We investigated blood pressure (BP) and heart rate variability and baroreflex sensitivity (BRS) in white-coat, masked and sustained hypertension in untreated patients ( n = 645). Normotension and white-coat, masked, and sustained hypertension were defined according to the clinic (cutoff 140/90 mmHg) and 24-h ambulatory (130/80 mmHg) BPs. The Finometer device recorded beat-to-beat finger BP and electrocardiograms in the supine and standing positions for the computation of frequency-domain power-spectral BP and heart rate variability indexes and BRS. In multivariate analysis, BP variability indexes in the supine position differed significantly ( P < 0.0001) for both low-frequency (LF) and high-frequency (HF) components and the LF/HF ratio, with the lowest LF and HF power and highest LF/HF ratio in white-coat hypertension ( n = 28), the highest LF and HF power and lowest LF/HF ratio in sustained hypertension ( n = 198), and intermediate values in normotension ( n = 189) and masked hypertension ( n = 230). These differences diminished in the standing position, being significant ( P < 0.0001) only for the LF component variability. The LF/HF ratio in BP in the supine position decreased with advancing age in normotension and sustained hypertension ( P ≤ 0.03) but not white-coat or masked hypertension ( P ≥ 0.12). For heart rate variability, a significant difference was observed only for the LF component in the supine position ( P = 0.0005), which was lowest in white-coat hypertension. BRS in masked and sustained hypertension was significantly ( P ≤ 0.0001) lower than that in normotension in both supine and standing positions and decreased with advancing age ( P ≤ 0.0001). In conclusion, masked, but not white-coat, hypertension showed similar patterns of, but slightly less severe, changes in BP and heart rate variability and BRS to sustained hypertension.

中文翻译：

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白大衣、蒙面和持续性高血压的血压和心率变异性和压力反射敏感性

我们调查了未经治疗的白大衣、隐匿性和持续性高血压患者的血压 (BP) 和心率变异性和压力反射敏感性 (BRS) (n = 645)。正常血压和白大衣、隐匿性和持续性高血压是根据诊所（临界值 140/90 mmHg）和 24 小时动态血压（130/80 mmHg）定义的。Finometer 设备在仰卧位和站立位记录每搏手指血压和心电图，用于计算频域功率谱血压和心率变异指数和 BRS。在多变量分析中，低频（LF）和高频（HF）成分以及 LF/HF 比率的仰卧位血压变异性指数差异显着（ P < 0.0001），LF 和 HF 功率最低，最高白大衣高血压的 LF/HF 比值 (n = 28)，持续性高血压 (n = 198) 中 LF 和 HF 功率最高，LF/HF 比最低，血压正常 (n = 189) 和隐匿性高血压 (n = 230) 处于中间值。这些差异在站立位置时减小，仅对于低频分量变异性显着（ P < 0.0001）。正常血压和持续性高血压（ P ≤ 0.03）中，仰卧位BP的LF / HF比值随着年龄的增长而降低（ P ≤ 0.03），但白大衣或隐匿性高血压没有（ P ≥ 0.12）。对于心率变异性，仅在仰卧位的 LF 分量中观察到显着差异（ P = 0.0005），其在白大衣高血压中最低。隐匿性和持续性高血压的 BRS 在仰卧位和站立位均显着低于正常血压组（ P ≤ 0.0001），并且随着年龄的增长而降低（ P ≤ 0.0001）。