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Coffee and blood pressure: exciting news! 咖啡和血压:令人兴奋的消息!
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2136621
Claudio Borghi

A growing number of epidemiological studies have reported the beneficial effects of habitual coffee consumption on incident cardiovascular disease (CVD), and mortality. However, the effects of coffee on arterial hypertension are still objects of active discussion mainly because of the debated effects of caffeine on blood pressure and cardiovascular system. In particular, the negative impact of caffeine would involve the whole cardiovascular system and could be responsible for an excess in the relative risk of new onset of hypertension and a worsening of blood pressure control. Recent evidence has been published excluding a significant effect of coffee consumption on hypertension development and blood pressure control in treated and untreated hypertensive supporting a protective role for the antioxidant components of coffee that may counteract the claimed negative effect of caffeine. The presence and amount of caffeine and cardio-protective chemical constituents of coffee is largely dependent on the type, production, and method of preparation and this can partially explain the divergent opinions on the effects of coffee intake on blood pressure and cardiovascular system. In addition, some genetic aspect of caffeine metabolism can contribute to the heterogeneity of published evidence while the most recent cardiovascular guidelines largely endorse coffee consumption in hypertension and CV disease. The purpose of this short review is to briefly summarise some of the recent information available in the literature on coffee and blood pressure.Key points  According to the considerable amount of observational evidence we can suggest that:  • While acute coffee administration in non-habitual users may induce a blood pressure rise, habitual coffee consumption in medium-high dosages (from 3 to 5 cups/day), has neutral or even beneficial impact on blood pressure values and the new onset of hypertension.   • The same intake significantly reduces the incidence of cardiovascular disease, as well as all-cause mortality.   • The consumption of coffee is compatible with a correct and balanced lifestyle and should therefore not be discouraged in subjects with hypertension and cardiovascular diseases.

越来越多的流行病学研究报告了习惯性饮用咖啡对心血管疾病(CVD)和死亡率的有益影响。然而,咖啡对动脉高血压的影响仍然是积极讨论的对象,主要是因为咖啡因对血压和心血管系统的影响存在争议。特别是,咖啡因的负面影响会涉及到整个心血管系统,并可能导致新发高血压的相对风险过高,以及血压控制的恶化。最近发表的证据排除了咖啡对高血压发展和高血压控制的显著影响,支持咖啡的抗氧化成分的保护作用,可能抵消咖啡因所声称的负面作用。咖啡中咖啡因和保护心脏的化学成分的存在和数量在很大程度上取决于咖啡的种类、生产和制备方法,这可以部分解释关于咖啡摄入对血压和心血管系统影响的不同观点。此外,咖啡因代谢的某些遗传方面可能导致已发表证据的异质性,而最新的心血管指南在很大程度上支持高血压和心血管疾病的咖啡饮用。这篇简短综述的目的是简要总结一些最近在咖啡和血压方面的文献信息。根据大量的观察证据,我们可以提出:•虽然非习惯性饮用咖啡的急性饮用可能会导致血压升高,但习惯性饮用中高剂量的咖啡(每天3到5杯)对血压值和新发高血压的影响是中性的,甚至是有益的。•同样的摄入量可显著降低心血管疾病的发病率和全因死亡率。•饮用咖啡符合正确和平衡的生活方式,因此不应阻止高血压和心血管疾病患者。
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引用次数: 7
Accuracy of blood pressure measurement across BMI categories using the OptiBP™ mobile application. 使用OptiBP™移动应用程序测量BMI类别血压的准确性。
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2132214
Mary Caillat, Jean Degott, Arlene Wuerzner, Martin Proençain, Guillaume Bonnier, Jean-François Knebel, Chloé Stoll, Urvan Christen, Virginie Durgnat, Gregory Hofmann, Michel Burnier, Grégoire Wuerzner, Patrick Schoettker

Purpose: Obesity is a clear risk factor for hypertension. Blood pressure (BP) measurement in obese patients may be biased by cuff size and upper arm shape which may affect the accuracy of measurements. This study aimed to assess the accuracy of the OptiBP smartphone application for three different body mass index (BMI) categories (normal, overweight and obese).

Materials and methods: Participants with a wide range of BP and BMI were recruited at Lausanne University Hospital's hypertension clinic in Switzerland. OptiBP estimated BP by recording an optical signal reflecting light from the participants' fingertips into a smartphone camera. Age, sex and BP distribution were collected to fulfil the AAMI/ESH/ISO universal standards. Both auscultatory BP references and OptiBP BP were measured and compared using the simultaneous opposite arms method, as described in the 81060-2:2018 ISO norm. Subgroup analyses were performed for each BMI category.

Results: We analyzed 414 recordings from 95 patients: 34 were overweight and 15 were obese. The OptiBP application had a performance acceptance rate of 82%. The mean and standard deviation (SD) differences between the optical BP estimations and the auscultatory reference rates (criterion 1) were respected in all subgroups: SBP mean value was 2.08 (SD 7.58); 1.32 (6.44); -2.29 (5.62) respectively in obese, overweight and normal weight subgroup. For criterion 2, which investigates the precision errors on an individual level, the threshold for systolic BP in the obese group was slightly above the requirement for this criterion.

Conclusion: This study demonstrated that the OptiBP application is easily applicable to overweight and obese participants. Differences between the reference measure and the OptiBP estimation were within ISO limits (criterion 1). In obese participants, the SD of mean error was outside criterion 2 limits. Whether auscultatory measurement, due to arm morphology or the OptiBP is associated with increasing bias in obese still needs to be studied.

目的:肥胖是高血压的明显危险因素。肥胖患者的血压测量可能会受到袖带大小和上臂形状的影响,从而影响测量的准确性。本研究旨在评估OptiBP智能手机应用程序对三种不同体重指数(BMI)类别(正常、超重和肥胖)的准确性。材料和方法:在瑞士洛桑大学医院高血压门诊招募血压和BMI范围广泛的参与者。OptiBP通过记录参与者指尖反射光线到智能手机摄像头的光信号来估计血压。收集年龄、性别和血压分布符合AAMI/ESH/ISO通用标准。按照81060-2:2018 ISO标准的描述,使用同时对臂法测量和比较听诊参考BP和OptiBP BP。对每个BMI类别进行亚组分析。结果:我们分析了95例患者的414份记录:34例超重,15例肥胖。OptiBP应用程序的性能接受率为82%。在所有亚组中,光学血压估计值与听诊参考率(标准1)之间的平均值和标准差(SD)差异均得到尊重:收缩压平均值为2.08 (SD 7.58);1.32 (6.44);肥胖、超重和正常体重亚组分别为-2.29(5.62)。标准2调查个体水平上的精度误差,肥胖组的收缩压阈值略高于该标准的要求。结论:本研究表明OptiBP应用程序易于适用于超重和肥胖参与者。参考测量值与OptiBP估计值之间的差异在ISO范围内(标准1)。在肥胖参与者中,平均误差的SD超出标准2的范围。听诊测量、臂形态或OptiBP是否与肥胖患者偏倚增加有关仍需研究。
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引用次数: 0
Clinical characteristics do not reliably identify non-adherence in patients with uncontrolled hypertension. 临床特征不能可靠地确定高血压未控制患者的不依从性。
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2104215
Eline H Groenland, Indranil Dasgupta, Frank L J Visseren, Kim C M van der Elst, Nathan Lorde, Alexander J Lawson, Michiel L Bots, Wilko Spiering

Purpose: Chemical adherence testing is a reliable method to assess adherence to antihypertensive drugs. However, it is expensive and has limited availability in clinical practice. To reduce the number and costs of chemical adherence tests, we aimed to develop and validate a clinical screening tool to identify patients with a low probability of non-adherence in patients with uncontrolled hypertension.

Materials and methods: In 495 patients with uncontrolled hypertension referred to the University Medical Centre Utrecht (UMCU), the Netherlands, a penalised logistic regression model including seven pre-specified easy-to-measure clinical variables was derived to estimate the probability of non-adherence. Non-adherence was defined as not detecting at least one of the prescribed antihypertensive drugs in plasma or urine. Model performance and test characteristics were evaluated in 240 patients with uncontrolled hypertension referred to the Heartlands Hospital, United Kingdom.

Results: Prevalence of non-adherence to antihypertensive drugs was 19% in the UMCU and 44% in the Heartlands Hospital population. After recalibration of the model's intercept, predicted probabilities agreed well with observed frequencies. The c-statistic of the model was 0.63 (95%CI 0.53-0.72). Predicted probability cut-off values of 15%-22.5% prevented testing in 5%-15% of the patients, carrying sensitivities between 97% (64-100) and 90% (80-95), and negative predictive values between 74% (10-99) and 70% (50-85).

Conclusion: The combination of seven clinical variables is not sufficient to reliably discriminate adherent from non-adherent individuals to safely reduce the number of chemical adherence tests. This emphasises the complex nature of non-adherence behaviour and thus the need for objective chemical adherence tests in patients with uncontrolled hypertension.

目的:化学依从性试验是评价抗高血压药物依从性的可靠方法。然而,它是昂贵的,在临床实践中可用性有限。为了减少化学依从性试验的次数和成本,我们旨在开发并验证一种临床筛选工具,以识别不受控制的高血压患者中低概率不依从性的患者。材料和方法:在荷兰乌得勒支大学医学中心(UMCU)的495例未控制的高血压患者中,导出了一个惩罚逻辑回归模型,其中包括7个预先指定的易于测量的临床变量,以估计不依从性的概率。不依从性定义为在血浆或尿液中未检测到至少一种处方降压药。模型性能和测试特征在240例未控制的高血压患者转介到英国心脏地带医院进行评估。结果:UMCU的抗高血压药物不依从率为19%,Heartlands医院的人群为44%。在对模型的截距进行重新校准后,预测的概率与观测到的频率非常吻合。模型的c统计量为0.63 (95%CI 0.53 ~ 0.72)。15%-22.5%的预测概率临界值阻止了5%-15%的患者进行检测,敏感性在97%(64-100)和90%(80-95)之间,阴性预测值在74%(10-99)和70%(50-85)之间。结论:七个临床变量的组合不足以可靠地区分粘附者和非粘附者,从而安全减少化学粘附试验的次数。这强调了不依从性行为的复杂性,因此需要在不受控制的高血压患者中进行客观的化学依从性试验。
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引用次数: 0
Psychological determinants of drug adherence and severity of hypertension in patients with apparently treatment-resistant vs. controlled hypertension. 明显治疗抵抗与控制高血压患者药物依从性和高血压严重程度的心理决定因素
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2099346
Coralie M G Georges, Sabrina Ritscher, Marco Pappaccogli, Géraldine Petit, Marilucy Lopez-Sublet, Achille Bapolisi, Silvia Di Monaco, Pierre Wallemacq, Franco Rabbia, Stefan W Toennes, Philippe de Timary, Alexandre Persu

Purpose: In a pilot study including 35 patients with apparently treatment-resistant hypertension (ATRH), we documented associations between psychological profile, drug adherence and severity of hypertension. The current study aims to confirm and expand our findings in a larger and more representative sample of patients with ATRH, using controlled hypertensive patients as the comparator.

Materials and methods: Patients with ATRH were enrolled in hypertension centres from Brussels and Torino. The psychological profile was assessed using five validated questionnaires. Drug adherence was assessed by high-performance liquid chromatography-tandem mass spectrometry analysis of urine samples, and drug resistance by 24-hour ambulatory blood pressure was adjusted for drug adherence.

Results: The study sample totalised 144 patients, including 81 ATRH and 63 controlled hypertensive patients. The mean adherence level was significantly lower in the "resistant" group (78.9% versus 92.7% in controlled patients, p-value = .022). In patients with ATRH, independent predictors of poor drug adherence were somatisation, smoking and low acceptance level of difficult situations, accounting for 41% of the variability in drug adherence. Independent predictors of severity of hypertension were somatisation, smoking, more frequent admissions to the emergency department and low acceptation, accounting for 63% of the variability in the severity of hypertension. In contrast, in patients with controlled hypertension, the single predictors of either drug adherence or severity of hypertension were the number of years of hypertension and, for the severity of hypertension, alcohol consumption, accounting for only 15-20% of the variability.

Conclusion: Psychological factors, mostly related to somatisation and expression of emotions are strong, independent predictors of both drug adherence and severity of hypertension in ATRH but not in controlled hypertensive patients.

目的:在一项包括35例明显难治性高血压(ATRH)患者的初步研究中,我们记录了心理状况、药物依从性和高血压严重程度之间的关联。目前的研究旨在以控制高血压患者为对照,在更大、更有代表性的ATRH患者样本中证实和扩展我们的发现。材料和方法:纳入来自布鲁塞尔和都灵的高血压中心的ATRH患者。使用五份有效问卷对心理状况进行评估。采用高效液相色谱-串联质谱法对尿样进行药物依从性评估,并通过24小时动态血压调整耐药性来评估药物依从性。结果:研究样本共144例,其中ATRH 81例,控制高血压63例。“耐药”组的平均依从性水平明显较低(78.9% vs .对照组的92.7%,p值= 0.022)。在ATRH患者中,药物依从性差的独立预测因素是身体化、吸烟和对困难情况的接受程度低,占药物依从性变异性的41%。高血压严重程度的独立预测因素是躯体化、吸烟、更频繁地进入急诊科和低接受度,占高血压严重程度变化的63%。相比之下,在控制高血压的患者中,药物依从性或高血压严重程度的单一预测因素是高血压的年数,对于高血压的严重程度,饮酒仅占变异的15-20%。结论:心理因素主要与躯体化和情绪表达相关,是ATRH患者药物依从性和高血压严重程度的独立预测因素,但在控制高血压患者中并非如此。
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引用次数: 1
Thirty years with LIFE-a randomized clinical trial with more than 200 published articles on clinical aspects of left ventricular hypertrophy. LIFE 30年——一项随机临床试验,发表了200多篇关于左心室肥大临床方面的文章
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2083578
Sverre E Kjeldsen, Brent M Egan, Krzysztof Narkiewicz, Reinhold Kreutz, Michel Burnier, Suzanne Oparil
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引用次数: 0
Accuracy of home blood pressure measurement: the ACCURAPRESS study - a proposal of Young Investigator Group of the Italian Hypertension Society (Società Italiana dell'Ipertensione Arteriosa). 家庭血压测量的准确性:ACCURAPRESS研究-意大利高血压学会(societ<s:1> Italiana dell'Ipertensione Arteriosa)青年研究小组的建议。
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2137461
Costantino Mancusi, Valeria Bisogni, Alessandro Maloberti, Maria Virginia Manzi, Valeria Visco, Marco Biolcati, Valentina Giani, Francesco Spannella, Silvia Monticone, Francesca Saladini, Giulia Rivasi, Giada Turrin, Giacomo Pucci, Martino Pengo, Fabio Bertacchini, Claudio Ferri, Guido Grassi, Maria Lorenza Muiesan

Purpose: Home blood pressure monitoring (HBPM) might be considered a valid alternative to ambulatory blood pressure monitoring (ABPM) for both the diagnosis and management of hypertension. Correct information on how to perform HBPM are crucial for its reliability. The aim of the present survey was to assess if hypertensive patients followed current recommendation on how to correctly perform HBPM measurements.

Materials and methods: The survey included 30 different items on how to perform the HBPM. It was developed by the 'Young Investigators' group of the Italian Society of Arterial Hypertension (SIIA) and it was administered during the office visit between May 2019 and December 2021.

Results: A total of 643 hypertensive patients participated in the study. Main results show that, despite the rate of informed patients was relatively high (71% of the whole population), unacceptable number of patients did not follow indications on how to perform a correct HBPM. Patients who were informed on how to measure home BP had a significantly higher rate of correct position during measurement (78 vs. 22%, p < 0.01), avoidance of talking and moving during measurement (68 vs. 32%, p < 0.0001), and correct number and time interval between two measurements (85 vs. 15%, p < 0.001). More accurate measurements of home BP were associated with less prevalence of carotid plaque.

Conclusions: Correct performance for HBPM is low among patients treated in Italian hypertension centers. These findings shed light on the importance of correct HBPM measurements for the detection of accurate BP values for the proper management of hypertensive patients.

目的:家庭血压监测(HBPM)可能被认为是一个有效的替代动态血压监测(ABPM)的诊断和管理高血压。关于如何执行HBPM的正确信息对其可靠性至关重要。本调查的目的是评估高血压患者是否遵循当前关于如何正确进行HBPM测量的建议。材料和方法:调查包括30个不同的项目如何执行HBPM。它由意大利动脉高血压学会(SIIA)的“青年调查员”小组开发,并在2019年5月至2021年12月的办公室访问期间进行管理。结果:共有643例高血压患者参与研究。主要结果显示,尽管知情患者的比例相对较高(占总人口的71%),但仍有不可接受的患者没有按照指征进行正确的HBPM。被告知如何测量家庭血压的患者在测量过程中正确体位的比例明显更高(78比22%,p p p p)。结论:在意大利高血压中心接受治疗的患者中,HBPM的正确表现较低。这些发现揭示了正确的HBPM测量对于检测准确的血压值对于高血压患者的正确管理的重要性。
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引用次数: 2
Masked hypertension in type 2 diabetes: never take normotension for granted and always assess out-of-office blood pressure. 2型糖尿病隐匿性高血压:不要想当然地认为血压正常,经常评估门诊外血压。
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2107483
Krzysztof Narkiewicz, Sverre E Kjeldsen, Brent M Egan, Reinhold Kreutz, Michel Burnier
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引用次数: 2
Diverse pharmacological properties, trial results, comorbidity prescribing and neural pathophysiology suggest European hypertension guideline downgrading of beta-blockers is not justified. 不同的药理学特性、试验结果、合并症处方和神经病理生理学表明,欧洲高血压指南下调β受体阻滞剂是不合理的。
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2110858
Murray Esler, Sverre E Kjeldsen, Atul Pathak, Guido Grassi, Reinhold Kreutz, Giuseppe Mancia

Beta-blockers have solid documentation in preventing cardiovascular complications in the treatment of hypertension; atenolol, metoprolol, oxprenolol and propranolol demonstrate proven cardiovascular prevention in hypertension mega-trials. Hypertension is characterised by activation of the sympathetic nervous system from early to late phases, which makes beta-blockers an appropriate treatment seen from a pathophysiological viewpoint, especially in patients with an elevated heart rate. Beta-blockers represent a heterogenous class of drugs with regard to both pharmacodynamic and pharmacokinetic properties. This position is manifest by reference to another clinical context, beta-blocker treatment of heart failure, where unequivocally there is no class effect (no similar benefit from all beta-blockers); there are good and less good beta-blockers for heart failure. Analogous differences in beta-blocker efficacy is also likely in hypertension. Beta-blockers are widely used for the treatment of diseases comorbid with hypertension, in approximately 50 different concomitant medical conditions that are frequent in patients with hypertension, leading to many de facto beta-blocker first choices in clinical practice. Thus, beta-blockers should be regarded as relevant first choices for hypertension in clinical practice, particularly if characterised by a long half-life, highly selective beta-1 blocking activity and no intrinsic agonist properties.SUMMARYBeta-blockers have solid documentation in preventing cardiovascular complications in the treatment of hypertension; atenolol, metoprolol, oxprenolol and propranolol demonstrate proven cardiovascular prevention in hypertension mega-trialsHypertension is characterised by activation of the sympathetic nervous system from early to late phases, which makes beta-blockers an appropriate treatment seen from a pathophysiological viewpoint, especially in patients with an elevated heart rateBeta-blockers represent a heterogenous class of drugs with regard to both pharmacodynamic and pharmacokinetic propertiesThis position is manifest by reference to another clinical context, beta-blocker treatment of heart failure, where unequivocally there is no class effect (no similar benefit from all beta-blockers); there are good and less good beta-blockers for heart failureAnalogous differences in beta-blocker efficacy is also likely in hypertensionBeta-blockers are widely used for the treatment of diseases comorbid with hypertension, in approximately 50 different concomitant medical conditions that are frequent in patients with hypertension, leading to many de facto beta-blockers first choices in clinical practiceThese observations, in totality, inform our opinion that beta-blockers are relevant first choices for hypertension in clinical practice and this fact needs highlightingFurther, these arguments suggest European hypertension guideline downgrading of beta-blockers is not justified.

-受体阻滞剂在高血压治疗中预防心血管并发症方面有坚实的文献记录;阿替洛尔、美托洛尔、奥普萘洛尔和心得安在高血压大型试验中证实可预防心血管疾病。高血压的特点是从早期到晚期交感神经系统的激活,这使得从病理生理学的角度来看-受体阻滞剂是一种适当的治疗方法,特别是在心率升高的患者中。β受体阻滞剂在药效学和药代动力学特性方面代表了一类异质性的药物。这一观点在另一项临床研究中得到了体现,即β -受体阻滞剂治疗心力衰竭,在该研究中明确没有同类效应(并非所有β -受体阻滞剂都有类似的益处);治疗心力衰竭有好的和不好的-受体阻滞剂。受体阻滞剂疗效的类似差异也可能出现在高血压中。-受体阻滞剂被广泛用于治疗与高血压共病的疾病,在高血压患者中常见的大约50种不同的伴随医疗状况中,导致许多事实上的-受体阻滞剂在临床实践中的首选。因此,β -受体阻滞剂应被视为临床治疗高血压的首选药物,特别是具有长半衰期、高选择性β -1阻断活性和无内在激动剂特性的β -受体阻滞剂。-受体阻滞剂在高血压治疗中预防心血管并发症方面有可靠的文献记录;阿替洛尔、美托洛尔、奥普萘洛尔和心得安在高血压中证实可预防心血管疾病。高血压的特点是从早期到晚期交感神经系统的激活,这使得从病理生理学的角度来看-受体阻滞剂是一种合适的治疗方法。-受体阻滞剂在药效学和药代动力学特性方面代表了一类异质性的药物,这一立场在另一个临床背景中得到了体现,-受体阻滞剂治疗心力衰竭,其中明确没有一类效应(所有-受体阻滞剂都没有类似的益处);-受体阻滞剂在治疗心力衰竭方面有好的和不太好的,在高血压方面也可能存在类似的疗效差异。-受体阻滞剂广泛用于治疗高血压合并疾病,在高血压患者中常见的大约50种不同的伴随疾病中,导致许多事实上的-受体阻滞剂在临床实践中成为首选。我们认为-受体阻滞剂是临床治疗高血压的首选药物,这一事实需要强调。此外,这些论点表明,欧洲高血压指南中-受体阻滞剂的降级是不合理的。
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引用次数: 4
Blood pressure response to close or loose contact between physician and patient during attended office blood pressure measurement. 在门诊血压测量期间,医患之间密切或松散接触对血压的影响。
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2104694
Jitka Seidlerová, Jan Filipovský, Veronika Kordíková, Július Gelžinský, Štěpán Mareš, Otto Mayer

Purpose: Compared to unattended office blood pressure (uOBP), attended office blood pressure (aOBP) is higher. It is not known, however, to what extent distance between physician and patient influences blood pressure (BP) values.

Materials and methods: Participants were stable hypertensive patients, followed in the university hospital-based out-patient center. During a session, automated office BP was measured three times after a pre-set five-minute pause, using the Omron 907 device; both aOBP and uOBP were done, in a random order. Simultaneously, beat-to-beat BP measurement was performed using the Finapress device. During aOBP, some participants were in close contact with the physician while others were in loose contact where the doctor was sitting in the room about 2.5 m apart. One year later, the second session with the same protocol was organized, but the close and loose contact were interchanged. The data were analyzed using a paired t-test.

Results: Complete data were collected in 32 patients, baseline uOBP was 122.8 ± 14.8/69.5 ± 11.7 mmHg. Systolic and diastolic aOBP with close contact was higher by 4.6 ± 6.9 and 1.9 ± 3.4 mmHg (p < 0.0007 and 0.0039, respectively), while aOBP with loose contact was not different from uOBP. Beat-to-beat BP increased during aOBP by 6.5 ± 8.5/3.3 ± 4.8 mmHg. The increase persisted during all the three aOBP measurements (p < 0.0001 for all systolic and diastolic BP values); the results were similar for close and loose contact. The peak increase during uOBP was of similar magnitude as during aOBP but it lasted shorter: it reached the significance level of p < 0.0001 only during the first uOBP measurement.

Conclusions: Compared to uOBP, aOBP values were higher with close, but not with loose contact between physician and patient. These differences were, however, not detected by beat-to-beat BP measurement.

目的:与无人值守办公室血压(uOBP)相比,值守办公室血压(aOBP)更高。然而,尚不清楚医患之间的距离在多大程度上影响血压(BP)值。材料和方法:参与者为稳定期高血压患者,随访于大学附属医院门诊中心。在会议期间,在预先设定的五分钟暂停后,使用欧姆龙907设备自动测量三次办公室血压;aOBP和uOBP均按随机顺序进行。同时,使用Finapress设备进行搏动间血压测量。在aOBP期间,一些参与者与医生保持密切接触,而另一些参与者则与医生保持松散接触,医生坐在距离约2.5米的房间里。一年后,第二次会议以相同的协议组织,但密切和松散的接触互换。数据采用配对t检验进行分析。结果:32例患者资料完整,基线uOBP为122.8±14.8/69.5±11.7 mmHg。密切接触时收缩期aOBP和舒张期aOBP分别升高4.6±6.9和1.9±3.4 mmHg (p p p p)。结论:与无obp相比,医患密切接触时aOBP升高,而疏离接触时aOBP升高。然而,这些差异并没有被心跳间的血压测量检测到。
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引用次数: 0
Relationship between morning peak phenomenon and early renal injury NGAL in H-type hypertension. h型高血压患者早峰现象与早期肾损伤NGAL的关系。
IF 1.8 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-12-01 DOI: 10.1080/08037051.2022.2106186
Chi Zhang, Dan-Dan Zhang, Yu-Mei Feng, Zhan-Qiang Huang, Yun-Bo Xie, Jian Zhou, Jun Li

Purpose: To investigate the relationship between morning blood pressure surge (MBPS) and neutrophilgelatinase associated lipocalin (NGAL) in patients with H-type hypertension.

Materials and methods: A total of 224 patients with diagnosed H-type hypertension [homocysteine (Hcy)≧10umol/L] were selected and underwent 24-hour ambulatory blood pressure monitoring (ABPM). In the morning peak group (115 cases), NGAL and serum cystatin C levels, β2-microglobulin levels were detected in each group, and general biochemical indicators were also detected.

Results: There was no significant difference in the course of hypertension, age, blood glucose, blood lipids, Hcy, BUN, Cr, and UA between the two groups (p > 0.05). CysC, β2-MG were higher than those in the nonmorning peak group, and the difference was statistically significant (p < 0.05).; Pearson correlation analysis showed that NGAL was moderately and highly correlated with CysC, systolic blood pressure morning peak, β2-MG, and high (p < 0.05), low-density lipoprotein (LDL-C), and Hcy were lowly correlated (p < 0.05).) and morning peak diastolic blood pressure (p > 0.05); multiple linear stepwise regression analysis indicated that morning peak systolic blood pressure, CysC,β2-MG, and FBG were the risk factors for NGAL.

Conclusion: The morning peak of systolic blood pressure in H-type hypertension is an important factor causing kidney injury. Paying attention to the ambulatory blood pressure monitoring and the control of morning peak blood pressure in patients with H-type hypertension, and early screening of NGAL has important clinical significance for the early prevention and treatment of renal injury in patients with H-type hypertension. PLAIN LANGUAGE SUMMARYThe morning peak of blood pressure is closely related to target organ damage.There are few studies on the relationship between morning peak phenomenon and renal damage in patients with H-type hypertension at home and abroad.We investigated the relationship between MBPS and NGAL in H-type hypertensive patients with BUN, Cr and UA in the normal range to provide a clinical basis for early renal protection in hypertensive patients.

目的:探讨h型高血压患者晨起血压升高(MBPS)与中性粒细胞明胶酶相关脂钙蛋白(NGAL)的关系。材料与方法:选取确诊为h型高血压[同型半胱氨酸(Hcy)≧10umol/L]的患者224例,进行24小时动态血压监测(ABPM)。早峰组(115例)检测各组NGAL、血清胱抑素C、β2微球蛋白水平,并检测一般生化指标。结果:两组患者高血压病程、年龄、血糖、血脂、Hcy、BUN、Cr、UA比较,差异无统计学意义(p > 0.05)。CysC、β2-MG均高于非晨峰组,且差异有统计学意义(p β2-MG、p > 0.05);多元线性逐步回归分析表明,晨峰收缩压、CysC、β2-MG、FBG是NGAL发生的危险因素。结论:h型高血压患者收缩压晨峰是引起肾损伤的重要因素。重视h型高血压患者的动态血压监测和晨峰血压控制,早期筛查NGAL对h型高血压患者早期预防和治疗肾损伤具有重要的临床意义。摘要早晨血压峰值与靶器官损伤密切相关。国内外关于h型高血压患者晨峰现象与肾损害关系的研究较少。探讨BUN、Cr、UA均在正常范围内的h型高血压患者MBPS与NGAL的关系,为高血压患者早期肾保护提供临床依据。
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引用次数: 3
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Blood Pressure
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