Asayama Kei, Wei Fang-Fei, Liu Yan-Ping, Hara Azusa, Gu Yu-Mei, Schutte Rudolph, Li Yan, Thijs Lutgarde, Staessen Jan A
1] Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium [2] Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
1] Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium [2] Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Hypertens Res. 2015 Feb;38(2):97-101. doi: 10.1038/hr.2014.153. Epub 2014 Oct 16.
This review addresses methodological issues in the assessment of blood pressure variability and the predictive value of blood pressure variability derived from blood pressure readings obtained in the relaxed home environment. Preference should be given to indexes of blood pressure variability that are independent of the mean because we should evaluate the impact of blood pressure variability by eliminating the effect of blood pressure levels. Beat-to-beat blood pressure recordings outperform home blood pressure measurement in the assessment of blood pressure variability in longitudinal Belgian and Japanese population studies, whereas blood pressure variability did not incrementally predict outcome beyond blood pressure level and other cardiovascular risk factors. In conclusion, clinicians should focus on blood pressure level, given that it is the predominant risk factor and is manageable by lifestyle modifications and adequate antihypertensive drug treatment. Blood pressure variability remains a research tool that requires further prospective studies with hard end points to define its potential application, as it may be potentially useful in daily clinical practice.
本综述探讨了血压变异性评估中的方法学问题，以及在轻松家庭环境中获取的血压读数所衍生的血压变异性的预测价值。应优先选择与平均值无关的血压变异性指标，因为我们应通过消除血压水平的影响来评估血压变异性的影响。在比利时和日本的纵向人群研究中，逐搏血压记录在评估血压变异性方面优于家庭血压测量，而血压变异性在预测结局方面并没有超过血压水平和其他心血管危险因素。总之，鉴于血压水平是主要危险因素，可通过生活方式改变和适当的降压药物治疗加以控制，临床医生应关注血压水平。血压变异性仍是一种研究工具，需要进一步开展具有硬终点的前瞻性研究来确定其潜在应用，因为它在日常临床实践中可能具有潜在用途。
