Cesana G, De Vito G, Ferrario M, Libretti A, Mancia G, Mocarelli P, Sega R, Valagussa F, Zanchetti A
Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy.
J Hypertens Suppl. 1991 Dec;9(3):S17-23.
Although ambulatory blood pressure monitoring is gaining in popularity, it still has important limitations in clinical use, particularly for the definition and diagnosis of hypertension. Various attempts have been made to calculate 'normal' or 'reference' values for ambulatory blood pressure, mostly by 24-h non-invasive monitoring in groups of 'normal' subjects. The most appropriate approach, however, is to compare 24-h ambulatory blood pressure values and casual or clinic blood pressure values in a random sample of a suitably large population. The PAMELA Study has been planned to obtain an epidemiological evaluation of 24-h ambulatory blood pressure values, and its design is described here. In the city of Monza, 2400 subjects aged between 25 and 64 years have been randomly selected according to World Health Organization Monitoring Cardiovascular Diseases (WHO-MONICA) project criteria within sex and age strata. In these subjects, clinic blood pressure, random-zero blood pressure, ambulatory blood pressure (24-h monitoring with SpaceLabs 90207; Redmond, Washington, USA), home blood pressure, electrocardiographic and echocardiographic indices, cardiovascular risk factors and psychological variables are being measured.
尽管动态血压监测越来越受欢迎，但它在临床应用中仍存在重要局限性，尤其是在高血压的定义和诊断方面。人们已经进行了各种尝试来计算动态血压的“正常”或“参考”值，主要是通过对“正常”人群进行24小时无创监测。然而，最合适的方法是在一个足够大的随机样本中比较24小时动态血压值与偶测或诊室血压值。帕梅拉研究（PAMELA Study）旨在对24小时动态血压值进行流行病学评估，其设计在此进行描述。在蒙扎市，根据世界卫生组织心血管疾病监测（WHO-MONICA）项目标准，在性别和年龄分层内随机选择了2400名年龄在25至64岁之间的受试者。对这些受试者测量诊室血压、随机零点血压、动态血压（使用美国华盛顿州雷德蒙德市太空实验室公司的90207型设备进行24小时监测）、家庭血压、心电图和超声心动图指标、心血管危险因素以及心理变量。
