Rion F, Waeber B, Graf H J, Jaussi A, Porchet M, Brunner H R
J Hypertens. 1985 Apr;3(2):139-43. doi: 10.1097/00004872-198504000-00005.
Blood pressure readings obtained by the physician in his office and ambulatory blood pressures recorded with the semi-automatic Remler device, were compared during a controlled antihypertensive drug trial. Either timolol or methyldopa was administered in in double-blind fashion to 30 patients with uncomplicated essential hypertension. All exhibited a diastolic office blood pressure greater than 95 mmHg at the end of a four-week placebo period. All patients then received a combination of hydrochlorothiazide (25 mg/day) and amiloride (2.5 mg/day). After four weeks of diuretic therapy, timolol (10 mg/day, n = 14) or methyldopa (250 mg/day, n = 16) were added randomly for six weeks. The dose of all antihypertensive agents was doubled after two weeks of therapy with diuretics combined with timolol (n = 7) or methyldopa (n = 16) because of the persistence of diastolic blood pressure levels greater than 90 mmHg at the office. When assessed in the office, the antihypertensive effect of timolol and methyldopa was similar. During ambulatory blood pressure monitoring, however, pressure levels were lower in the patients given timolol (P less than 0.05 for the diastolic). With both regimens, the blood pressure response measured outside the clinic during usual daily activities could not be predicted from that observed with office blood pressure readings. Furthermore the magnitude of the drug induced blood pressure decrease was more reproducible in time when determined outside the clinic. These data suggest that ambulatory blood pressure monitoring is more precise in evaluating the efficacy of antihypertensive therapy than office blood pressure measurement.
在一项对照性抗高血压药物试验中，比较了医生在其办公室测得的血压读数与使用半自动Remler设备记录的动态血压。以双盲方式给30例无并发症的原发性高血压患者服用噻吗洛尔或甲基多巴。在为期四周的安慰剂期结束时，所有患者的诊室舒张压均高于95 mmHg。然后所有患者接受氢氯噻嗪（25毫克/天）和阿米洛利（2.5毫克/天）的联合治疗。利尿治疗四周后，随机添加噻吗洛尔（10毫克/天，n = 14）或甲基多巴（250毫克/天，n = 16），持续六周。由于在使用利尿剂联合噻吗洛尔（n = 7）或甲基多巴（n = 16）治疗两周后，诊室舒张压持续高于90 mmHg，所有抗高血压药物的剂量在两周后加倍。在诊室评估时，噻吗洛尔和甲基多巴的抗高血压作用相似。然而，在动态血压监测期间，服用噻吗洛尔的患者血压水平较低（舒张压P<0.05）。对于两种治疗方案，日常活动期间在诊所外测得的血压反应无法根据诊室血压读数预测。此外，在诊所外测定时，药物引起的血压下降幅度在时间上更具可重复性。这些数据表明，动态血压监测在评估抗高血压治疗效果方面比诊室血压测量更精确。
