Prognostic role of masked and white-coat hypertension: 10-Year mortality in treated elderly hypertensives.,Journal of Human Hypertension

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Prognostic role of masked and white-coat hypertension: 10-Year mortality in treated elderly hypertensives.
Journal of Human Hypertension ( IF 2.7 ) Pub Date : 2018-12-05 , DOI: 10.1038/s41371-018-0140-4
Francesco Spannella _{1,

2} , Andrea Filipponi _{1,

2} , Federico Giulietti _{1,

2} , Paolo Balietti _{1,

2} , Beatrice Bernardi _{1,

2} , Giulia Rosettani _{1,

2} , Riccardo Sarzani _{1,

2}

Affiliation

White-coat uncontrolled hypertension (WUCH) and masked uncontrolled hypertension (MUCH) are common in the elderly. The prognostic role of these hypertension phenotypes is not completely defined in this subpopulation. Our aim is to evaluate the long-term prognostic role of WUCH and MUCH in treated elderly hypertensives. Observational study conducted on 120 consecutive treated elderly hypertensives. Patients were assessed on a first clinical visit in 2006. Subsequently, such patients or their relatives have been recalled after 10 years to evaluate the survival rates. Main inclusion criteria at baseline: age ≥ 65 years, a previous diagnosis of essential hypertension, a valid 24-h ambulatory blood pressure monitoring (ABPM). All participants received anti-hypertensive drugs during the 10-year period and we considered 10-year mortality for the analysis. General characteristics at baseline: mean age was 71.2 ± 5.3 years; females were 53.3%; 15.1% of patients had sustained controlled hypertension (SCH), 35.8% had WUCH, 10.8% had MUCH and 38.3% had sustained uncontrolled hypertension (SUCH). Thirty-two patients (26.7%) died during the 10-year period. Deceased patients were older, had lower treatment intensity, HDLc levels and eGFR than survivors. After adjusting for these covariates, MUCH (HR 12.30, p < 0.001) and SUCH (HR 4.84, p = 0.007) were associated with higher risk of death, compared to SCH, while no relationship emerged with WUCH (HR 1.58, p = 0.455). In our real-life study on treated elderly hypertensives, MUCH was associated with higher risk of death, compared to SCH and SUCH, while WUCH was not. ABPM is a key tool to improve management and therefore prognosis in this subpopulation.

中文翻译：

面罩和白大衣的高血压的预后作用：老年高血压患者的10年死亡率。

白大衣失控高血压（WUCH）和蒙面失控高血压（MUCH）在老年人中很常见。在这些亚群中，这些高血压表型的预后作用尚未完全确定。我们的目的是评估WUCH和MUCH在老年高血压患者中的长期预后作用。对120例连续治疗的老年高血压患者进行了观察性研究。在2006年的首次临床访问中对患者进行了评估。随后，这些患者或其亲属在10年后被召回以评估存活率。基线时的主要纳入标准：年龄≥65岁，先前诊断为原发性高血压，有效的24小时动态血压监测（ABPM）。所有参与者在10年期间都接受了降压药治疗，我们考虑了10年死亡率进行分析。基线时的一般特征：平均年龄为71.2±5.3岁；女性为53.3％；15.1％的患者患有持续控制性高血压（SCH），35.8％的患者患有WUCH，10.8％的患者患有MUCH，38.3％的患者患有持续性非控制性高血压（SUCH）。在这10年中，有32例患者（26.7％）死亡。死者年龄较大，治疗强度，HDLc水平和eGFR低于幸存者。校正这些协变量后，与SCH相比，MUCH（HR 12.30，p <0.001）和SUCH（HR 4.84，p = 0.007）与较高的死亡风险相关，而与WUCH无关（HR 1.58，p = 0.455）。）。在我们对已治疗的老年高血压的现实生活研究中，与SCH和SUCH相比，MUCH与更高的死亡风险相关，而WUCH则没有。ABPM是改进管理的重要工具，因此可以改善此亚人群的预后。

更新日期：2019-01-26

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