Wexler Randy
Department of Family Medicine, Ohio State University Medical Center, Columbus, OH 43210, USA.
South Med J. 2010 May;103(5):447-52. doi: 10.1097/SMJ.0b013e3181d82404.
The accurate assessment and appropriate management of blood pressure (BP) is critical for primary care physicians. Traditional office-based BP measurement has limitations that can be addressed, in part, through the use of ambulatory BP monitoring (ABPM). Because BP readings are provided at specific time intervals throughout a 24-hour period, ABPM represents a better picture of the normal fluctuations in BP levels associated with daily activities, including sleep. Blood pressure values obtained by 24-hour ABPM are a better predictor of cardiovascular risk than office-based BP measurements, and the technique can be used to discern white-coat hypertension and to evaluate masked, resistant, and pseudoresistant hypertension. It can also be helpful in the assessment of autonomic dysfunction and monitoring of a patient's response to antihypertensive therapy. Ambulatory BP monitoring is also being increasingly used in clinical trials that assess the antihypertensive effects of medications.
对基层医疗医生而言,准确评估和合理管理血压至关重要。传统的诊室血压测量存在局限性,而动态血压监测(ABPM)在一定程度上可解决这些问题。由于动态血压监测能在24小时内按特定时间间隔提供血压读数,因此它能更好地反映与日常活动(包括睡眠)相关的血压水平正常波动情况。通过24小时动态血压监测获得的血压值比诊室血压测量更能预测心血管风险,该技术可用于识别白大衣高血压,并评估隐匿性、顽固性和假性顽固性高血压。它在评估自主神经功能障碍以及监测患者对抗高血压治疗的反应方面也可能有所帮助。动态血压监测在评估药物降压效果的临床试验中也越来越常用。