为P<0.01),对照组无明显变化(均为P>0.05),两组组间比较有统计学意义(均为P<0.01)。治疗组治疗后WCE值较治疗前均明显缩小(均为P<0.01),对照组无明显变化(均为P>0.05),两组组间比较差异有统计学意义(均为P<0.01)。(3)治疗组患者治疗后杓型血压昼夜节律的发生率明显升高(P=0.006),对照组无明显变化(P=1.0),两组组间比较差异有统计学意义(P=0.031)。结论氟哌噻吨美利曲辛片能明显降低伴有焦虑的白大衣高血压患者WCE值,改善血压昼夜节律,可作为此类患者的一种较好的用药选择。
文摘目的探讨动态血压监测中存在的第1小时白大衣现象及其影响。方法选择2004—2005年门诊和病房住院的患者共626例(其中男性369例,女性257例)年龄范围13～90岁,平均年龄为(55.0±13.7)岁。所有观察对象测量诊室血压,在上午8:30—9:29之间开始监测24小时动态血压,将此期间检测的3次血压平均值作为第1小时血压。结果所有观察对象第1小时的平均收缩压和舒张压显著高于23 h、白天、夜间和最后1 H 的平均水平(P<0.01),在不同年龄、性别组人群中也同样存在此种现象。女性中自大衣现象显著高于男性[第1小时平均血压-白天平均血压:女性:(9.5±13.4/6.0±7.8)mm Hg(1 mm Hg=0.133 kPa);男性:(5.5±11.9/4.2±7.8)mm Hg,P<0.01],而各年龄组间差异无统计学意义。结论动态血压监测中,普遍存在着明显的第1小时内血压升高的现象,建议在临床上判断血压水平和诊断中,删除第1小时的记录数据,以便更加准确客观地反映患者的真实血压水平,在临床药物疗效观察评价及科学研究中尤其重要。
