Palatini Paolo
Clinica Medica 4, University of Padova, via Giustiniani, 2-35128 Padova, Italy.
Curr Hypertens Rep. 2008 Apr;10(2):119-26. doi: 10.1007/s11906-008-0023-0.
Diagnosis of hypertension is critically dependent on accurate blood pressure (BP) measurement, especially in patients with chronic kidney disease (CKD), in whom early antihypertensive treatment is imperative to prevent cardiovascular events. Ambulatory BP monitoring (ABPM) has successfully identified hypertensive patients at increased risk, but its role in management of CKD patients is not well defined. Loss of the nocturnal decline in BP, which is common in CKD, is associated with adverse cardiovascular events. Increased BP variability has been documented as related to worse outcome, and patients on dialysis are subject to marked BP swings. Traditional measurement in the office fails to provide a thorough picture of the 24-hour BP pattern in CKD patients. Thus, ABPM appears mandatory to better define the hypertensive status in these subjects because it provides information on diurnal BP rhythm and variability and allows identification of subjects with white-coat and masked hypertension.
高血压的诊断严重依赖于准确的血压测量，尤其是在慢性肾脏病（CKD）患者中，对于这类患者，早期进行抗高血压治疗对于预防心血管事件至关重要。动态血压监测（ABPM）已成功识别出风险增加的高血压患者，但其在CKD患者管理中的作用尚不明确。CKD患者常见的夜间血压下降消失与不良心血管事件相关。血压变异性增加已被证明与更差的预后相关，并且透析患者会出现明显的血压波动。诊室中的传统测量方法无法全面反映CKD患者的24小时血压模式。因此，ABPM对于更好地确定这些患者的高血压状态似乎是必不可少的，因为它提供了关于日间血压节律和变异性的信息，并能够识别白大衣高血压和隐匿性高血压患者。
