Rion F, Waeber B, Graf H J, Jaussi A, Porchet M, Brunner H R
Schweiz Med Wochenschr. 1985 Dec 14;115(50):1829-31.
In the context of a controlled antihypertensive drug trial, blood pressure readings obtained by the physician in his office were compared with ambulatory blood pressures recorded with the semi-automatic Remler device. The beta-adrenoceptor blocking agent timolol or methyldopa were administered in double-blind fashion to 30 patients with uncomplicated essential hypertension. All exhibited a diastolic office blood pressure of greater than 95 mm Hg at the end of a 4-week placebo period. All patients then received a combination of hydrochlorothiazide (25 mg/d) and amiloride (2.5 mg/d). After 4 weeks of diuretic therapy, timolol (10 mg/d, n = 14) or methyldopa (250 mg/d, n = 16) were added randomly for 6 weeks. The dose of all antihypertensive agents was doubled after 2 weeks of therapy with diuretics combined with timolol (n = 7) or methyldopa (n = 16) because of the persistence of diastolic blood pressure levels of greater than 90 mm Hg 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 tended to be lower in the patients given timolol (p less than 0.05 for the diastolic). These data show that ambulatory blood pressure monitoring may be very useful in comparing the antihypertensive efficacy of different drugs.
在一项对照性抗高血压药物试验中，将医生在其办公室测得的血压读数与用半自动Remler装置记录的动态血压进行了比较。以双盲方式给30例无并发症的原发性高血压患者服用β-肾上腺素能受体阻滞剂噻吗洛尔或甲基多巴。在为期4周的安慰剂期结束时，所有患者的办公室舒张压均高于95 mmHg。然后所有患者接受氢氯噻嗪（25 mg/d）和阿米洛利（2.5 mg/d）的联合治疗。利尿治疗4周后，随机加用噻吗洛尔（10 mg/d，n = 14）或甲基多巴（250 mg/d，n = 16），持续6周。由于在利尿剂联合噻吗洛尔（n = 7）或甲基多巴（n = 16）治疗2周后办公室舒张压持续高于90 mmHg，所有抗高血压药物的剂量在2周后加倍。在办公室评估时，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往往较低（舒张压p<0.05）。这些数据表明，动态血压监测在比较不同药物的抗高血压疗效方面可能非常有用。
