Department of Medicine, Kasturba Medical College, Manipal University, Mangalore 575001, India.
Singapore Med J. 2012 Feb;53(2):95-8.
24-hour ambulatory blood pressure (BP) monitoring is a well-validated tool that can reveal the patient's nocturnal dipping pattern. However, to the best of our knowledge, the role of home BP monitoring in identifying nocturnal dipping has not been studied.
We evaluated the nocturnal BP of 30 treatment-naive subjects using a home BP monitoring device. BP measurements were taken once during the daytime and once at night (three hours after sleep) by a blinded observer. Readings were correlated with left ventricular mass index.
Night BP measurements were significantly lower in subjects without left ventricular hypertrophy (LVH) as compared to those with LVH, while the daytime readings were not significantly different between the two. The mean dips in nocturnal systolic and diastolic BP were 1.92% ± 6.89% and -0.55% ± 14.31%, respectively, in subjects with LVH. The corresponding values were 12.96% ± 6.16% and 11.36% ± 11.90% in those without LVH. The correlation between left ventricular mass index and night BP readings was statistically significant (systolic r = 0.66, p < 0.001; diastolic r = 0.496, p < 0.005).
Nocturnal BP measurement using a home BP monitoring device may be a reliable and cost-effective method for detecting early signs of end-organ involvement such as LVH in hypertensives, especially in a resource-limited setting.
24 小时动态血压监测是一种经过充分验证的工具，可以揭示患者的夜间血压下降模式。然而，据我们所知，家庭血压监测在识别夜间血压下降方面的作用尚未得到研究。
我们使用家庭血压监测设备评估了 30 名未经治疗的受试者的夜间血压。由一名盲法观察者在白天和夜间（睡眠后 3 小时）各测量一次血压。读数与左心室质量指数相关。
与左心室肥厚（LVH）患者相比，无 LVH 患者的夜间血压测量值明显较低，而白天读数在两组之间无显著差异。LVH 患者夜间收缩压和舒张压的平均下降幅度分别为 1.92%±6.89%和-0.55%±14.31%，而无 LVH 患者的相应值分别为 12.96%±6.16%和 11.36%±11.90%。左心室质量指数与夜间血压读数之间存在显著相关性（收缩压 r=0.66，p<0.001；舒张压 r=0.496，p<0.005）。
使用家庭血压监测设备进行夜间血压测量可能是一种可靠且具有成本效益的方法，可用于检测高血压患者早期靶器官受累的迹象，如 LVH，尤其是在资源有限的环境中。
