Elliott H L, Meredith P A
Department of Medicine and Therapeutics, Gardiner Institute, Western Infirmary, Glasgow, UK.
J Hum Hypertens. 1995 Jun;9(6):423-7.
The conventional blood pressure (BP) measurement is essentially a 'snapshot' at a single time point in any given 24 h period. In the clinical management of the hypertensive patient, however, it is assumed that this snapshot is representative of the BP throughout 24 h and indicative of the consistency of the control produced by anti-hypertensive drug treatment. However, anti-hypertensive drugs vary in the duration and consistency of their anti-hypertensive effect and a single measurement of BP can only be reliably indicative if the drug effect is known to be consistently maintained throughout the 24 h. Following the deliberations of the Food and Drug Administration in the USA, the calculation of a trough:peak ratio has been proposed as an index of the consistency of the anti-hypertensive response and the suitability of an anti-hypertensive drug for its chosen dose and dose interval. In brief, to confirm that the magnitude of the BP is relatively consistent throughout 24 h it is recommended that the magnitude of the BP reduction at the end of the dose interval (at trough) should be at least 50% of the BP reduction measured at peak, namely a trough:peak of 50%. The trough:peak ratio provides a clinically relevant index for assessing whether an anti-hypertensive drug is likely to provide a consistent anti-hypertensive effect throughout the 24 h.
传统的血压（BP）测量本质上是在任何给定的24小时时间段内某一时刻的“快照”。然而，在高血压患者的临床管理中，人们假定这一快照代表了24小时内的血压情况，并能表明抗高血压药物治疗所产生的血压控制的一致性。然而，抗高血压药物的降压效果在持续时间和一致性方面存在差异，只有当已知药物效果在24小时内持续维持时，单次血压测量才能可靠地反映情况。在美国食品药品监督管理局进行审议之后，有人提议计算谷峰比值，以此作为抗高血压反应一致性以及一种抗高血压药物对于其选定剂量和给药间隔是否合适的指标。简而言之，为了确认血压在24小时内相对稳定，建议剂量间隔结束时（谷值时）的血压降低幅度应至少为峰值时测量的血压降低幅度的50%，即谷峰比值为50%。谷峰比值为评估一种抗高血压药物是否可能在24小时内提供持续的抗高血压效果提供了一个临床相关指标。
