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Lower utilization of home blood pressure monitoring in younger, poorly educated hypertensive males - real-life data.

年轻、受教育程度低的高血压男性家庭血压监测利用率较低-真实数据。

  • 影响因子:1.92
  • DOI:10.1080/08037051.2019.1684818
  • 作者列表:"Chudek A","Owczarek AJ","Ficek J","Almgren-Rachtan A","Chudek J
  • 发表时间:2020-04-01
Abstract

:Background: Home blood pressure monitoring (HBPM) became a standard in the management of hypertension. However, there are few data concerning the utilisation of blood pressure (BP) monitors in daily clinical practice.Aim: The aim of this analysis was to show: (1) how frequently hypertensive patients are equipped with BP monitors, (2) how often they perform regular HBPM and running BP diaries, (3) what are the correlates of utilisation of BP monitors, in a large real-life cohort of hypertensives examined for the efficacy of antihypertensive therapy. Patients and methods: The survey was conducted by 570 physicians among 14,200 hypertensive patients, of whom 12,289 (6163 women; mean age 63 ± 12 years) declared use of antihypertensive medicines. Each patient was asked whether at home is having and using regularly or occasionally BP monitor and running BP diary. BP control was assessed based on the mean of two attended office BP measurements.Results: Among patient equipped with BP monitors (87.2%), 73.4% were conducting HBPM regularly, while 26.6% occasionally, and 66.9% were running BP diaries. Controlled BP was achieved by 34.5% (32.9% men and 36.1% women; p < .001), more frequently by equipped with BP monitors (34.9 vs 31.7%, p < .001). Female sex, education, professional activity, active lifestyle, older age, hypertensive polytherapy, longer than 5-year therapy for hypertension, and coexistence of diabetes were factors increasing, while alcohol consumption, visceral obesity and heart failure decreasing the probability of being equipped with BP monitor and running BP diary. Regular HBPM were more frequently among women, physically active, older, diabetics, viscerally obese and patients with coronary artery disease.Conclusions: (1) The majority of hypertensive Poles are already equipped with BP monitors, (2) three-fourth patients perform regular HBPM and two-third run BP diaries, (3) there is still a need to promote utilisation of BP monitors among younger, poorly educated hypertensive males.

摘要

背景: 家庭血压监测 (HBPM) 成为高血压管理的标准。然而,关于在日常临床实践中使用血压 (BP) 监测仪的数据很少。目的: 本分析的目的是显示 :( 1) 高血压患者配备血压监测仪的频率,(2) 他们定期进行 HBPM 和运行 BP 日记的频率, (3)在检测降压治疗疗效的大型真实高血压患者队列中,使用 BP 监测仪的相关因素是什么。患者与方法: 调查了 570 名高血压患者中的 14,200 名医生,其中 12,289 名 (6163 名女性; 平均年龄 63 ± 12 岁) 宣布使用抗高血压药物。询问每位患者在家是否定期或偶尔使用 BP 监测仪和运行 BP 日记。根据两次参加办公室 BP 测量的平均值评估 BP 控制。结果: 在装有 BP 监测仪的患者中 (87.2%),73.4% 定期进行 HBPM,26.6% 偶尔进行,66.9% 进行 BP 日记。控制血压达到 34.5% (32.9% 为男性,36.1% 为女性; P <.001),更频繁地通过配备 BP 监视器 (34.9 vs 31.7%,p <.001)。女性、文化程度、职业活动、积极生活方式、高龄、高血压综合治疗、高血压治疗 5 年以上、糖尿病并存是增加因素,而饮酒、内脏肥胖和心力衰竭降低配备 BP 监测仪和运行 BP 日记的概率。定期 HBPM 在女性、体力活动、老年、糖尿病、内脏肥胖和冠心病患者中更常见。结论 :( 1) 大多数高血压患者已经配备了 BP 监测仪,(2) 4分之3 的患者定期执行 HBPM,3分之2 的患者运行 BP 日记,(3)仍然需要促进年轻、受教育程度低的高血压男性使用 BP 监测仪。

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METHODS:BACKGROUND:'Neuronal precursor cell expressed developmentally down-regulated 4-like' (NEDD4L) is considered a candidate gene for hypertension-both functionally and genetically-through the regulation of the ubiquitination of the epithelial sodium channel (ENaC). This study explores the relationship between genetic variation in NEDD4L and hypertension with chronic kidney disease (CKD) in the southeastern Han Chinese population. METHODS:We recruited 623 CKD patients and measured ambulatory blood pressure monitoring (ABPM), and the rs4149601 and rs2288774 polymorphisms in NEDD4L were genotyped using qPCR. RESULTS:For rs4149601, significant differences in genotype frequencies in an additive model (GG vs GA vs AA) were observed between normotensive patients and hypertensive patients when hypertension was classified into ambulatory hypertension, clinical hypertension and ambulatory systolic hypertension (P = 0.038, 0.005 and 0.006, respectively). In a recessive model (GG+GA vs AA), the frequency of the AA genotype of rs4149601 in the hypertension groups were all higher than that in the normotensive groups. The genotype distribution of rs2288774 did not differ significantly between the normotensive and hypertensive patients. In both the full cohort and the propensity score matching (PSM) cohort, the AA genotype of rs4149601 (compared to the GG+GA genotype group) was independently correlated with ambulatory hypertension, clinical hypertension and ambulatory systolic hypertension by multivariate logistic regression analysis. CONCLUSIONS:The present study indicates that the AA genotype of rs4149601 associates with hypertension in CKD. Consequently, the rs4149601 A allele might be a risk factor for hypertension with CKD.

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