Ambulatory blood pressure monitoring in the management of hypertension
Ambulatory blood pressure monitoring in the management of hypertension
复制标题
动态血压监测在高血压治疗中的应用
作者：
E. O’Brien
动态血压测量（ABPM）在临床实践中的应用越来越广泛。认识到这一点，英国高血压学会发布了关于在临床实践中使用和解释 ABPM 的建议，1 欧洲高血压学会也发布了关于血压测量设备（包括 ABPM 设备）的建议。2 重要的是，该技术最终在美国获得了报销批准。3 因此，随着该技术在全世界范围内的接受，现在是时候重新评估 ABPM 最终成为高血压治疗不可或缺的技术的原因，并总结其在临床实践中使用的当前建议。
过去 25 年来，ABPM 提供的信息优于传统血压测量 (CBPM) 的证据一直在稳步增长。 w1 有许多明显的优点：该技术比 CBPM 提供更多的测量结果，并且通过重复测量可以更准确地反映真实血压 4； ABPM 提供远离医疗环境的血压概况，从而可以识别具有白大衣反应的个体5； ABPM 显示 24 小时内的血压行为，而不是提供血压快照； ABPM 可以证明抗高血压药物在 24 小时内的疗效，而不是根据仅限于昼夜周期短时间内的一项或多项 CBPM 做出决定4； ABPM 可以识别夜间血压不降低的患者（非杓型患者），他们可能处于高风险6；最后，该技术可以展示可能与临床管理相关的多种血压行为模式——孤立性收缩期高血压、低血压、浸入式和非浸入式等。w2 这些优点在很多年前就应该使 ABPM 得到更广泛的临床应用。然而， …
Ambulatory blood pressure measurement (ABPM) is being used increasingly in clinical practice. In recognition of this the British Hypertension Society has published recommendations for the use and interpretation of ABPM in clinical practice,1 and the European Society of Hypertension has published recommendations on blood pressure measuring devices, including devices for ABPM.2 Importantly, the technique has finally been approved for reimbursement in the USA.3 So with worldwide acceptance of the technique, it is timely to reappraise the reasons why ABPM has at last become an indispensable technique for the management of hypertension, and to summarise current recommendations for its use in clinical practice.
The evidence that ABPM gives information over and above conventional blood pressure measurement (CBPM) has been growing steadily over the past 25 years.w1 There are a number of obvious advantages: the technique simply gives more measurements than CBPM, and the real blood pressure is reflected more accurately by repeated measurements4; ABPM provides a profile of blood pressure away from the medical environment, thereby allowing identification of individuals with a white coat response5; ABPM shows blood pressure behaviour over a 24 hour period rather then giving a snapshot of blood pressure; ABPM can demonstrate the efficacy of antihypertensive medication over a 24 hour period rather than making a decision based on one or a few CBPMs confined to a short period of the diurnal cycle4; ABPM can identify patients whose blood pressure does not reduce at night-time—the non-dippers—who are probably at high risk6; and finally, the technique can demonstrate a number of patterns of blood pressure behaviour that may be relevant to clinical management—isolated systolic hypertension, hypotension, dipping and non-dipping, etc.w2 These advantages should have brought ABPM into much wider clinical use many years ago. However, …
DOI：
10.1001/jama.1988.03720020027031
发表时间：
1988-01
期刊：
JAMA
影响因子：
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作者：
T. Pickering;G. James;Charlene Boddie;G. Harshfield;S. Blank;J. Laragh
通讯作者：
T. Pickering;G. James;Charlene Boddie;G. Harshfield;S. Blank;J. Laragh