Blood pressure reductions during self-recording of home blood pressure.
Blood pressure reductions during self-recording of home blood pressure.
复制标题
自我记录家庭血压期间血压降低。
DOI：
10.1016/0002-8703(79)90289-8
复制
发表时间：
1979
影响因子：
4.8
通讯作者：
D. Sherrard
中科院分区：
文献类型：
--
作者：
K. D. Laughlin;L. Fisher;D. Sherrard
对60例原发性高血压患者进行了一个月的家庭血压测量，每天两次。基于拟合每个受试者数据的二次曲线的每日平均变化值（对于整个月或药物变化当天）为负值，并且对于收缩压和舒张压以及a.m.和p.m.读数具有统计学显著性。43%的受试者出现了具有临床意义的血压下降，定义为从最初两天到最后两天收缩压和/或舒张压下降≥ 10 mmHg。观察到的血压下降可能是由于（1）安慰剂效应和/或与治疗方案改变相关的依从性增加，（2）医疗保健从业人员的关注增加，（3）血压对测量条件的适应，或（4）生物反馈效应。最有可能的解释是习惯性的血压下降。在头两天之后，较小但持续的下降可能是由于，至少部分是由于生物反馈效应。如果进一步的研究支持这种假设，那么家庭血压读数应该在更广泛的范围内用于治疗目的。他们比其他行为治疗更容易管理，观察到的下降似乎是相同的数量级，无论这种类型的生物反馈的治疗潜力，家庭血压的下降，而患者每天在家里自己的压力表明诊断等待期的重要性，直到血压稳定和药物治疗之前。这段时间可能会持续一个月或更长的时间为一些患者。
Blood pressure readings were taken at home twice a day for one month by 60 subjects with essential hypertension. The average change-perday value based on quadratic curves fit to each subject's data (for the entire month or to the day of medication change) was negative and was statistically significant for both systolic and diastolic and fora.m.andp.m.readings. Clinically significant decreases in blood pressure, defined as systolic and/or diastolic decreases ≥ 10 mm. Hg from the first two to the last two days, occurred in 43 per cent of the subjects.The observed blood pressure decreases may have been due to (1) placebo effects and/or increased compliance associated with the change of treatment program, (2) increased attention of health care practitioners, (3) habituation of blood pressure to the conditions of measurement, or (4) biofeedback effects. The most likely explanation for the initial blood pressure decrease in habituation. The smaller but continuing decrease after the first two days was probably due, at least in part, to a biofeedback effect. If further studies support such an hypothesis, then home blood pressure readings should be used on a wider scale for treatment purposes. They are easier to administer than other behavioral treatments and the observed decreases appear to be of the same order of magnitude.Regardless of the treatment potential of this type of biofeedback, the decreases in home blood pressures while patients are taking their own pressures daily at home suggest the importance of a diagnostic waiting period until blood pressure stabilizes and before pharmacological treatment is prescribed. This period may last a month or longer for some patients.