隐匿性夜间高血压和隐藏器官风险：系统综述
Masked Nocturnal Hypertension and Hidden Organ Risk: A Systematic Review.
摘要(中文译文)
隐匿性夜间高血压是一种隐蔽的血压表型，即诊室血压看似正常或已控制，而夜间动态血压仍持续升高。本系统综述评估了经24小时动态血压监测检出的隐匿性夜间高血压或孤立性夜间高血压与诊室血压正常或已控制成人的心血管结局或靶器官结局之间的关联。研究在PubMed、Web of Science东地中海区域（WOS-EMR）、Web of Science、Scopus和Cochrane Library进行了系统检索。纳入标准为诊室血压正常或已控制、接受24小时动态血压监测并报告了心血管结局或靶器官损害的成人研究。排除综述、社论、儿科研究、妊娠相关研究、无夜间血压数据的研究以及无相关结局的研究。研究筛选、数据提取和偏倚风险评估均采用预设标准进行。纳入的证据涵盖基于人群的队列、慢性肾脏病队列、糖尿病队列、高血压门诊样本以及未治疗的门诊人群。总体而言，各研究报告的隐匿性夜间高血压和孤立性夜间高血压通常与较高的心血管、卒中和死亡风险相关，并与肾脏、心脏、血管和脑血管靶器官损害相关，包括肾功能损害、白蛋白尿或蛋白尿、左心室肥厚、左心室质量增加、动脉僵硬度增加、颈动脉内膜中层厚度增加以及无症状脑血管病变。然而，由于各研究在人群、夜间血压阈值、治疗状态、随访时长和结局定义方面存在差异，对结果的解读应保持谨慎。经动态血压监测检出的隐匿性夜间高血压似乎是诊室血压正常或已控制成人中具有临床重要意义的表型。研究结果支持将夜间血压评估作为改善心血管和靶器官风险分层的有效方法，尤其是在慢性肾脏病、糖尿病和已治疗高血压等高危人群中。
Abstract
Masked nocturnal hypertension is a hidden blood pressure phenotype in which office blood pressure appears normal or controlled while nighttime ambulatory blood pressure remains elevated. This systematic review evaluated the association between masked nocturnal hypertension or isolated nocturnal hypertension detected by 24-hour ambulatory blood pressure monitoring and cardiovascular or target-organ outcomes in adults with normal or controlled office blood pressure. A systematic search was conducted across PubMed, Web of Science East Mediterranean Region (WOS-EMR), Web of Science, Scopus, and Cochrane Library. Eligible studies included adults with normal or controlled office blood pressure who underwent 24-hour ambulatory blood pressure monitoring and had reported cardiovascular outcomes or target-organ damage. Reviews, editorials, pediatric studies, pregnancy-related studies, studies without nighttime blood pressure data, and studies without relevant outcomes were excluded. Study selection, data extraction, and risk-of-bias assessment were performed using predefined criteria. The included evidence covered population-based cohorts, chronic kidney disease cohorts, diabetes cohorts, hypertension clinic samples, and untreated outpatient populations. Across studies, masked nocturnal hypertension and isolated nocturnal hypertension were generally associated with higher cardiovascular, stroke, and mortality risks, as well as renal, cardiac, vascular, and cerebrovascular target-organ damage, including renal impairment, albuminuria or proteinuria, left ventricular hypertrophy, increased left ventricular mass, arterial stiffness, carotid intima-media thickness, and silent cerebrovascular lesions. However, interpretation should remain cautious because studies differed in population, nocturnal blood pressure thresholds, treatment status, follow-up duration, and outcome definitions. Masked nocturnal hypertension detected by ambulatory blood pressure monitoring appears to be a clinically important phenotype among adults with normal or controlled office blood pressure. The findings support nighttime blood pressure assessment as a useful approach for improving cardiovascular and target-organ risk stratification, especially in high-risk groups such as chronic kidney disease, diabetes, and treated hypertension.
如何引用
AMA
Anas M Berro, Mostafa M Obeid Alla, Mohamed Madani, Rayan E Elkhair, Eithar Musa, Morad Mohammad Ahourani, et al. Masked Nocturnal Hypertension and Hidden Organ Risk: A Systematic Review.. Cureus. 2026; doi:10.7759/cureus.111479.
APA
Anas M Berro, Mostafa M Obeid Alla, Mohamed Madani, Rayan E Elkhair, Eithar Musa, Morad Mohammad Ahourani, et al (2026). Masked Nocturnal Hypertension and Hidden Organ Risk: A Systematic Review.. Cureus. https://doi.org/10.7759/cureus.111479
GB/T 7714
Anas M Berro, Mostafa M Obeid Alla, Mohamed Madani, Rayan E Elkhair, Eithar Musa, Morad Mohammad Ahourani, et al. Masked Nocturnal Hypertension and Hidden Organ Risk: A Systematic Review.[J]. Cureus, 2026 doi:10.7759/cureus.111479.
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