14例偶测血压正常动态血压升高病人临床分析

背景 长期以来,临床工作者常常只注意偶测血压高而动态血压正常者,即“自大衣高血压”(white coat hyperten-sion),而对偶测血压正常、动态血压升高的病人未予以重视。目的 探讨偶测血压正常、动态血压升高病人(masked hyper-tension)的临床特征与临床意义。方法 89例临床诊断为血压正常的受试者,由受过专门训练的护士在受试者家中测量血压二次,时间间隔为2～3周,二次测量共获得10个读数的平均值作为偶测血压。采用24小时动态血压监测仪记录动态血压。结果 该人群中偶测血压正常、动态血压升高的患病率为15．7％,以男性多见,其中64．3％为偶测血压正常高值者(血压13l～139／85～89mmHg);患者中饮酒的比例、体重指数、血清胆固醇及低密度脂蛋白胆固醇均高于偶测血压及动态血压均正常者。不同日二次测量共10个血压读数的均数与白昼动态血压的相关性好于同日测量、5个读数的均数。结论由于偶测血压的局限性,可使一部分白昼动态血压升高的患者漏诊,后者主要见于偶测血压正常高值者。应对偶测血压正常高值者予以随访检查。

Analysis of 14 Cases with Masked Hypertension

Background Ambulatory blood pressure (ABP) may be higher or lower than causal blood pressure (CBP) Attention has been focused on "white coat hypertension" (elevated causal blood pressure with normal ambulatory blood pressure), while only few studies explored the converse phenomenon of high ambulatory blood pressure with normal causal blood pressure (masked hypertension, MHT) Objective To study patients with normal causal blood pressure and high ambulatory blood pressure in terms of clinical manifestation and significance Methods The average of the 10 blood pressure readings during each of two home visits was used as causal blood pressure and 24 h ABP monitoring was carried out in 89 presumed health participants Results Prevalence rate of MHT was 15 7% in this small population 64 3% of patients occurred in high normal blood pressure Patients with MHT were more often male; higher prevalence of current drinking; higher body mass index, serum cholesterol and LDL cholesterol level than NT The relationship between ABP and CBP was more significant in 10 readings of two occasions than 5 readings of one occasion Conclusion Causal measurements of BP may be misdiagnosis in a sizable portion of individuals who have normal causal with elevated ambulatory blood pressure(MHT) Attention should be paid to these patients who might associate with cardiovascular risk