Parati G, Pomidossi G, Casadei R, Trazzi S, Ravogli A, Zanchetti A, Mancia G
Cattedra di Semeiotica Medica, Università di Milano, Italy.
Am J Cardiol. 1988 Feb 10;61(5):27C-33C. doi: 10.1016/0002-9149(88)90481-x.
The use of ambulatory blood pressure monitoring has gained popularity because it is not subject to those limitations associated with traditional sphygmomanometry (inaccuracy of blood pressure readings, low number of readings, and failure to represent daytime blood pressure readings). In the present study, we provide evidence that the 24-hour mean blood pressure obtained through intraarterial blood pressure measurements in ambulatory patients provides a more accurate diagnosis (and perhaps a prognosis) of hypertension than that provided by cuff-obtained casual blood pressure measurement. Furthermore, despite a reduction in the amount and in the accuracy of the information obtained, blood pressure data provided by noninvasive blood pressure monitoring are also more accurate diagnostically than cuff-obtained casual blood pressure measurements. In 15 essential hypertensive patients in whom celiprolol, 400 mg once daily, was compared with placebo in a randomized double-blind crossover study, the use of noninvasive 24-hour automatic blood pressure monitoring showed that in responsive patients, celiprolol induced a sustained reduction in systolic and diastolic blood pressure throughout the 24 hours. The blood pressure reduction was also apparent during the night, despite the concomitant occurrence of a slight tachycardia. These findings demonstrate that once-daily administration of celiprolol provides an effective lowering of the 24-hour blood pressure profile. This dosing schedule can therefore be regarded as appropriate for antihypertensive therapy.
动态血压监测的应用越来越广泛，因为它不受传统血压计测量方法的限制（血压读数不准确、读数次数少以及无法反映日间血压读数）。在本研究中，我们提供的证据表明，通过动态患者的动脉内血压测量获得的24小时平均血压，比通过袖带测量的偶然血压测量能更准确地诊断（或许还有预测）高血压。此外，尽管获得的信息量和准确性有所降低，但无创血压监测提供的血压数据在诊断上也比袖带测量的偶然血压测量更准确。在一项随机双盲交叉研究中，对15例原发性高血压患者每天一次给予400毫克塞利洛尔并与安慰剂进行比较，使用无创24小时自动血压监测显示，在有反应的患者中，塞利洛尔在24小时内使收缩压和舒张压持续降低。尽管同时伴有轻微心动过速，但夜间血压也明显下降。这些发现表明，每天一次服用塞利洛尔可有效降低24小时血压水平。因此，这种给药方案可被视为适用于抗高血压治疗。
