背景:尽管衰老和非洲人后裔是众所周知的隐性不受控制的高血压(MUCH)的危险因素,撒哈拉以南非洲老年黑人(BSSA)的数据有限。此外,目前尚不清楚年轻人的“多”决定因素是否与老年人不同。
目的:本研究旨在确定老年和年轻BSSA个体中与MUCH相关的患病率和危险因素。
方法:在本研究中,对168例接受治疗的高血压患者进行病史评估,临床检查,眼底镜检查,超声心动图,实验室数据。所有患者均接受动态血压(BP)监测24h。如果平均24h平均BP≥130/80mmHg,白天平均血压≥135/85mmHg,和/或夜间平均血压≥120/70mmHg,尽管临床血压控制(≤140/90mmHg)。采用Logistic回归分析评估与MUCH,分别包括老年人和年轻人。P值<0.05用于指示统计学显著性。
结果:在168例53.6±11.6岁的患者中,92人(54.8%)是男性,性别比为1.2,66人(39%)年龄≥60岁。老年患者的MUCH患者比例(所有患者为27.4%)明显高于年轻患者(45.5%vs.15.7%)。糖尿病(调整后的比值比[aOR],2.44;95%置信区间[CI],1.27-4.46;p=0.043),贫血(aOR,3.18;95%CI,1.07-5.81;p=0.043),高血压视网膜病变(aOR,4.50;95%CI,1.57-5.4;p=0.043),和左心室肥厚(aOR,4.48;95%CI,2.26-8.35;p=0.043)与老年人MUCH独立相关。在年轻人中,男性性别(aOR,2.16;95%CI,(1.33-4.80);p=0.029),肥胖(AOR,3.02;95%CI,(1.26-5.32);p=0.001),和左心室肥厚(LVH)(aOR,3.08;95%CI(2.14-6.24);p=0.019)与MUCH独立相关。
结论:老年人比年轻的BSSA个体更普遍。许多因素因年龄而异。许多预防和管理策略应针对特定年龄。
BACKGROUND: Although aging and being of African descent are well-known risk factors for masked uncontrolled hypertension (MUCH), data on MUCH among elderly black sub-Saharan Africans (BSSA) are limited. Furthermore, it is unclear whether the determinants of MUCH in younger individuals differ from those in the elderly.
OBJECTIVE: This study aimed to determine the prevalence and risk factors associated with MUCH in both elderly and younger BSSA individuals.
METHODS: In this study, 168 patients with treated hypertension were assessed for medical history, clinical examination, fundoscopy, echocardiography, and laboratory data. All patients underwent ambulatory blood pressure (BP) monitoring for 24 h. MUCH was diagnosed if the average 24-h mean BP ≥ 130/80 mmHg, the daytime mean BP ≥ 135/85 mmHg, and/or the nighttime mean BP ≥ 120/70 mmHg, despite controlled clinic BP (≤ 140/90 mmHg). Logistic regression analysis was performed to assess independent factors associated with MUCH, including elderly and younger adults separately. P-values < 0.05 were used to indicate statistical significance.
RESULTS: Of the 168 patients aged 53.6 ± 11.6 years, 92 (54.8%) were men, with a sex ratio of 1.2, and, 66 (39%) were aged ≥ 60 years. The proportion of patients with MUCH (27.4% for all patients) was significantly higher (p = 0.002) among elderly patients than among younger patients (45.5% vs. 15.7%). Diabetes mellitus (adjusted odds ratio [aOR], 2.44; 95% confidence interval [CI], 1.27-4.46; p = 0.043), anemia (aOR, 3.18; 95% CI, 1.07-5.81; p = 0.043), hypertensive retinopathy (aOR, 4.50; 95% CI, 1.57-5.4; p = 0.043), and left ventricular hypertrophy (aOR, 4.48; 95% CI, 2.26-8.35; p = 0.043) were independently associated with MUCH in the elderly. In younger individuals, male gender (aOR, 2.16; 95% CI, (1.33-4.80); p = 0.029), obesity (aOR, 3.02; 95% CI, (1.26-5.32); p = 0.001), and left ventricular hypertrophy (LVH) (aOR, 3.08; 95% CI, (2.14-6.24); p = 0.019) were independently associated with MUCH were independently associated with MUCH.
CONCLUSIONS: MUCH is more prevalent among elderly than among younger BSSA individuals. Determinants of MUCH vary by age. MUCH prevention and management strategies should be age-specific.