Dadlani Apaar, Madan Kushal, Sawhney J P S
Division of Nephrology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA.
Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi 110060, India.
Indian Heart J. 2019 Jan-Feb;71(1):91-97. doi: 10.1016/j.ihj.2018.11.015. Epub 2018 Nov 27.
Being one of the most widely prevalent diseases throughout the world, hypertension has emerged as one of the leading causes of global premature morbidity and mortality. Hence, blood pressure (BP) measurements are essential for physicians in the diagnosis and management of hypertension. Current American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend initiating antihypertensive medications on the basis of office BP readings. However, office BP readings provide a snapshot evaluation of the patient's BP, which might not reflect patient's true BP, with the possibility of being falsely elevated or falsely low. Recently, there is ample evidence to show that ambulatory blood pressure monitoring (ABPM) is a better predictor of major cardiovascular events than BP measurements at clinic settings. ABPM helps in reducing the number of possible false readings, along with the added benefit of understanding the dynamic variability of BP. This article will focus on the significance of ambulatory BP, its advantages and limitations compared with the standard office BP measurement and a brief outlook on its use and interpretation to diagnose and treat hypertension.
高血压是全球范围内最普遍流行的疾病之一,已成为全球过早发病和死亡的主要原因之一。因此,血压(BP)测量对于医生诊断和管理高血压至关重要。美国心脏病学会/美国心脏协会(ACC/AHA)现行指南建议根据诊室血压读数开始使用抗高血压药物。然而,诊室血压读数只是对患者血压的一个快照评估,可能无法反映患者的真实血压,有可能出现假性升高或假性降低。最近,有充分证据表明,动态血压监测(ABPM)比诊所环境中的血压测量更能预测主要心血管事件。ABPM有助于减少可能的错误读数数量,同时还能带来了解血压动态变化的额外好处。本文将重点探讨动态血压的重要性、与标准诊室血压测量相比的优缺点,以及对其在诊断和治疗高血压中的使用和解读的简要展望。