BILATERAL INDIRECT AND DIRECT ARTERIAL PRESSURES
BILATERAL INDIRECT AND DIRECT ARTERIAL PRESSURES
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DOI：
10.1161/01.cir.22.3.419
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发表时间：
1960-01-01
期刊：
影响因子：
37.8
通讯作者：
HINES, EA
中科院分区：
文献类型：
--
作者：
HARRISON, EG;ROTH, GM;HINES, EA
本文对447例病人在基础状态下用间接法非同时和同时进行双侧血压测定。结果表明，双侧血压测定必须同时进行对患者进行检查，以确定可能的血压不平等。本文比较了14例正常人和53例病人同时间接法和同时直接法测得的双侧血压差。观察到的双侧压力差异的特点是其不稳定性和缺乏协议与随后的测量时，研究的直接和间接的方法，这显然是分开的，由于改变了血液动力学的主动脉弓或其支流的病理条件。当双侧血压差异很大且可通过直接和间接方法重现时，其具有临床意义。本研究中检测到一例极度肥胖和一例晚期动脉硬化患者出现假性高血压。在一组先测量仰卧位后测量坐位血压的患者中，发现间接血压双侧差异的发生率略有增加。通过比较非高血压患者和高血压患者在降压药物治疗前和治疗期间的血压，发现血压水平较高时双侧差异的发生率略有增加。双侧血压不平等似乎与受试者的年龄或性别无关。臂围或左右手的差异似乎并没有影响这些不平等。对于将接受降压药物治疗的高血压患者，应进行双侧同时间接血压测量。双侧直接测量可用于验证间接方法检测到的血压不平等的存在，并确定要遵循的正确压力。这对于正在筛查嗜铬细胞瘤的患者尤其重要，因为这种差异可能产生假阳性结果。
Bilateral determinations of the blood pressures were made nonsimultaneously and simultaneously by the indirect method under basal conditions in 447 patients. The results indicate that bilateral determinations of blood pressure must be performed simultaneously on patients being examined for possible inequalities of blood pressure. Bilateral differences in blood pressure obtained by the simultaneous indirect and simultaneous direct methods in 14 normal subjects and 53 selected patients were compared. Observed differences in bilateral pressure were characterized by their inconstancy and lack of agreement with subsequent measurements when studied by both the direct and indirect methods, which apparently separates them from those due to altered hemodynamics from pathologic conditions of the aortic arch or its tributaries. Bilateral differences of blood pressure are of clinical importance when they are great and reproducible by the direct and indirect methods. One case of extreme obesity and one of advanced arteriosclerosis had pseudohypertension which was detected in this study. A slight increase in the incidence of bilateral differences in the indirect blood pressure was found in a group of patients whose blood pressures were measured in the supine and then the sitting position. A slight increase of the incidence of bilateral differences was found at higher levels of blood pressure by comparing the pressures of nonhypertensive and hypertensive patients and of hypertensive patients before and during treatment with antihypertensive drugs. Bilateral inequalities of blood pressure did not appear to be related to the age or sex of the subjects. Differences in arm circumference or right- or left-handedness did not appear to influence these inequalities. Bilaterally simultaneous, indirect measurements of blood pressure should be carried out on patients with hypertension who will be treated with antihypertensive drugs. Bilateral direct measurements may be used to verify the existence of inequality of blood pressures detected by the indirect method and to determine the correct pressure to be followed. This is particularly important in patients being screened for pheochromocytomas, since such differences may produce false-positive results.