文件测量药物高血压患者自测血压监测早晚差异过大决定因素济.pdfVIP

AJH 2005; 18:958 –965 BP Measurement Determinants of Exaggerated Difference in Morning and Evening Blood Pressure Measured by Self-measured Blood Pressure Monitoring in Medicated Hypertensive Patients: Jichi Morning Hypertension Research (J-MORE) Study Joji Ishikawa, Kazuomi Kario, Satoshi Hoshide, Kazuo Eguchi, Masato Morinari, Ruri Kaneda, Yuji Umeda, Shizukiyo Ishikawa, Toshio Kuroda, Yukihiro Hojo, Kazuyuki Shimada, on Behalf of the J-MORE Study Group Background: Morning blood pressure (BP) surge in groups (Q1 to Q3), whereas there was no significant dif- ambulatory BP monitoring was a risk factor for stroke in ference in the average of morning and evening (ME aver- our previous study. We studied the determinants of the age) BP. In logistic regression ysis controlling for ME morning minus evening systolic BP difference (ME dif- average and other confounding factors, t risks ference) in self-measured BP monitoring, as a possible risk for Q4 of ME difference were older age (10 years older: factor for stroke in medicated hypertensive patients. odds ratio [OR] 1.21, P .01, 95% confidence interval (CI) Methods: Nine hundred sixty-nine hypertensive outpa- 1.04 –1.42), regular alcohol drinker (OR 1.51, P tients receiving stable antihypertensive drug treatment .04, 95% CI 1.01–2.26), and -blocker use (OR 1.50, P were studied using self-measured BP monitoring in the .02, 95% CI 1.06 –2.12). morning and evening. Conclusions: Older age, -blocker use, and regular Results: The ME difference ranged from 37.3 to 53.3 alcohol drinking were significant determinants of the exag- mm Hg (mean 7.9 mm Hg). The highest quartile (Q4) of gerated ME difference in medicated hypertensiv