Preview

Rational Pharmacotherapy in Cardiology

Advanced search

THE RATE AND CHARACTERS OF MASKED ARTERIAL HYPERTENSION AND MASKED INEFFECTIVENESS OF HYPERTENSION TREATMENT IN INDUSTRIAL WORKERS ACCORDING TO THE PREVENTIVE EXAMINATION

https://doi.org/10.20996/1819-6446-2014-10-5-481-487

Full Text:

Abstract

Aim. To study the rate and characters of masked arterial hypertension (HT) and masked ineffectiveness of HT treatment in industrial workers within annual preventive examination.

Material and methods. Workers (n=185) with normal office blood pressure (BP) <140 and <90 mm Hg were enrolled into cross-cohort study of industrial workers of large enterprise engaged in activity with harmful and/or dangerous conditions (n=477; mean age 53.2±5.5 years). Standard survey, anthropometry, ambulatory BP monitoring (ABPM), blood chemistry, electrocardiography, and echocardiography were performed. Criteria of masked HT and masked HT in treated subjects were the level of office BP <140 and <90 mm Hg in combination with mean BP during the operational period ≥135 and/or ≥85 mmHg. Patient characters significantly associated with this ratio of office BP and BP during the operational period were considered as features of isolated increase in ambulatory BP level.

Results. The rate of masked HT among workers with normal office BP was 10.8%, and masked HT among treated subjects was 34.6%. Workers with masked HT, in contrast to the normotensive workers according to the office BP and ABPM measurements, had a higher left ventricular mass index (in males 129.0±21.2 vs. 109.5±28.8 g/m2, respectively, in women 105.2±43.2 vs. 82.4±25.3 g/m2, respectively, p<0.05), and higher body weight (85.4±13.3 vs. 81.3±10.1 kg, respectively; p=0.05). Treated subjects with masked HT, unlike workers with effective antihypertensive therapy had a higher body weight (89.4±16.1 vs. 85.4±15.8 kg, respectively, p<0.05), higher levels of triglycerides (1.56±0.95 vs. 1.23±0.55 mmol/l, respectively, p<0.01) and uric acid (388.5±89.5 vs. 357.2±84.5 mmol/l, respectively, p<0.05), more prominent left ventricular hypertrophy, lower incidence of ischemic heart disease, but higher number of persons taking ACE inhibitors. Occupation and work features were not characters of the masked HT and masked ineffectiveness of HT treatment.

Conclusion. Masked HT and masked HT in treated subjects (masked ineffectiveness of HT treatment) can occur in almost a half of industrial workers with normal office BP. Ambulatory BP measurement methods, especially ABPM, as well as standard risk factors detection are necessary for early revealing of HT phenotypes during preventive examination.

About the Authors

M. I. Smirnova
State Research Centre for Preventive Medicine
Russian Federation

Petroverigsky per. 10, Moscow, 101990 Russia



E. M. Platonova
Industrial hospital № 170, Federal Medical-Biological Agency of the Russian Federation
Russian Federation
Lenina ul. 2, Korolev, Moscow Region, 141071 Russia


A. N. Britov
State Research Centre for Preventive Medicine
Russian Federation

Petroverigsky per. 10, Moscow, 101990 Russia



V. M. Gorbunov
State Research Centre for Preventive Medicine
Russian Federation

Petroverigsky per. 10, Moscow, 101990 Russia



A. D. Deev
State Research Centre for Preventive Medicine
Russian Federation

Petroverigsky per. 10, Moscow, 101990 Russia



Y. N. Koshelyaevskaya
State Research Centre for Preventive Medicine
Russian Federation

Petroverigsky per. 10, Moscow, 101990 Russia



References

1. Shalnova SA, Deev AD, Vihireva OV et al. Prevalence of arterial hypertension in Russia. Awareness, treatment and control. Profilaktika Zabolevaniy i Ukreplenie Zdorov'ya 2001, 2: 3-7. Russian (Шальнова С.А., Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертонии в России. Ин-формированность, лечение, контроль. Профилактика Заболеваний и Укрепление Здоровья 2001;2:3-7).

2. Fagard RH, Cornelissen VA. Incidence of cardiovascular events in white-coat, masked and sustained hypertension vs. true normotension: a meta-analysis. J Hypertens 2007; 25:2193-8.

3. Pierdominico SD, Cuccurillo F. Prognostic value of white-coat and masked hypertension diagnosed by ambulatory monitoring in initially untreated subjects: an update meta analysis. Am J Hypertens 2011; 24:52-8.

4. Bobrie G, Clerson P, Menard J et al. Masked hypertension: a systematic review. J Hypertens 2008; 26:1715-25.

5. Bjorklund K, Lind L, Zethelius B et al. Isolated ambulatory hypertension predicts cardiovascular morbidity in elderly men. Circulation 2003; 107:1297-302.

6. Stergiou GS, Asayama K, Thijs L et al. Prognosis of white-coat and masked hypertension: International Database of HOme blood pressure in relation to Cardiovascular Outcome. Hypertension 2014;63(4):675-82.

7. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res 2009; 32:3-107.

8. 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens 2013; 31:1281-357.

9. Pickerihg T.G., Eguchi K., Kario K. Masked hypertension: a review. Hypertens Res 2007; 30: 479-88.

10. Hänninen MR, Niiranen TJ, Puukka PJ et al. Determinants of masked hypertension in the general population: the Finn-Home study. J Hypertens 2011;29(10):1880-8.

11. Ogedegbe G. Casual mechanisms of masked hypertension: socio-psychological aspects. Blood Press Monit 2010; 15:90-92.

12. Harada K, Karube Y, Saruhara H et al. Workplace hypertension is associated with obesity and family history of hypertension. Hypertens Res 2006;29(12):969-76.

13. Trudel X, Brisson C, Larocque B, Milot A. Masked hypertension: different blood pressure measurement methodology and risk factors in a working population. J Hypertens 2009;27(8):1560-7.

14. Trudel X, Brisson C, Milot A. Job strain and masked hypertension. Psychosom Med 2010;72(8):786-93.

15. Landsbergis PA, Travis A, Schnall PL. Working conditions and masked hypertension. High Blood Press Cardiovasc Prev 2013;20(2):69-76.

16. Gorbunov VM, Smirnova MI, Andreeva GF, et al. Prevalence and predictors of treatment failure latent hypertension using different antihypertensive drugs. Kardiologiya 2009; 2 (49): 32-7. Russian (Гор-бунов В.М., Смирнова М.И., Андреева Г.Ф., и др. Распространенность и предикторы скрытой неэффективности лечения артериальной гипертонии при использовании различных антиги-пертензивных препаратов. Кардиология 2009; 2(49): 32-7).

17. Gorbunov VM, Smirnova MI. Modern problems of evaluating the effectiveness of antihypertensive therapy: the silent treatment failure and "white coat hypertension." Ration Pharmacother Cardiol 2009; 5 (3): 76-82. Russian (Горбунов В.М., Смирнова М.И. Современные проблемы оценки эф-фективности антигипертензивной терапии: скрытая неэффективность лечения и «гипертония белого халата». Рациональная Фармакотерапия в Кардиологии 2009; 5(3):76-82).

18. Smirnova MI, Oganov RG, Gorbunov VM et al. Hidden ineffective treatment of hypertension: incidence and predictors. Kardiovaskulyarnaya Terapiya i Profilaktika 2011; 6: 11-7. Russian (Смирнова М.И., Оганов Р.Г., Горбунов В.М. и соавт. Скрытая неэффективность лечения артериальной гиперто-нии: частота и предикторы. Кардиоваскулярная Терапия и Профилактика 2011; 6:11-7).

19. Ishikava J.,Kario K., Eguchi K. et al. Regular alcohol drinking is a determinant of masked morning hypertension detected by home blood pressure monitoring in medicated hypertensive patients with wellcontrolled clinic blood pressure: the Jichi Morning Hypertension Research (J-MORE) study. Hypertens Res 2006;29:679-86.

20. Kotovskaya Y., Bagmanova N., Kobalava Zh. High prevalence of masked uncontrolled hypertension in treated inpatients. J Hypertens 2006; 25 (suppl 2): S300.


For citation:


Smirnova M.I., Platonova E.M., Britov A.N., Gorbunov V.M., Deev A.D., Koshelyaevskaya Y.N. THE RATE AND CHARACTERS OF MASKED ARTERIAL HYPERTENSION AND MASKED INEFFECTIVENESS OF HYPERTENSION TREATMENT IN INDUSTRIAL WORKERS ACCORDING TO THE PREVENTIVE EXAMINATION. Rational Pharmacotherapy in Cardiology. 2014;10(5):481-487. (In Russ.) https://doi.org/10.20996/1819-6446-2014-10-5-481-487

Views: 451


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)