Rizzoni D, Bonfanti V, Zulli R
Istituto di Clinica medica, Università, Brescia.
Recenti Prog Med. 1990 Apr;81(4):269-75.
Recently, new devices for ambulatory blood pressure monitoring have been developed, which have become widely used as highly reliable diagnostic tools. It is now necessary to establish the rationale for their use, and to fully elucidate the diagnostic, prognostic and therapeutic advantages for their use in hypertensive patients. Average 24-hour blood pressure is more closely correlated with the degree of structural cardiovascular alterations than casual blood pressure measurements. Non-invasive blood pressure monitoring therefore seems to be more useful, from a prognostic point of view, than traditional, sphygmomanometric measurement. There is some evidence that ambulatory blood pressure monitoring is more reliable than casual measurements in assessing the efficacy of antihypertensive therapy. From a diagnostic point of view, the significance of blood pressure values obtained with these devices, and the most appropriate index to evaluate the 24-hour blood pressure load remain to be clarified. It is necessary to identify new normal limits for monitored blood pressure values i.e. to establish the baseline level for the start of treatment. At present, due to the lack of widely accepted upper limits of monitored blood pressure, the therapeutic decision should be based on casual blood pressure values, obtained with traditional mercury sphygmomanometer.
最近，已开发出用于动态血压监测的新设备，这些设备已作为高度可靠的诊断工具被广泛使用。现在有必要确立其使用的基本原理，并充分阐明其在高血压患者中使用的诊断、预后和治疗优势。平均24小时血压与心血管结构改变程度的相关性比偶测血压更为密切。因此，从预后角度来看，无创血压监测似乎比传统的血压计测量更有用。有证据表明，在评估降压治疗效果方面，动态血压监测比偶测更可靠。从诊断角度来看，这些设备所测血压值的意义以及评估24小时血压负荷的最合适指标仍有待阐明。有必要确定监测血压值的新正常范围，即确定治疗开始的基线水平。目前，由于缺乏广泛接受的监测血压上限，治疗决策应基于用传统汞柱血压计测得的偶测血压值。
