1.Significance of ambulatory blood pressure monitoring in the prevention and early intervention of hypertension
Chinese Journal of Tissue Engineering Research 2005;9(27):248-249
OBJECTIVE: The application of ambulatory blood pressure monitoring (ABPM) has been a great impetus to clinical hypertension research in respect of the liability, differentiation between high-risk and low-risk patients and the therapeutic effect of antihypertensive drugs. Therefore, in this study we reviewed recent research on ABPM in the prevention and early intervention of hypertension. DATA SOURCF: Related articles were retrieved by computer in the Medline between January 1993 and January 2002, with the key words of 'ambulatory blood pressure monitoring', 'hypertension', 'life satisfaction', 'effect factors'and 'blood pressure monitoring' and the language confined to English. STUDY SELECTION: After the first trial, literature containing research randomized controlled clinical trial and review on the confirmed primary,allel control group. Repetitive studies were excluded. DATA EXTRACTION: We selected a total of 20 articles on the association of ABPM with the prevention and early intervention of hypertension, 7of which accorded with the inclusion criteria. The other 13 articles were excluded because 10 of them had little relevance to the objective of our study and 13 were repetitive studies.DATA SYNTHESIS: ABPM was used to assess general BP profile, the peak level of drug action and lasting time under various states, such as resting, instable emotion, as well as movement and sleep. Then the safe dosage and medication time were draw up according to the peak-effect (the maximum decrement of diastolic pressure and systolic pressure after a dosage administration) and the valley effect (the decreasing amplitude when completing a dosage medication), as well as the relationship between them, aiming to keep the antihypertensive peak-to-valley ratio above 60%,which guaranteed the stable antihypertensive effect within 24 hours and was beneficial to the individualized treatment. CONCLUSION: ABPM can decide whether patients with hypertension need earlier intervention, and has been used in the assessment of therapeutic effect. It is also considered as an important independent predictor for the occurrence of hypertension complications. Twenty-four hours ABPM can not only determine the type of hypertension, but also keep the patients informed of their BP fluctuation profile at any time in order to avoid hypotension when sleeping, thus helping prevent severe hypertension complications such as stroke. Furthermore, ABPM can predict the severity of hypertension, and BP variation and day-night fluctuation, which provides guidance for the early intervention, correct medication and regular life.