Weber M A
Hypertension Center, Veterans Administration Medical Center, Long Beach, California 90822.
Am J Cardiol. 1990 Sep 25;66(9):43C-48C. doi: 10.1016/0002-9149(90)90763-q.
The technique of automated ambulatory blood pressure (BP) monitoring offers an innovative means for measuring BP throughout the 24-hour period. Recently available compact monitoring instruments have been shown to be accurate and to provide reproducible measurements of the circadian BP pattern. The monitoring procedure is advantageous in that it minimizes or avoids placebo effects during therapeutic trials. Moreover, its power makes it possible to draw statistically valid conclusions regarding efficacy in fewer patients than would be required if conventional methods were used. This procedure also enhances the diagnosis of hypertension by identifying patients with "office" or "white coat" hypertension, and thereby facilitates assessment of treatment effects in those patients who are truly hypertensive. Automated monitoring measures BP at critical times of the day, including the preawakening and early morning hours, and it enables peak and trough antihypertensive drug effects to be carefully quantified. Since patient compliance appears to be enhanced with once- or twice-daily dosing, antihypertensive agents with long durations of action (24 hours) are of considerable interest. This report reviews some recent studies in which the monitoring technique has been used to measure the efficacy and duration of action of differing antihypertensive drugs.
动态血压自动监测技术为全天测量血压提供了一种创新方法。最近可用的紧凑型监测仪器已被证明是准确的，并且能够对昼夜血压模式进行可重复测量。监测程序的优势在于，它在治疗试验期间将安慰剂效应降至最低或避免了安慰剂效应。此外，与使用传统方法相比，它的强大功能使得在更少的患者中得出关于疗效的统计学有效结论成为可能。该程序还通过识别患有“诊室”或“白大衣”高血压的患者来增强高血压的诊断，从而有助于评估那些真正高血压患者的治疗效果。自动监测在一天中的关键时间测量血压，包括觉醒前和清晨时段，并且它能够仔细量化降压药物的峰效应和谷效应。由于每日一次或两次给药似乎能提高患者的依从性，作用持续时间长（24小时）的抗高血压药物备受关注。本报告回顾了一些最近的研究，其中监测技术已被用于测量不同抗高血压药物的疗效和作用持续时间。
