| Objective:To explore the difference of blood pressure measured by AOBP(Automated office blood pressure)and other blood pressure measurement methods,and the correlation between AOBP and early target organ damage in patients with hypertension.Method:Using the method of cross-sectional study,208 patients with essential hypertension、OBP≥140/90 mm Hg、aged between 18 to 75 in the first affiliated hospital of fujian medical university from September 2017 to January 2020 were selected as the hypertension group,and 80 healthy subjects with normal blood pressure were selected as the normal control group.The general relevant data were collected and OBP(Office blood pressure),AOBP,24 h AMBP(24h ambulatory blood pressure),HBP(Home blood pressure)and clinical biochemical indexes were measured.The hypertension group was divided into AOBP elevated group and normal AOBP group by AOBP≥135/85 mm Hg.The differences of blood pressure measured by different methods were compared by repeated measurement analysis of variance,Pearson correlation analysis was used to compare the relationship between different blood pressure measurement methods and the correlation between blood pressure value and target organ damage,and multiple linear regression analysis was performed to analyze the independent risk factors of early target organ damage in hypertension.ROC curve was used to find the cut-off point of AOBP in the diagnosis of hypertension.Results:1.There were significant differences between OBP and AOBP,HBP and 24 h AMBP in hypertensive patients.AOBP was higher than HBP and 24 AMBP,but there was no significant difference between HBP and 24 AMBP.Pearson correlation analysis showed that AOBP-SBP was closest to the OBP-SBP(r = 0.792),AOBP-DBP was closest to H-d DBP(r = 0.697);AOBP elevated group: no matter systolic blood pressure or diastolic blood pressure,the AOBP value was closest to the OBP.The normal AOBP group: AOBP-SBP was closest to 24 h SBP,AOBP-DBP was closest to 24 hd DBP.2.The cut-off point of AOBP diagnosis of hypertension: According to the ROC curve,the cut-off point of hypertension diagnosed by AOBP was 133.5/88.5 mm Hg with ambulatory blood pressure as the gold standard.3.The mean walues of ba PWV(Brachial-ankle pulse wave velocity)、MA(Microalbuminuria)and ACR(Urinary albumin to creatinine ratio)in hypertension group were higher than those in normal control group,and ABI(Ankle-brachial index)was lower(P<0.05);The ba PWV、MA、ACR in AOBP elevated group were higher than those in normal AOBP group.There was significant difference in ba PWV and ACR between the two groups(P<0.05),but there was no significant difference in ABI and MA(P>0.05).4.Analysis of blood pressure and target organ damage:(1)there was a positive correlation between OBP-SBP,AOBP-SBP,H-d SBP,H-n SBP,24 h SBP,24 hd SBP,24 hn SBP and ba PWV at 0.01 level;(2)a negative correlation between OBP-DBP,AOBP-SBP,AOBP-DBP,H-d DBP,H-n DBP and ABI;(3)a positive correlation between OBP-DBP,AOBP-SBP,AOBP-DBP,24 h SBP,24 hd SBP,24 hd DBP and MA;(4)a positive correlation between OBP-SBP,AOBP-SBP,AOBP-DBP,H-n SBP,24 h SBP,24 hd SBP,24 hn SBP were positively correlated with ACR.5.Multivariate regression analysis showed that:(1)in hypertension group: age,Glu and OBP-SBP were independent risk factors for ba PWV;while BMI,TC,TG,family history and H-n SBP were independent related factors for ABI(P<0.05);BMI was a common independent risk factor for MA and ACR,while male might be a protective factor for ACR.(2)AOBP elevated group: age and 24h-n SBP were independent risk factors for ba PWV,TG and family history were independent influencing factors for ABI,BMI was a common independent risk factor for MA and ACR,and male was a protective factor for ACR(P<0.05).(3)normal AOBP group:age and Glu were independent risk factors for ba PWV,and smoking history was independent risk factors for ABI(P<0.05),No independent factors related to MA and ACR were identified.6.Age subgroup analysis showed that in the non-elderly group(<60 years),age and OBP-SBP were independent risk factors for ba PWV,family history was an independent factor related to ABI,BMI was a common independent risk factor for MA and ACR(P < 0.05).In the elderly group(≥60 years),high-density lipoprotein cholesterol(HDL-C)and Glu were independent risk factors for ba PWV,TC was an independent risk factor for ABI(P<0.05).Conclusion:1.For patients with elevated AOBP and OBP,AOBP was closest to OBP,but significantly higher than 24 h AMBP and HBP;while for patients with normal AOBP and elevated OBP,AOBP was closer to 24 h AMBP and HBP,which was significantly lower than OBP(11.5 mm Hg lower on average);The cutoff point of hypertension diagnosed by AOBP was 133.5/88.5 mm Hg in our study.2.AOBP was related to early arteriosclerosis and renal function damage in patients with hypertension.Age,Glu and OBP-SBP were independent risk factors for hypertensive atherosclerosis,In patients with elevated AOBP,age and 24h-n SBP were also independent risk factors;BMI was an independent risk factor for MA and ACR. |
