社区高血压患者诊室血压与动态血压达标情况

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英文篇名：Comparison of the hypertension control rates based on office or ambulatory blood pressure measurements in community hypertensive patients 作者：祁巧茹 ; 袁惠莹 ; 陈燕双 ; 陈东 ; 廖锦鹏 ; 汤松涛 英文作者：QI Qiao-ru;YUAN Hui-ying;CHEN Yan-shuang;CHEN Dong;LIAO Jin-peng;TANG Song-tao;Community Health Services Center of Dongguan Liaobu; 关键词：社区高血压 ; 诊室血压 ; 动态血压 ; 达标率 英文关键词：hypertension in the community;;office blood pressure;;ambulatory blood pressure;;control rate 中文刊名：ZGGZ 英文刊名：Chinese Journal of Hypertension 机构：东莞市寮步镇社区卫生服务中心; 出版日期：2019-03-15 出版单位：中华高血压杂志 年：2019 期：v.27 基金：东莞市社会科技发展项目(2014108101043) 语种：中文; 页：ZGGZ201903018 页数：5 CN：03 ISSN：11-5540/R 分类号：67-71

摘要

目的分析社区高血压患者诊室血压与24 h动态血压达标情况之间的差异性。方法于2016年8-12月,在寮步镇社区卫生服务中心对995例社区高血压患者分别采用欧姆龙HBP-1300型电子血压计及爱安德TM2430动态血压计进行诊室血压及动态血压监测(ABPM)。诊室血压、24 h、白天、夜间血压达标的阈值分别为<140/90、<130/80、<135/85、<120/70 mm Hg。分别采用配对t检验及χ~2检验比较各血压参数和血压达标率。结果共入选995例正在降压治疗的社区高血压患者,年龄(61.2±11.5)岁,其中男性462例(46.4%),诊室收缩压和舒张压平均值分别为(136.1±15.2)和(83.6±10.4) mm Hg。诊室血压达标率明显高于24 h动态血压达标率、白天血压达标率和夜间血压达标率(55.8%比34.2%、41.0%、26.0%,P<0.001)。在诊室血压达标的555例患者中,仍分别有310例(55.9%)24 h平均血压、261例(47.0%)白天平均血压和374例(67.4%)夜间平均血压不达标,而诊室血压不达标的440例患者中,有95例(21.6%)24 h平均血压达标、114例(25.9%)白天平均血压达标和78例(17.7%)夜间平均血压达标。社区高血压患者中未控制的隐蔽性高血压和白大衣效应分别约为31.2%和9.5%。结论诊室血压与动态血压达标率之间存在明显差异,ABPM达标率更低。ABPM可能更真实地反映血压控制情况。
        Objective To examine the differences in hypertension control rates based on office blood pressure(BP) measurement or 24-hour ambulatory BP monitoring(ABPM) in community hypertensive patients. Methods From August to December 2016, 995 hypertensive patients in Liaobu Community Health Service Center had their office BP and ambulatory BP measured by OMRON HBP-1300 electronic sphygmomanometer and A&D TM2430 monitors, respectively. Thresholds of controlled office, 24-hour, daytime and nighttime BP were defined as <140/90, <130/80, <135/85, <120/70 mm Hg, respectively. BP parameters and control rates were analyzed and compared using paired t-test and chi-square test. Results A total of 995 hypertensive patients on antihypertensive therapy were enrolled in the study including 462(46.4%) men. The average age was(61.2±11.5) years; the average office systolic and diastolic BPs were(136.1±15.2) and(83.6±10.4)mm Hg, respectively. Control rate based on office BP was significantly higher than those based on 24-hour mean BP, daytime BP, or nighttime BP(55.8% vs 34.2%, 41.0%, 26.0%, P<0.001). Among the 555 patients with controlled office BP, 310(55.9%) had uncontrolled 24 hour mean BP; 261(47.0%) had uncontrolled daytime BP; 374(67.4%) had uncontrolled nighttime BP. Whereas among the 440 patients with uncontrolled office BP, 95(21.6%) had normal 24 hour mean BP, 114(25.9%) had normal daytime BP, 78(17.7%) had normal nighttime BP. The prevalence of uncontrolled masked and white-coat hypertension was respectively about 31.2% and 9.5%. Conclusion Significant differences were observed between hypertension control rates based on office BP measurement and based on ABPM, and the control rate based on ABPM was lower. ABPM may more accurately reflect the real BP control status.

引文

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