Can simultaneous ambulatory blood pressure and activity monitoring improve the definition of blood pressure?
Can simultaneous ambulatory blood pressure and activity monitoring improve the definition of blood pressure?
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同时动态血压和活动监测能否改善血压的定义？
DOI：
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发表时间：
1993
影响因子：
3.2
通讯作者：
P. L. Padfield
中科院分区：
文献类型：
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作者：
Michael J. Stewart;Helen Brown;P. L. Padfield
在这项研究中，我们使用手腕活动记录仪测量了319例进行动态血压监测（ABPM）的患者的活动和睡眠时间。用该技术得到的平均醒时和睡眠血压（BP）以及昼夜血压变化与白天（定义不同，从早上7点到晚上8点，早上7点到晚上10点，或早上7点到午夜）和夜间血压进行比较。为了更详细地研究活动记录仪衍生的活动数据与血压变异性的关系，30例患者间隔1至18天（平均8天）进行配对监测。然后校正平均清醒血压的活动性，以确定该技术是否可以提高再现性。醒着和白天血压有统计学差异，但没有临床意义，睡眠和夜间血压差异更大，可能具有临床意义。午夜到早上7点这段时间给出了观察到的睡眠时间和夜间血压下降的最佳估计。血压活动与收缩压的平均相关性为0.25，舒张压的平均相关性为0.34，但个体患者之间和个体患者之间的相关性强度差异很大。平均而言，活动占收缩压变化的20%和舒张压变化的26%。将平均清醒血压校正到标准活动水平可减少患者内差异6%/9%。这对总体重现性没有显著影响，可能是因为调整前该样本的可变性较低，差异的标准差为8/4 mm Hg。
In this study we measured activity and sleep time, using a wrist actigraph, in a population of 319 patients referred for ambulatory blood pressure monitoring (ABPM). Mean waking and sleeping blood pressure (BP) and the diurnal BP variation derived with this technique were compared to daytime (defined variously as 7 AM to 8 PM, 7 AM to 10 PM, or 7 AM to midnight) and nighttime pressure. To study the relationship of actigraph-derived activity data to BP variability in more detail, 30 patients underwent paired monitoring 1 to 18 (mean 8) days apart. Mean waking BP was then corrected for activity to determine whether this technique could improve reproducibility. Statistically but not clinically significant differences between waking and daytime BP were seen, with larger and potentially clinically relevant differences between sleeping and nighttime BP. The midnight to 7 AM time period gave the best estimate of observed sleeping time and the nocturnal dip of BP. The average correlation between activity and BP was 0.25 for systolic and 0.34 for diastolic BP, but with wide variation in the strength of the relationship both between and within individual patients. On average, activity accounts for 20% of systolic and 26% of diastolic BP variation. Correcting the mean waking BP to a standard activity level reduced within-patient variation by 6%/9%. This made no significant difference to overall reproducibility, perhaps because variability in this sample was low before adjustment, with the standard deviation of the difference equal to 8/4 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)