DiPette D J, Townsend R R
Department of Internal Medicine, The University of Texas Medical Branch, Galveston 77555-0566, USA.
Am J Med Sci. 1996 Nov;312(5):221-4. doi: 10.1097/00000441-199611000-00006.
Despite tremendous advances in detection and treatment, including both non-pharmacologic and pharmacologic methods, hypertension continues to be a major health concern. In addition to efforts at reducing mortality, recent clinical and research attention has been focused on reducing morbidity from hypertension. Therefore, such efforts are focused on the effect of an elevated blood pressure on individual target organs and in particular on the heart, brain, and kidney. Although the role of blood pressure reduction alone in preserving target organ damage from hypertension is intensely debated, there is little debate that reducing blood pressure is important. The primary manner in which the blood pressure level is determined in the clinical setting continues to be the casual office measurement of blood pressure. However, the clinical use of ambulatory blood pressure determinations, including 24-hour automated blood pressure monitoring, is increasing. Recent data suggest that the determination of ambulatory blood pressures may be a better predictor not only of mortality but also of target organ damage from hypertension. This article will review recent key clinical studies addressing the role of ambulatory blood pressure on certain cardiac, cerebral, and renal manifestations of hypertension.
尽管在检测和治疗方面取得了巨大进展，包括非药物和药物方法，但高血压仍然是一个主要的健康问题。除了降低死亡率的努力外，最近临床和研究的重点一直是降低高血压的发病率。因此，这些努力集中在血压升高对各个靶器官的影响上，特别是对心脏、大脑和肾脏的影响。尽管仅降低血压在预防高血压所致靶器官损害中的作用存在激烈争论，但降低血压很重要这一点几乎没有争议。在临床环境中确定血压水平的主要方式仍然是在诊室偶然测量血压。然而，动态血压测定（包括24小时自动血压监测）的临床应用正在增加。最近的数据表明，动态血压测定不仅可能是死亡率的更好预测指标，也是高血压所致靶器官损害的更好预测指标。本文将综述近期关于动态血压在高血压某些心脏、脑和肾脏表现中作用的关键临床研究。
