Mancia G, Omboni S, Ravogli A, Frattola A, Villani A
Cattedra di Medicina Interna, Ospedale S. Gerardo, Monza, Italy.
Drugs. 1992;44 Suppl 1:17-22. doi: 10.2165/00003495-199200441-00004.
This paper reviews the evidence that, in patients with hypertension, end-organ damage correlates more closely with blood pressure values obtained by ambulatory blood pressure monitoring than with those obtained by conventional sphygmomanometry. However, ambulatory blood pressure monitoring is not suitable for routine use in the clinical setting because of a lack of standard reference values and data regarding the prognostic significance of this method. Ambulatory blood pressure values are reproducible and this method avoids the so-called placebo effect; thus, this method is useful in clinical studies investigating the efficacy and duration of action of antihypertensive drugs. Data from 1 study in which hypertensive patients were treated with slow release verapamil 240 mg, enalapril 20 mg, nitrendipine 20 mg and placebo, given once daily for 8 weeks according to a double-blind parallel group design, showed that mean 24-hour ambulatory blood pressure was reduced by all 3 drugs compared with placebo. Verapamil and enalapril showed similar antihypertensive efficacy and both drugs reduced night-time blood pressure more effectively than nitrendipine.
本文回顾了相关证据，即在高血压患者中，靶器官损害与动态血压监测所获血压值的相关性，比与传统血压计测量值的相关性更为密切。然而，由于缺乏标准参考值以及关于该方法预后意义的数据，动态血压监测并不适合在临床环境中常规使用。动态血压值具有可重复性，且该方法避免了所谓的安慰剂效应；因此，该方法在研究抗高血压药物疗效及作用持续时间的临床研究中很有用。一项研究的数据显示，根据双盲平行组设计，高血压患者每日服用一次缓释维拉帕米240毫克、依那普利20毫克、尼群地平20毫克及安慰剂，持续8周，结果表明，与安慰剂相比，所有三种药物均使24小时动态平均血压降低。维拉帕米和依那普利显示出相似的降压疗效，且两种药物降低夜间血压的效果均比尼群地平更有效。
