降压治疗对白大衣高血压病人预后影响的Meta分析  

The Effect of Antihypertensive Agents on White Coat Hypertension:a Meta-analysis

作　　者：刘金婷 李彬[2,3] 石榴 岳耀彬 梁霄 李嘉琦 陈羿璇 罗雅澜 LIU Jinting;LI Bin;SHI Liu;YUE Yaobin;LIANG Xiao;LI Jiaqi;CHEN Yixuan;LUO Yalan(Logistics University of PAP,Tianjin 300162,China)

机构地区：[1]武警后勤学院,天津300162 [2]天津中医药大学第一附属医院,天津300381 [3]国家中医针灸临床医学研究中心,天津300381 [4]中国中医科学院西苑医院 [5]天津市南开医院

出　　处：《中西医结合心脑血管病杂志》2024年第1期123-128,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的:通过Meta分析探讨降压治疗对白大衣高血压(WCH)病人预后的影响。方法:计算机检索PubMed、EMbase、the Cochrane Library和Web of Science数据库中降压治疗对WCH病人预后影响的相关文献。由2名研究员独立对纳入文献进行质量评价并提取文献资料,采用RevMan5.3软件进行Meta分析。结果:纳入8篇文献,涉及2 886例受试者,包括914例服用降压药物的WCH病人和1 972例未经治疗的WCH病人,随访时间为1.0~10.9年。Meta分析显示,接受降压药物治疗的WCH病人心血管事件发生率高于未经治疗的WCH病人[RR=1.67,95%CI(1.35,2.06),P<0.000 01];在进行亚组分析时,年龄≤60岁的WCH病人中,接受降压治疗的心血管事件发生率低于未经治疗,但差异无统计学意义[RR=0.90,95%CI(0.51,1.59),P=0.72]。结论:现有证据表明,接受过降压治疗的WCH病人心血管事件风险未降低。由于纳入研究较少和降压治疗不明确等局限性,仍需要大量随机对照试验确认降压治疗对WCH病人是否有效。Objective:To investigate the effect of antihypertensive agents on the prognosis of patients with white coat hypertension(WCH).Methods:Literatures of the effects of antihypertensive agents on the prognosis of WCH patients were searched through PubMed,EMbase,the Cochrane Library and Web of Science databases.Two researchers independently evaluated the quality of the included literature and extracted the literature data.Meta-analysis was performed using RevMan 5.3 software.Results:A total of 8 literatures were included,involving 2886 subjects,including 914 WCH patients taking antihypertensive drugs and 1972 WCH patients without treatment with medicine.The average follow-up period ranged from 1.0 to 10.9 years.Meta-analysis showed that the incidence of cardiovascular events in WCH patients treated with antihypertensive drugs was higher than that in untreated WCH patients(RR=1.67,95%CI 1.35-2.06,P<0.00001).In subgroup analysis,the incidence of cardiovascular events in WCH patients≤60 years of age receiving antihypertensive therapy was lower than that in untreated WCH patients,but the difference showed no statistically significant(RR=0.90,95%CI 0.51-1.59,P=0.72).Conclusion:The available evidence suggests that the risk of cardiovascular events is not reduced in WCH patients who treated with antihypertensive agents.Due to the few studies included in this meta-analysis and the ambiguity of antihypertensive treatment,a large number of randomized controlled trials are still needed to confirm the effectiveness of antihypertensive treatment for WCH.

关 键 词：白大衣高血压 降压治疗 心血管事件 预后 META分析 

分 类 号：R544.1[医药卫生—心血管疾病]