Olano D, de Lena S M, Cingolani H E
Centro de Investigaciones Cardiovasculares, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina.
Medicina (B Aires). 1995;55(1):21-7.
The purpose of this paper was to evaluate the characteristics of the alarm reaction that induces an increase of blood pressure (BP) above the "basal" when it is measured in the clinic. This "supplemental" increase that is added to the "basal" pressure was analyzed through the decrease of systolic blood pressure (SBP) along ten consecutive measurements separated by 3 minutes intervals in 85 patients with BP values within a wide range (Table I). 91% of the patients showed a decrease in consecutive measurements and only 9% showed increases or no significant change in SBP values. The decrease showed good correlation with the exponential decay (r = 0.99). The asymptote was for the SBP of -8.7 +/- .81 mmHg (P < 0.01) (Fig. 2) with a time constant T (tau) of 4.7 +/- 1.3 minutes. There was no correlation between the magnitude of the decrease and the BP levels, which does not support the idea that this reaction would be increased in hypertensives. The decrease of DBP was lower (3.87 +/- .71 mmHg (P < 0.01) but with similar characteristics (Fig. 3). If we consider the characteristics of the exponential decay and the fact that after 4 or 5 measurements we arrive at values near the asymptote, basal BP could be simply determined by the average of 2 or 3 determinations with 3 minutes intervals measured after discarding the first two or three readings obtained in the same conditions or by calculating the exponential decay from the equation SBP = Po.e-1/T + As (Fig. 6).(ABSTRACT TRUNCATED AT 250 WORDS)
本文旨在评估在临床测量时引起血压(BP)高于“基础值”的警报反应特征。通过对85例血压值范围较广的患者,每隔3分钟进行连续10次收缩压(SBP)测量,分析添加到“基础”压力上的这种“补充性”升高情况(表I)。91%的患者连续测量值下降,只有9%的患者SBP值升高或无显著变化。下降情况与指数衰减显示出良好的相关性(r = 0.99)。渐近线为SBP -8.7 +/- 0.81 mmHg(P < 0.01)(图2),时间常数T(tau)为4.7 +/- 1.3分钟。下降幅度与血压水平之间无相关性,这并不支持高血压患者这种反应会增强的观点。舒张压(DBP)的下降幅度较小(3.87 +/- 0.71 mmHg(P < 0.01),但具有相似特征(图3)。如果考虑指数衰减的特征以及在4或5次测量后我们得到接近渐近线的值这一事实,基础血压可以简单地通过在相同条件下丢弃前两或三个读数后,每隔3分钟进行2或3次测量的平均值来确定,或者通过根据方程SBP = Po.e-1/T + As计算指数衰减来确定(图6)。(摘要截取自250字)