背景:心血管疾病是全球范围内导致大多数死亡的一组疾病,动脉高血压是可改变的危险因素,主要是其他心血管疾病的发展。在这方面,动态血压监测(ABPM)可以检测整个24h内血压的不同变化,被称为昼夜节律模式(北斗星,非北斗星,立管或极端铲斗)。这些模式与心血管风险之间可能存在关联,因此,本研究旨在使用2种经过验证的量表REGICOR和SCORE,在使用ABMP的不同昼夜节律模式的患者中比较心血管风险.
方法:对2015年至2021年在AlcázardeSanJuan和Madridejos注册的ABMP高血压患者进行回顾性研究。数据来自临床病史(动脉高血压,BMI,合并症,和吸烟习惯)和ABPM记录,以及社会人口统计学和分析变量,心血管风险量表(REGICOR和SCORE)和昼夜节律变量(北斗星,极端的北斗星,非北斗星和上升模式)。
结果:二百六十九名患者(女性占46.5%,包括64.3±12.6岁)。有38.3%的人有北斗星图案,10%极端北斗星,33.1%非铲斗和18.6%立管。冒口型患者在REGICOR和SCORE量表上得分较高(34%和68%,分别)。在两个量表之间建立了显着的相关性(Spearmanrho:0.589;p<0.001),但一致性较差(kappa=0.348[95%CI0.271-0.425])。
结论:ABMP已成为诊断和治疗动脉高血压的非常有用的工具。此外,这些患者的昼夜节律模式可能与选择适当的治疗方法和正确的随访有关.
BACKGROUND: Cardiovascular diseases are the group of diseases that cause most deaths worldwide, being arterial hypertension the modifiable risk factor that mostly predisposes to other cardiovascular diseases development. In this regard, ambulatory blood pressure monitoring (ABPM) lets to detect the different changes in blood pressure throughout 24h, known as circadian patterns (dipper, non-dipper, riser or extreme dipper). There may be an association between these patterns and cardiovascular risk, so this study aims to compare cardiovascular risk using the 2 validated scales REGICOR and SCORE in patients with different circadian patterns using ABMP.
METHODS: Retrospective study of hypertensive patients with ABMP registered between 2015 and 2021 in Alcázar de San Juan and Madridejos. Data were collected from clinical history (arterial hypertension, BMI, comorbidities, and smoking habits) and ABPM records, as well as sociodemographic and analytical variables, cardiovascular risk scales (REGICOR and SCORE) and circadian rhythm variables (dipper, extreme dipper, non-dipper and rise pattern).
RESULTS: Two hundred and sixty-nine patients (46.5% female, 64.3±12.6 years old) were included. There were 38.3% with dipper pattern, 10% extreme dipper, 33.1% non-dipper and 18.6% riser. Patients with riser pattern showed higher score on the REGICOR and SCORE scales (34 and 68%, respectively). A significant correlation was established between both scales (Spearman rho: 0.589; p<0.001), but with poor concordance (kappa=0.348 [95% CI 0.271-0.425]).
CONCLUSIONS: ABMP has turned into a very useful tool in the diagnosis and treatment of arterial hypertension. In addition, the circadian patterns of these patients may correlate to the choice of an adequate treatment and correct follow-up.