Pickering Thomas G, Gerin William, Schwartz Joseph E, Spruill Tanya M, Davidson Karina W
College of Physicians and Surgeons, Columbia University Medical Center, New York, NY 10032, USA.
J Hypertens. 2008 Dec;26(12):2259-67. doi: 10.1097/HJH.0b013e32831313c4.
The traditional reliance on blood pressure (BP) measurement in the medical setting misses a significant number of individuals with masked hypertension, who have normal clinic BP but persistently high daytime BP when measured out of the office. We suggest that masked hypertension may be a precursor of clinically recognized sustained hypertension and is associated with increased cardiovascular risk compared with consistent normotension. We discuss factors that may contribute to clinic-daytime BP differences as well as the changing relationship between these two measures over time. Anxiety at the time of BP measurement and having been diagnosed as hypertensive appear to be two possible mechanisms. The identification of individuals with masked hypertension is of great clinical importance and requires out-of-office BP screening. Ambulatory BP monitoring is the best established technique for doing this, but home monitoring may be applicable in the future.
在医疗环境中，传统上依赖血压（BP）测量会遗漏大量隐匿性高血压患者，这些患者诊所血压正常，但在诊室外测量时白天血压持续偏高。我们认为，隐匿性高血压可能是临床确诊的持续性高血压的先兆，与持续正常血压相比，其心血管风险增加。我们讨论了可能导致诊所血压与白天血压差异的因素，以及这两种测量方法随时间变化的关系。血压测量时的焦虑和被诊断为高血压似乎是两种可能的机制。识别隐匿性高血压患者具有重要的临床意义，需要进行诊室外血压筛查。动态血压监测是目前确定此类患者的最佳技术，但家庭血压监测未来可能也适用。
