NEJM：动态血压较诊室血压更能预测死亡

2018-04-21 北京佑安医院伍慧丽信诺医讯

与诊室或家庭单次偶测血压相比，动态血压监测能获得更全面的血压信息，并具有识别特殊类型高血压（如白大衣高血压、隐匿性高血压和夜间高血压）的优势从而减少漏诊误诊。

与诊室或家庭单次偶测血压相比，动态血压监测能获得更全面的血压信息，并具有识别特殊类型高血压（如白大衣高血压、隐匿性高血压和夜间高血压）的优势从而减少漏诊误诊。

近来更有研究认为动态血压可作为一项死亡预测指标，但因数据少致预测能力有限，为此，西班牙开展了一项大型队列研究，将诊室血压、平均动态血压（夜晚、白天或24小时）以及特殊类型高血压对全因和心血管死亡率的预测作用进行了全面评估。

研究纳入6万余名成人，经测量诊室血压及24小时平均动态血压后分4类：持续高血压（诊室血压和动态血压均升高）、白大衣高血压（诊室血压升高而动态血压正常）、隐匿性高血压（诊室血压正常而动态血压升高）和正常血压（诊室血压和动态血压均正常）。中位随访4.7年间，有3808人死亡，其中1295人死于心血管病因。

24小时动态收缩压较诊室收缩压与全因死亡率关系更密切（危险比1.58vs1.02），其中夜间与日间动态收缩压影响差别不大（危险比1.55vs1.54），在按照年龄、性别、肥胖、糖尿病、心血管疾病和抗高血压治疗等区分的亚组间也是一致的；隐匿性高血压比持续高血压或白大衣高血压与全因死亡率关系更密切（危险比2.83vs1.80vs1.79）；心血管死亡率与全因死亡率的结果相似。

动态血压比诊室血压更能预测全因和心血管死亡率。在特殊类型高血压中，白大衣高血压并非良性，而隐匿性高血压较持续高血压有更高的死亡风险。

原始出处:José R. Banegas, M.D., Luis M. Ruilope, M.D., Alejandro de la Sierra, M.D., et al. Relationship between Clinic and Ambulatory Blood-Pressure Measurements and Mortality. NEJM. April 19, 2018

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2019-01-16 柳叶一刀

#诊室血压#

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2018-04-22 limedical1977

#动态血压#

0 0
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2018-04-21 186****0580(小山羊）

学习了谢谢了

55 0
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2018-04-21 清风拂面

谢谢分享学习

59 0
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2018-04-21 戒馋，懒，贪

谢谢分享学习了

58 0
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2018-04-21 1ddf0692m34(暂无匿称)

学习了.长知识

60 0
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2018-04-21 龙胆草

学习谢谢分享

56 0
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2018-04-21 医者仁心5538

学习了

28 0
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2018-04-21 flysky120

高血压的讲解很有帮助

29 0
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2018-04-21 明月清辉

谢谢分享.学习了

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