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Significant Correlates of Nocturnal Hypertension in Patients With Hypertension Who Are Treated With Antihypertensive Drugs

医学 夜行的 抗高血压药 内科学 血压 隐匿性高血压 心脏病学 动态血压
作者
Tatsuya Maruhashi,Yoshihiko Kinoshita,Ryoji Ozono,Mitsuaki Nakamaru,Masanori Ninomiya,Jiro Oiwa,Takuji Kawagoe,Osamu Yoshida,Toshiyuki Matsumoto,Yasuo Fukunaga,Kotaro Sumii,Hironori Ueda,Nobuo Shiode,Kosuke Takahari,Yasuhiko Hayashi,Yujiro Ono,Yukiko Nakano,Masakazu Takahashi,Yasuki Kihara,Yukihito Higashi
出处
期刊:American Journal of Hypertension [Oxford University Press]
卷期号:36 (6): 287-296 被引量:3
标识
DOI:10.1093/ajh/hpad014
摘要

Abstract Background Nocturnal hypertension assessed by a home blood pressure monitoring (HBPM) device is associated with an increased risk of cardiovascular events. However, it is still difficult to assess nighttime blood pressure (BP) frequently. The purpose of this cross-sectional study was to identify significant correlates of nocturnal hypertension assessed by an HBPM device in patients with hypertension who are treated with antihypertensive drugs. Methods We measured nighttime BP, morning BP, and evening BP by an HBPM device for 7 consecutive days in 365 medicated patients with hypertension. Results Of the 365 subjects, 138 (37.8%) had nocturnal hypertension defined as a mean nighttime systolic BP of ≥ 120 mm Hg. Receiver operating characteristic curve analyses showed that the diagnostic accuracy of morning systolic BP for subjects with nocturnal hypertension was significantly superior to that of evening systolic BP (P = 0.04) and that of office systolic BP (P < 0.001). Multivariate analysis revealed that morning systolic BP of 125–<135 mm Hg (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.13–4.58; P = 0.02), morning systolic BP of ≥ 135 mm Hg (OR, 16.4; 95% CI, 8.20–32.7; P < 0.001), and a history of cerebrovascular disease (OR, 3.99; 95% CI, 1.75–9.13; P = 0.001) were significantly associated with a higher risk of nocturnal hypertension and that bedtime dosing of antihypertensive drugs was significantly associated with a lower risk of nocturnal hypertension (OR, 0.56; 95% CI, 0.32–0.97; P = 0.04). Conclusions Morning systolic BP of ≥ 125 mm Hg, a history of cerebrovascular disease, and bedtime dosing were significant correlates of nocturnal hypertension in medicated patients with hypertension, and may help detect this risky BP condition. Clinical trials registration University Hospital Medical Information Network Clinical Trials Registry (UMIN000019173).
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