Bottini P B, Prisant L M, Carr A A
Section of Hypertension and Vascular Diseases, Medical College of Georgia School of Medicine, Augusta 30912-3150.
Postgrad Med. 1994 May 1;95(6):89-90, 93-6, 101-2 passim.
Twenty-four-hour automated blood pressure measurements are representative of and more reliable than casual office blood pressure measurements; they also are more closely correlated with evidence of target-organ damage caused by hypertension and may have better diagnostic specificity. Nevertheless, broad use of automated monitoring in the routine evaluation and management of hypertension has been discouraged because of the lack of prospective epidemiologic studies linking automated measurements to cardiovascular morbidity and mortality, the inability to define a normal range for such measurements, and the cost of the monitoring. However, if it is accepted that conventions established for casual office blood pressure measurements are applicable to data obtained by automated methods, then routine use of automated monitoring is justified, since automated monitoring has better diagnostic capabilities that offset much of its cost.
24小时动态血压测量比随机的诊室血压测量更具代表性且更可靠；它们也与高血压所致靶器官损害的证据相关性更强，并且可能具有更好的诊断特异性。然而，由于缺乏将动态测量与心血管发病率和死亡率联系起来的前瞻性流行病学研究、无法确定此类测量的正常范围以及监测成本等原因，不鼓励在高血压的常规评估和管理中广泛使用动态监测。但是，如果认为适用于随机诊室血压测量的标准也适用于通过动态方法获得的数据，那么常规使用动态监测是合理的，因为动态监测具有更好的诊断能力，足以抵消其大部分成本。
