O'Brien E, O'Malley K, Cox J, Stanton A
Blood Pressure Unit, Beaumont Hospital, Dublin, Ireland.
Am Heart J. 1991 Mar;121(3 Pt 2):999-1006. doi: 10.1016/0002-8703(91)90611-k.
Conventional clinic measurement of blood pressure is influenced by many factors that make the technique unsuitable for the assessment of antihypertensive drug efficacy. The major drawback of conventional measurement is that it cannot indicate the duration of drug effect or the influence of antihypertensive drugs on nocturnal blood pressure. Noninvasive 24-hour ambulatory blood pressure measurement has a number of advantages over conventional measurement: it provides a profile of blood pressure over the 24-hour period; it detects white coat responders; it is free of regression to the mean and the placebo response, thereby making it possible to consider efficacy studies which need not have a placebo phase; it enables considerably more observations than is possible with clinic measurement by increasing the power of studies, which may reduce significantly the numbers of patients needed for antihypertensive drug studies. Twenty-four-hour ambulatory blood pressure measurement offers the opportunity to study antihypertensive drugs in fewer patients with greater accuracy than is possible with conventional clinic measurement and should be a mandatory requirement for such studies.
传统的诊所血压测量受到多种因素影响，使得该技术不适用于评估抗高血压药物的疗效。传统测量的主要缺点是它无法表明药物作用的持续时间或抗高血压药物对夜间血压的影响。与传统测量相比，无创24小时动态血压测量有许多优点：它能提供24小时期间的血压概况；能检测出白大衣反应者；不存在均值回归和安慰剂反应，从而使得开展无需安慰剂阶段的疗效研究成为可能；通过提高研究效能，它能进行比诊所测量多得多的观察，这可能显著减少抗高血压药物研究所需的患者数量。24小时动态血压测量提供了一个机会，能够以比传统诊所测量更高的准确性在更少患者中研究抗高血压药物，并且应该成为此类研究的一项强制性要求。
