Methods for assessing blood pressure values in humans.
Methods for assessing blood pressure values in humans.
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评估人类血压值的方法。
DOI：
10.1161/01.hyp.5.5_pt_2.iii5
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发表时间：
1983
期刊：
影响因子：
8.3
通讯作者：
G. Mancia
中科院分区：
文献类型：
--
作者：
G. Mancia
在临床医学和流行病学中，血压的测量主要依赖于袖带充气和柯氏音的使用。虽然仍然是最实用的方法，但已认识到该方法具有重要的局限性。本文着重于两个局限性的袖带方法，已被发现，而记录24小时动脉内血压在自由生活正常和高血压患者。首先，24小时血压的特征在于大的长期和短期变化，其幅度根据患者的基础血压和年龄而变化。这可能会降低少数孤立袖带测量值准确并代表患者平均血压的可能性。第二，在由医生（以及由护士在较小程度上）进行袖带血压评估期间，患者的血压通常由于警报反应而升高，在前4分钟内具有大的峰值并且随后下降。峰值上升的幅度，以及其在受试者之间的巨大且不可预测的差异可能是导致严重和过度高估血压的原因。从医生就诊开始的10分钟等待通常可以避免这种不便。最后，本文简要地考虑了袖带方法的替代方法，包括在非卧床受试者中进行有创动脉内24小时记录，该方法提供了大量信息，但不切实际，以及无创自动血压装置，该装置提供了一种有前途的实用方法，但必须等待技术验证。
In clinical medicine and epidemiology, measurements of blood pressure largely rely upon the use of cuff inflation and Korotkoff sounds. Although still the most practical, this method has been recognized to have important limitations. This paper focuses on two limitations of the cuff method that have been found while recording 24-hour intraarterial blood pressure in free-living normotensive and hypertensive patients. First, the 24-hour blood pressure is characterized by large long- and short-term variabilities whose magnitudes vary according to the patient's basal blood pressure and age. This is likely to reduce the possibility that a few isolated cuff measurements are accurate and representative of the patient's average blood pressure. Second, during cuff blood pressure assessment by the doctor (and to a lesser degree by the nurse), the patient's blood pressure normally rises due to an alarm reaction, with a large peak within the first 4 minutes and a subsequent decline. The magnitude of the peak rise, as well as its large and unpredictable difference among subjects may be responsible for seriously and variably overestimating the blood pressure. A 10-minute wait from the beginning of the doctor's visit usually avoids this inconvenience. Finally, the paper briefly considers alternative methods to the cuff method, including invasive intraarterial 24-hour recording in ambulatory subjects, which provides a large amount of information but is impractical, and noninvasive automatic blood pressure devices, which offer a promising practical approach but must wait for technical validation.