Lacourcière Y
Hypertension Research Unit, Centre Hospitalier de l'Université Laval, Ste-Foy, Québec.
Can J Cardiol. 1993 Jan-Feb;9(1):73-9.
Clinical blood pressure often does not permit estimation of ambulatory blood pressure levels which may be lower than, identical to or higher than office pressure. By providing a substantial number of blood pressure values, ambulatory monitoring decreases subject variability and greatly increases the accuracy of blood pressure measurements. This technique is, therefore, attractive for determining hypertensive patients who would benefit from treatment. Moreover, ambulatory blood pressure measurements correlate well with target organ damage and appear to be a more potent predictor of cardiovascular morbidity and mortality than causal blood pressure. In recent years, ambulatory blood pressure monitoring has proved to be more reliable than measurements in a physician's office when evaluating the efficacy of antihypertensive drugs. It may confirm a fall in blood pressure demonstrated by office measurements and may give valuable information about the antihypertensive effect during specific situations, such as a stressful work setting. Furthermore, ambulatory monitoring is a useful tool for assessing the duration of antihypertensive drug effects. This technique can help to determine whether a once-daily regimen provides 24 h antihypertensive efficacy. Thus, ambulatory blood pressure monitoring is useful in identifying genuinely hypertensive patients who would benefit from treatment, as well as the effects and duration of antihypertensive medications.
临床血压往往无法用于估算动态血压水平，动态血压水平可能低于、等于或高于诊室血压。通过提供大量血压值，动态血压监测可减少个体差异，并大大提高血压测量的准确性。因此，这项技术对于确定能从治疗中获益的高血压患者很有吸引力。此外，动态血压测量与靶器官损害密切相关，而且相比于偶测血压，它似乎是心血管发病和死亡更有力的预测指标。近年来，在评估降压药物疗效时，动态血压监测已被证明比在医生诊室测量更可靠。它可以证实诊室测量所显示的血压下降情况，还能提供特定情况下（如工作压力大时）降压效果的有价值信息。此外，动态血压监测是评估降压药物作用持续时间的有用工具。这项技术有助于确定每日一次给药方案是否能提供24小时的降压效果。因此，动态血压监测对于识别真正能从治疗中获益的高血压患者以及评估降压药物的效果和作用持续时间都很有用。
