ABPM.2015教程解决方案.ppt

* Blood pressure falls during sleep and rises rapidly just before the time of awakening and arising (Millar-Craig et al, 1978; Mancia et al, 1983). Millar-Craig M, Bishop CN, Raftery EB. Circadian variation of blood pressure. Lancet 1978; I: 795-797. Mancia G, Ferrari A, Gregorini L et al. Blood pressure and heart rate variabilities in normotensive and hypertensive human beings. Circ Res 1983; 53: 96-104. * Most patients with essential hypertension are ‘dippers’ - patients experience the same circadian pattern as normotensives with a night-time dip in blood pressure (Mancia et al, 1983). The ‘normal’ circadian pattern is lost in some patients with essential hypertension (‘non-dippers’). There appears to be a greater prevalence of this phenomenon in patients with secondary hypertension, renal insufficiency, pre-eclampsia, in elderly hypertensives, and in the accelerated form of malignant hypertension (Redman et al, 1976; Kobrin et al, 1984; Baumgart et al, 1989; Imai et al, 1990; Portaluppi et al, 1991). Redman CWG, Beilin LJ, Bonnar J. Reversed diurnal blood pressure rhythm in hypertensive pregnancies. Clin Sci Mol Med 1976; 51: 687-688. Mancia G, Ferrari A, Gregorini L et al. Blood pressure and heart rate variabilities in normotensive and hypertensive human beings. Circ Res 1983; 53: 96-104. Kobrin I, Oigman W, Kumar A et al. Diurnal variation of blood pressure in elderly patients with essential hypertension. J Am Geriatr Soc 1984; 32: 869-879. Baumgart P, Walger P, Gerke M, Dorst K-G, Vetter H, Raum K-H. Nocturnal hypertension in renal failure hemodialysis and after renal transplantation. J Hypertens 1989; 7 (Suppl 6): 70-71. Imai Y, Abe K, Munakata M et al. Does ambulatory blood pressure monitoring improve the diagnosis of secondary hypertension? J Hypertens 1990; 8 (Suppl 6): 71-78. Portaluppi F, Montanari L, Massari M, Di Chiari V, Capanna M. Loss of nocturnal decline of blood pressure in hypertensives due to chronic renal failure. Am J Hyp