White W B, Baker L H
Arch Intern Med. 1986 Jun;146(6):1129-30.
Episodic elevation of blood pressure was evaluated in two middle-aged men by assessing home, clinic, and 24-hour ambulatory values following exclusion of secondary forms of hypertension. Both individuals had normotensive home and clinic readings. The 24-hour blood pressure was 125/85 +/- 12/9 mm Hg in patient 1 and 119/84 +/- 13/13 mm Hg in patient 2; however, both patients experienced large, sustained rises in blood pressure associated with panic attacks that were not abolished with prophylactic benzodiazepine therapy. Episodic blood pressure elevations were not associated with concomitant increases in heart rate. Patient 1 underwent extensive psychological investigation that diagnosed a panic disorder, and he underwent therapy that reduced the frequency and intensity of his panic-related hypertensive episodes. Because patient 2 demonstrated hypertensive readings at work, he was given a beta-blocking agent that ultimately controlled his blood pressure during episodes of anxiety and panic. These findings suggest that patients with panic attacks may present with episodic hypertension and that ambulatory blood pressure monitoring is useful in the diagnosis of this disorder and in assessment of treatment outcome.
在排除继发性高血压形式后，通过评估家庭、诊所和24小时动态血压值，对两名中年男性的血压间歇性升高情况进行了评估。两人的家庭和诊所血压读数均为正常血压。患者1的24小时血压为125/85 +/- 12/9毫米汞柱，患者2为119/84 +/- 13/13毫米汞柱；然而，两名患者都经历了与惊恐发作相关的大幅、持续性血压升高，预防性苯二氮䓬类药物治疗未能消除这种情况。血压间歇性升高与心率的同时增加无关。患者1接受了广泛的心理调查，被诊断为惊恐障碍，他接受了治疗，减少了与惊恐相关的高血压发作的频率和强度。由于患者2在工作时血压读数升高，他服用了一种β受体阻滞剂，最终在焦虑和惊恐发作期间控制了血压。这些发现表明，惊恐发作患者可能出现间歇性高血压情况，动态血压监测有助于诊断这种疾病和评估治疗效果。
