隐蔽性未控制高血压的影响因素  

The risk factors of masked uncontrolled hypertension

作　　者：李秋云[1] 张亚静[2,3] 李昊轩 李晶 宋永健[2,3] 袁金环 刘盈池 迟玉玉 高竞生 陈朔华 吴寿岭 LI Qiu-yun;ZHANG Ya-jing;LI Hao-xuan;LI-Jing;SONG Yong-jian;YUAN Jin-huan;LIU Ying-chi;CHI Yu-yu;GAO Jing-sheng;CHEN Shuo-hua;WU Shou-ling(Department of Endocrinology,Kailuan Hospital,Tangshan Hebei 063000,China)

机构地区：[1]开滦总医院内分泌科,河北唐山063000 [2]开滦总医院心内科,河北唐山063000 [3]华北理工大学研究生院 [4]南方医科大学临床学院

出　　处：《中华高血压杂志》2018年第11期1041-1047,共7页Chinese Journal of Hypertension

摘　　要：目的探讨隐蔽性未控制高血压(MUCH)的检出率及危险因素。方法以正在服用抗高血压药且接受了24h动态血压监测(24hABPM)的诊室血压达标人群作为观察对象。根据24hABPM是否达标将研究对象分为两组:高血压已控制(CH)组和MUCH组。采用逐步Logistic回归模型分析影响MUCH的危险因素。结果在有合格诊室血压及24hABPM数据的1815例患者中,诊室血压达标者482例(26.6%)。482例患者平均年龄为55.6岁,含男性363例(77.7%),其中CH组131例,占27.2%;MUCH组351例,占72.8%。逐步Logistic回归模型分析显示,吸烟、高体质量指数(BMI)和高诊室舒张压是影响MUCH的危险因素,OR(95%CI)分别为2.00(1.09~3.67)、2.54(1.50~4.29)和1.08(1.03~1.12)。结论约3/4诊室血压达标的高血压患者24hABPM不达标。高BMI、高诊室舒张压、吸烟是影响MUCH的独立危险因素。Objective To explore the prevalence and risk factors of masked uncontrolled hypertension(MUCH).Methods Patients whose office blood pressure were controlled and who underwent 24-hour ambulatory blood pressure monitoring(24 hABPM)were included in the study. According to 24 hblood pressure,patients were divided into 2 groups:controlled hypertension(CH)group and MUCH group. Stepwise Logistic regression model was used to analyze the risk factors associated with MUCH. Results Of the 1815 patients who had both valid office blood pressure and 24 hABPM,482(26.6%)had their office blood pressure controlled. Among those 482 patients[average age 55.6 years old,and 363(77.7%)were males],131 cases(27.2%)were in the CH group,and 351 cases in the MUCH group(72.8%). Stepwise Logistic regression analysis showed that smoking,higher body mass index(BMI)and higher office diastolic blood pressure(DBP)were the risk factors for MUCH. The odds ratios(95% CI)were 2.00(1.09-3.67),2.54(1.50-4.29)and 1.08(1.03-1.12),respectively. Conclusion About 3/4 of patients with controlled office blood pressure had uncontrolled 24 hambulatory blood pressure.Smoking,higher BMI and higher office DBP were the risk factors of MUCH.

关 键 词：隐蔽性未控制高血压 24H动态血压监测 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]