Comparative Evaluation Of Prevalence Of Hypertensive Phenotypes By Using Home And Office Blood Pressure Measurements In Treated And Untreated Subjects >= 55 Ages
INTERNATIONAL JOURNAL OF CARDIOLOGY(2009)
Abstract
The analysis prevalence of masked hypertension (MH) and white coat hypertension (WCH) in untreated subjects (US) and MH and WCH effects (MHE and WCE) in treated patients (TP) is usually performed excluding patients with previous cardiovascular events. Objective The aim was assess the prevalence and characteristics these hypertensive phenotypes in Moscow population by using home blood pressure measurements (HBPM) and office BPM (OBPM) in epidemiological study including patients with previous cardiovascular events. Methods One thousand eight hundred sixty-seven residents of Moscow≥55 ages were randomly selected from long observed cohort (mean age 68.9, 43% males). HBPM was performed during 4 day in the morning/evening, in sitting position after 5 min of rest, on the working arm. TP measured their HBP before intake the medication. The automatic devise “A&D-668B” and standard arm cuff were used. WCH/WCE were determined as OBP>140/90 and HBP<135/85 mmHg; MH/MHE — OBP<140/90 and HBP>135/85 mmHg. Stepwise logistic regression was performed to test 7 variables with age- and sex-adjusted. Results Data of 974 subjects were analyzed (US: n=556, mean age 68[8], males 47%; TP: n=418, mean age 69[6], males 37%). It was revealed 16% MH vs. 17% MHE and 10% WCH vs. 14% WCE. History of stroke was predictor of WCH/WCE (OR 2.18; 95%CI 1.17–4.05). Diabetes mellitus and history of myocardial infarction were predictors of MH/MHE (OR 1.61; 95%CI 1.01–2.59) and (OR 1.75; 95%CI 1.04–2.94), respectively. Conclusion According to preliminary data the prevalence of MH/MHE in Moscow population ≥55 ages is higher than WCH/WCE both US and TP. The patients with more severe prognosis (diabetes mellitus and history of myocardial infarction) have MH/MHE phenotypes. Low “sensitivity” of HBPM can “mask” the sustained hypertension in both US and TP with WCH/WCE and history of stroke. The analysis prevalence of masked hypertension (MH) and white coat hypertension (WCH) in untreated subjects (US) and MH and WCH effects (MHE and WCE) in treated patients (TP) is usually performed excluding patients with previous cardiovascular events. Objective The aim was assess the prevalence and characteristics these hypertensive phenotypes in Moscow population by using home blood pressure measurements (HBPM) and office BPM (OBPM) in epidemiological study including patients with previous cardiovascular events. Methods One thousand eight hundred sixty-seven residents of Moscow≥55 ages were randomly selected from long observed cohort (mean age 68.9, 43% males). HBPM was performed during 4 day in the morning/evening, in sitting position after 5 min of rest, on the working arm. TP measured their HBP before intake the medication. The automatic devise “A&D-668B” and standard arm cuff were used. WCH/WCE were determined as OBP>140/90 and HBP<135/85 mmHg; MH/MHE — OBP<140/90 and HBP>135/85 mmHg. Stepwise logistic regression was performed to test 7 variables with age- and sex-adjusted. Results Data of 974 subjects were analyzed (US: n=556, mean age 68[8], males 47%; TP: n=418, mean age 69[6], males 37%). It was revealed 16% MH vs. 17% MHE and 10% WCH vs. 14% WCE. History of stroke was predictor of WCH/WCE (OR 2.18; 95%CI 1.17–4.05). Diabetes mellitus and history of myocardial infarction were predictors of MH/MHE (OR 1.61; 95%CI 1.01–2.59) and (OR 1.75; 95%CI 1.04–2.94), respectively. Conclusion According to preliminary data the prevalence of MH/MHE in Moscow population ≥55 ages is higher than WCH/WCE both US and TP. The patients with more severe prognosis (diabetes mellitus and history of myocardial infarction) have MH/MHE phenotypes. Low “sensitivity” of HBPM can “mask” the sustained hypertension in both US and TP with WCH/WCE and history of stroke.
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Key words
blood pressure measurement
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