Waeber B, Burnier M, Perret F, Nussberger J, Brunner H R
Division of Hypertension, University Hospital, Lausanne, Switzerland.
J Hypertens Suppl. 1989 May;7(3):S33-9.
The traditional basis for assessing the effect of antihypertensive therapy is the blood pressure reading taken by a physician. However, several recent trials have been designed to evaluate the blood pressure lowering effect of various therapeutic agents during the patients' normal daytime activities, using a portable, semi-automatic blood pressure recorder. The results have shown that in a given patient, blood pressure measured at the physician's office often differs greatly from that prevailing during the rest of the day. This is true both in treated and untreated hypertensive patients. The difference between office and ambulatory recorded pressures cannot be predicted from blood pressure levels measured by the physician. Therefore, a prospective study was carried out in patients with diastolic blood pressures that were uncontrolled at the physician's office despite antihypertensive therapy. The purpose was to evaluate the response of recorded ambulatory blood pressure to treatment adjustments aimed at reducing office blood pressure below a pre-set target level. Only patients with high ambulatory blood pressures at the outset appeared to benefit from further changes in therapy. Thus, ambulatory blood pressure monitoring can be used to identify those patients who remain hypertensive only when facing the physician, despite antihypertensive therapy. Ambulatory monitoring could thus help to evaluate the efficacy of antihypertensive therapy and allow individual treatment.
评估抗高血压治疗效果的传统依据是医生测量的血压读数。然而，最近有几项试验旨在使用便携式半自动血压记录仪，评估各种治疗药物在患者正常日间活动期间的降压效果。结果表明，对于特定患者，在医生办公室测量的血压通常与一天中其余时间的血压有很大差异。这在接受治疗和未接受治疗的高血压患者中都是如此。无法根据医生测量的血压水平预测办公室测量血压与动态记录血压之间的差异。因此，对尽管接受了抗高血压治疗但在医生办公室舒张压仍未得到控制的患者进行了一项前瞻性研究。目的是评估动态记录的血压对旨在将办公室血压降低到预设目标水平以下的治疗调整的反应。只有一开始动态血压较高的患者似乎从进一步的治疗改变中获益。因此，动态血压监测可用于识别那些尽管接受了抗高血压治疗，但仅在面对医生时仍患有高血压的患者。动态监测因此有助于评估抗高血压治疗的疗效并实现个体化治疗。
