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Modern approaches to blood pressure measurement.

机译：血压测量的现代方法。

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BACKGROUND: Blood pressure (BP) is usually measured by conventional sphygmomanometry. Although apparently simple, this procedure is fraught with many potential sources of error. This review focuses on two alternative techniques of BP measurement: ambulatory monitoring and self measurement. REVIEW: BP values obtained by ambulatory monitoring or self measurement are characterised by high reproducibility, are not subject to digit preference or observer bias, and minimise the transient rise of the blood pressure in response to the surroundings of the clinic or the presence of the observer, the so called white coat effect. For ambulatory monitoring, the upper limits of systolic/diastolic normotension in adults include 130/80 mm Hg for the 24 hour BP and 135/85 and 120/70 mm Hg for the daytime BP and night time BP, respectively. For the the self measured BP these thresholds include 135/85 mm Hg. Automated BP measurement is most useful to identify patients with white coat hypertension. Whether or not white coat hypertension predisposes to sustained hypertension remains debated. However, outcome is better correlated with the ambulatory BP than with the conventional BP. In patients with white coat hypertension, antihypertensive drugs lower the BP in the clinic, but not the ambulatory BP, and also do not improve prognosis. Ambulatory BP monitoring is also better than conventional BP measurement in assessing the effects of treatment. Ambulatory BP monitoring is necessary to diagnose nocturnal hypertension and is especially indicated in patients with borderline hypertension, elderly patients, pregnant women, patients with treatment resistant hypertension, and also in patients with symptoms suggestive of hypotension. CONCLUSIONS: The newer techniques of BP measurement are now well established in clinical research, for diagnosis in clinical practice, and will increasingly make their appearance in occupational and environmental medicine.
机译：背景：血压（BP）通常是通过常规血压计测量的。尽管看似简单，但此过程充满了许多潜在的错误源。这篇综述着重于血压测量的两种替代技术：动态监测和自我测量。回顾：通过动态监测或自我测量获得的BP值具有高可重复性的特点，不受数字偏爱或观察者偏见的影响，并且可以根据诊所的周围环境或观察者的存在将血压的瞬时升高降至最低，所谓白大衣效果。对于门诊监护，成人的收缩/舒张血压正常值的上限分别是：24小时BP为130/80 mm Hg，白天BP为135/85 mm Hg，夜间BP为120/70 mm Hg。对于自测血压，这些阈值包括135/85 mm Hg。自动化BP测量对识别白大衣高血压患者最有用。白大衣高血压是否易患持续性高血压尚有争议。但是，与动态血压相比，与动态血压的相关性更好。在患有白大衣高血压的患者中，降压药物可降低临床血压，但不能降低门诊血压，也不能改善预后。动态血压监测在评估治疗效果方面也优于常规血压测量。动态BP监测对于诊断夜间高血压是必要的，尤其适用于边缘性高血压患者，老年患者，孕妇，具有抗药性高血压的患者以及具有低血压症状的患者。结论：现在，在临床研究中已经确立了较新的BP测量技术，可以在临床实践中进行诊断，并且将越来越多地在职业和环境医学中出现它们。

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