高血压的动态血压监测分析研究

目的分析研究高血压患者24h动态血压变化的规律及临床意义。方法对250例高血压患者进行24h动态血压监测,观察其昼夜变化规律。结果 250例患者中杓型组63例,非杓型组145例,反杓型组42例。结论 24h动态血压监测可以确定高血压分型,指导临床用药。     

脑卒中的动态血压监测研究

血压异常，特别是高血压是脑卒中发病中独立的和首要的因素，它与脑出血、腔隙性脑梗死、短暂性脑缺血发作(TIA)、脑血栓形成等发病有关，是临床上关注的重点。目前认为，高血压的治疗有助于预防脑卒中发病和减轻发病后的严重程度。因此临床上对高血压的诊断和治疗十分重视。多年来     

107例高血压患者24小时动态血压监测分析

早在60年代就有学者注意到血压的固有波动对高血压病的诊断、治疗和预后的判断等若干问题,并为     

高血压病的动态血压监测与分析

目的 探讨高血压（EH）患者血压节律的特点。方法 应用24小时动态血压监测（ABPM）对100例EH患者（A组）和80例对照组（B组）血压参数进行对比分析。结果 A组24小时、日间、夜间平均收缩压和舒张压均明显高于B组（P〈0.05）。昼夜下降比,轻、中型EH患者与对照组比较无显著性差异（P〉0.05）。重型EH患者昼夜下降比与轻、中型和B组比较有显著性差异（P〈0.05）。A组伴左心室肥厚（LVH）患者血压负荷值明显高于非LVH患者及B组（P〈0.05）。结论 轻、中型EH患者血压昼夜变化节律多有日间上升,夜间下降趋势。重症EH昼夜节律减弱或消失。血压负荷值〉40%时,LVH检出率高。     

动态血压监测的临床应用

动态血压监测表明12～21％轻型高血压是白大衣性高血压;在正常血压者诊所血压值与白昼动态血压值相接近,但在高血压者诊所血压值高出大约0.5～ 2/0.4～1.2kPa:靶器官损害严重程度与血压较大波动有关。(1kPa=7.5mmHg)     

基于CiteSpace可视化分析正常高值血压的研究热点趋势

目的:分析我国有关正常高值血压研究领域的发展现状和热点趋势。方法:以“正常高值血压”为主题词,检索中国知网数据库2003年1月1日—2021年11月30日的相关文献,通过CiteSpace 5.8.R3(64-bit)软件,对年发文量、作者、机构、关键词等进行可视化图谱分析。结果:共纳入1 130篇中文文献。年发文量2003年—2017年总体呈波动上升趋势,2017年—2021年则出现下降趋势。作者以张立德教授发文量最多,其团队以中医药应用于正常高值血压的理论和机制研究为主。关键词分析显示早期研究主要关注流行病学调查和影响转归的危险因素,随着研究的深入,正常高值血压与多种异常代谢指标和靶器官损伤的相关性研究也逐渐被重视,近年来中医药“治未病”理念对正常高值血压的早期干预具有重要意义,中医体质和证候特点、中医特色疗法的应用等研究日趋增加。结论:正常高值血压领域以临床研究为主,主要研究热点为流行病学调查、危险因素与转归的相关性研究、亚健康阶段的干预效果,尤其是中医诊疗已成为热点趋势。     

老年高血压患者动态血压监测分析

近年来 ,我们对 146例老年高血压患者进行了动态血压监测 ,以指导临床用药 ,现报告如下。临床资料 :本组 146例 ,男 132例 ,女 14例 ;平均年龄 6 1± 8.9岁。按 WHO诊断标准将高血压为分 、 、 期。采用英国产 BP- 5 0型动态血压记录器进行 2 4小时血压动态监测 ,每 2 0分钟监测 1次。嘱患者在 2 4小时内做活动、休息及症状的详细记录。监测前均做常规血压测量并记录 ,输入计算机。结合其活动做出综合分析 ,记录其最高血压、最低平均血压、睡眠时平均血压和活动时平均血压。结果 : ～ 期高血压患者活动时血压均明显增高 ,尤其是收缩压 ;…     

高血压脑卒中不同类型的动态血压监测分析

目的 探讨高血压(EH)脑出血与脑梗死患者的昼夜变化规律。方法 74例高血压患者中30例发生脑出血(A_1组),44例发生脑梗死(A_2组)。以47例Ⅰ期高血压患者作对照组(B组)。均作24h动态血压监测(ABPM)。结果 A_1组与A_2组收缩压(SBP)与舒张压(DBP)均较B组升高,有显著差异(P<0.05)。A_1组与A_2组的血压昼夜节律或消失或减弱,SBP与DBP夜间下降值均明显小于B组。但A_1组较A_2组更明显,二者有显著差异(P<0.05)。B组与A_1、A_2组血压昼夜波动规律明显不同。前者呈双峰双谷型,后者峰谷消失,A_1组尤甚。结论 血压的昼夜波动变化特点与发生脑卒中的类型有密切关系。     

高血压病脑出血的动态血压监测分析

对４０例高血压病脑出血及２０例Ｉ期高血压病患者进行了动态血压（ＡＢＰＭ）监测，结果显示，脑出血组夜间平均收缩压及舒张压，夜间血压下降率〈１０％者垃明显高于对照组，且血压昼夜波动节律基本消失，提示夜间平均血压过高及血压昼夜节律基本消失对高血压病脑出血具有早期预报价值。     

Reliability of ambulatory blood pressure monitoring

OBJECTIVE: To focus on the reliability of ambulatory blood pressure monitoring and on its limitations in clinical practice, and to construct adequate strategies to improve ambulatory monitoring performance. METHODS: The literature was reviewed, and personal data were used. DISCUSSION: Since the beginning of non-invasive ambulatory blood pressure monitoring, it appeared that some subjects had a high proportion of outlying readings that were unlikely to be accurate. Although ambulatory blood pressure is more reproducible than clinic blood pressure, large day-to-day differences have also been reported in reproducibility studies for average 24 h blood pressure. It has been shown that, for day-to-day 24 h blood pressure differences greater than 4/3 mmHg, ambulatory blood pressure is poorly predictive of the degree of target organ damage. The variability of average 24 h blood pressure may arise from several causes, including true biological variability, a lack of standardization of activities and measurement errors. Artefactual readings can easily occur if patients are not properly instructed. Although editing procedures can eliminate outliers, it is often impossible to identify inaccurate readings included within the patient's trend. To optimize ambulatory blood pressure monitoring, health-care providers should be instructed adequately on how to perform this technique. Appropriate patient selection, a proper application of instrumentation and the checking of its performance, careful instructions to patients, the immediate evaluation of the patient's diary and 24 h tracing after completion of the recording should improve the results of ambulatory monitoring. CONCLUSIONS: A checklist of criteria that should be used for optimizing ambulatory monitoring in clinical practice should be proposed by the Consensus Conference on ambulatory blood pressure monitoring. To improve doctors' proficiency, strategies including educational protocols and training programmes should be implemented.     

Reproducibility of ambulatory blood pressure monitoring

Short-term blood pressure variability has been studied extensively with monitoring techniques. To assess whether or not and to what extent average 24-hour blood pressure varies when repeatedly recorded, 12 mild to moderate hypertensive subjects underwent 3 non-invasive blood pressure monitorings at monthly intervals. When the average 24-hour blood pressure of the whole group was evaluated no substantial differences were found between the 3 recordings, even though slightly lower blood pressure values were recorded at the first monitoring. However, when the within-period comparison was studied in the single patients, remarkable discrepancies of up to 20.9/15.8 mmHg were detected. Systolic and diastolic blood pressure variations greater than or equal to 5 mmHg were recorded in 58% of the subjects. These differences were unrelated to the number of faulty readings. Casual blood pressure varied even to a greater extent between the first and the subsequent visits; no correlation was found between casual and 24-hour blood pressure variations. The results of the present study indicate that ambulatory blood pressure may vary even to a great extent when repeatedly recorded. This finding entails important clinical implications, as the evaluation of the hypertensive patient is usually made with a single blood pressure monitoring.     

Reproducibility of ambulatory blood pressure monitoring

OBJECTIVE: To investigate whether blood pressure monitoring is reproducible. DESIGN: Reproducibility of ambulatory blood pressure monitoring data was assessed by means of traditional and relatively new statistical methods, namely correlation coefficients, regression analysis and agreement analysis. METHODS: Ninety-one normotensive and hypertensive, uncomplicated outpatients underwent monitoring twice (mean interval 241 days). Data were analysed for reproducibility, correlation, difference and adaptation. Analyses were performed to verify the reproducibilities of the diagnosis of hypertension and of the treatment assessment. RESULTS: Ambulatory blood pressure monitoring is highly reproducible in terms of traditional statistics, but not in terms of the agreement analysis (error as high as 18 mmHg), although it performs better than does office sphygmomanometry (error as high as 38 mmHg). Reproducibility is acceptable in normotensive subjects and in patients who respond to treatment, but untreated hypertensives and those who do not respond to treatment show a worse ratio. CONCLUSION: The reproducibility of ambulatory blood pressure monitoring requires improvement. We do not know how many repeated measurements we need before diagnosing hypertension. Spontaneous variability of blood pressure interferes with blood pressure reproducibility. Diagnosis and treatment assessment in hypertension must take into account poor reproducibility.     

Epidemiology of ambulatory blood pressure monitoring

An operational threshold for making clinical decisions on the basis of ambulatory blood pressure monitoring must be defined [1-3]. This requires that the relationship between the ambulatory blood pressure and the incidence of cardiovascular complications be clarified beyond present understanding [4-7]. In addition, the distribution of the ambulatory blood pressure must be characterized better under various conditions and for various populations and compared with the centrality and spread of the conventional blood pressure under similar circumstances.     

24-hour ambulatory blood pressure monitoring

24-hour ambulatory blood pressure monitoring (ABPM) is the exact, fully automatic and noninvasive method for evaluation of the 24-hour hemodynamic profile of the subject by multiple and regular blood pressure and heart rate measurement. In comparison with causal blood pressure measurement, ABPM allows the definition of daytime and nighttime blood pressure averages, diurnal changes of blood pressure, localization of periods of the most frequent appearance of hypertensive values, specification of hypertensive load, percent time elevation and diagnosing of white coat phenomenon. The use of all mentioned findings leads to the improvement of blood pressure control in patients with resistant hypertension, polymorbidity, helps to analyze paroxysmal hypertension, verify diagnosis of the hypertension in patients with borderline or high normal blood pressure. The final profit is the reduction of the target organ damage and reduction of cardiovascular morbidity and mortality. Definite diagnosis of the white coat phenomenon markedly decreases consumption of the antihypertensive drugs. In addition, this method enables better evaluation of hypotensive syndromes and is very helpful in the investigation of physiology of blood pressure regulation, biorhythms and in pharmacodynamical studies of the new antihypertensives.     

Self monitoring versus ambulatory blood pressure monitoring]

Blood pressure is a variable parameter for which the isolated determination cannot be considered as a characteristic of the subject. Therefore, the clinical measurement of blood pressure constitutes the method of reference but presents limits and causes of errors which pose a problem for its validity in evaluating the average blood pressure level in certain patients. In order to overcome the limits of occasional measurement, different methods of blood pressure measurement have been proposed. Among these methods, self monitoring of blood pressure by the patient and 24 hour ambulatory blood pressure monitoring (ABPM) are the most used. Each of these methods presents advantages and disadvantages, indications and limits of use. The information obtained by each of them is of a different nature: these methods are not substitutes but are complementary. Self monitoring and ABPM seem to evaluate the pressure load better than clinical monitoring and are better correlated to the organic effects of hypertension and thus the cardiovascular morbidity and mortality, ABPM in particular. However, it remains to be clarified whether the use of these methods in the evaluation of cardiovascular risk and the therapeutic management of the hypertensive can improve the long term cardiovascular prognosis.