Portaluppi F, Montanari L, Capanna M, Ferlini M
Institute of Clinica Medica, University of Ferrara, Italy.
Clin Cardiol. 1989 Jul;12(7):380-3. doi: 10.1002/clc.4960120706.
The aim of this study was to assess the possible correlations between casual measurements and automatic monitoring analyzed with the chronobiologic technique in hospitalized hypertensive patients. Forty-three patients (24 men and 19 women) with mild to moderate essential hypertension were studied in an open hospital ward 5 to 7 days after admission. Meal times, sleep times, and visiting hours were standardized. A clinical value of blood pressure was calculated as the arithmetic mean of three sphygmomanometric measurements taken in the morning (patient seated; 5-min interval between measurements). Then, a basal value of blood pressure was considered as the lowest systolic and the lowest diastolic blood pressure among six sphygmomanometric measurements obtained every 5 min (patient supine). Noninvasive, automatic recording of blood pressure was also obtained every 15 min for 24 hours by a quasiportable oscillometric instrument. Blood pressure recordings were analyzed according to the "cosinor" method of Halberg. On average, clinical blood pressure was 160/96 +/- 14/10 mmHg, significantly higher (p less than 0.005) than either basal blood pressure (150/91 +/- 12/8 mmHg) or 24-h recorded blood pressure mesor (144/88 +/- 13/9 mmHg). The differences were not entirely due to diurnal variations, since morning casual measurements were significantly higher than daytime average blood pressure. A chronobiologic assessment of hypertension in hospitalized patients is more representative of true blood pressure behavior, not only because of the multiple recordings but also because of the absence of an alarm reaction that may trigger a pressor response.
本研究旨在评估住院高血压患者的偶然测量血压值与采用时间生物学技术进行的自动监测血压值之间可能存在的相关性。43例（24例男性和19例女性）轻度至中度原发性高血压患者在入院后5至7天于开放病房接受研究。用餐时间、睡眠时间和探视时间均标准化。临床血压值计算为早晨测量的三次血压计测量值的算术平均值（患者坐位；测量间隔5分钟）。然后，基础血压值被视为每5分钟测量的6次血压计测量值中最低的收缩压和最低的舒张压（患者仰卧位）。还使用一种准便携式示波仪每15分钟进行一次24小时无创自动血压记录。根据哈尔伯格的“余弦法”对血压记录进行分析。平均而言，临床血压为160/96±14/10 mmHg，显著高于基础血压（150/91±12/8 mmHg）或24小时记录血压的中值（144/88±13/9 mmHg）（p<0.005）。这些差异并不完全归因于昼夜变化，因为早晨的偶然测量值显著高于白天平均血压。住院患者高血压的时间生物学评估更能代表真实的血压行为，这不仅是因为进行了多次记录，还因为没有可能引发升压反应的警报反应。
