Conway J, Coats A, Radaelli A
Department of Cardiovascular Medicine, John Radcliffe Hospital, Headington, Oxford, UK.
J Hypertens Suppl. 1990 Dec;8(6):S83-5.
Spontaneous differences in blood pressure from one clinic visit to another inevitably lead to the use of unnecessarily high doses of drugs in the treatment of hypertension and to unnecessarily high recommended doses of new antihypertensive drugs. This can be avoided by the use of ambulatory blood pressure monitoring. The improved reproducibility achieved by ambulatory monitoring substantially reduces the number of subjects required to detect small differences in pressure between one treatment and another. Furthermore, 24-h monitoring eliminates time-related fluctuations and makes it possible to use crossover trials to compare the antihypertensive effects of different drugs. Differences of 5 mmHg in diastolic pressure between two treatments can thus be detected in a trial on less than 20 subjects.
在不同的门诊就诊时，血压出现自发差异，这不可避免地导致在治疗高血压时使用不必要的高剂量药物，以及新抗高血压药物的推荐剂量过高。通过使用动态血压监测可以避免这种情况。动态监测所实现的更高的可重复性，大幅减少了检测不同治疗之间微小血压差异所需的受试者数量。此外，24小时监测消除了与时间相关的波动，并使得使用交叉试验来比较不同药物的降压效果成为可能。因此，在一项不到20名受试者的试验中，就可以检测出两种治疗之间舒张压5 mmHg的差异。
