This article is a review of 25 publications on ambulatory blood pressure monitoring(ABPM) and the importance of its results in everyday clinical practice. These studies, published in 2008-2011, were selected from the ...This article is a review of 25 publications on ambulatory blood pressure monitoring(ABPM) and the importance of its results in everyday clinical practice. These studies, published in 2008-2011, were selected from the Scopus database, but are also available in Pubmed. They were prepared by researchers from around the world, concerned with the problems of proper control of blood pressure(BP), and of abnormalities in the circadian pattern of BP in patients with arterial hypertension, diabetes mellitus or renal failure. In the first part of this article, I analyse publications focused on some nuances in the methodology of ABPM and recommend ways to avoid some traps, related not only to the individual patient but also to the device used and the technical staff. The next section is devoted to the advantages of ABPM as a diagnostic tool which enables clinicians to learn about patients' BP during sleep, and emphasizes the practical implications of this information for so-called chronotherapy. This section also presents some new studies on the prognostic value of ABPM in patients with cardiovascular(CV) risk. Some recent articles on the results of various methods of pharmacological treatment of arterial hypertension in different agegroups are then described. The observations presented in this article may be helpful not only for researchers interested in the chronobiology of the CV system, but also for general practitioners using ABPM.展开更多
Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory syste...Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems （renin-angiotensin-aldosterone system, sympathetic nervous system, release of vasopressin）, and resistance to vasopressors. The vasodilatory state is mediated through adrenomedullin, calcitonin generelated peptide, nitric oxide, and other vasodilators, and is most pronounced in the splanchnic area. This constitutes an effective （although relative） counterbalance to increased arterial blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension （essential, secondary） may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most likely includes the combination of vasodilatation and vasoconstriction in parallel.展开更多
This paper presents a decoupling theory named as Vascular Loading Decoupling Technique (VLDT), extended from the beat-based Tissue Control Method (TCM), for noninvasive measurement of real-time-based intra-arterial bl...This paper presents a decoupling theory named as Vascular Loading Decoupling Technique (VLDT), extended from the beat-based Tissue Control Method (TCM), for noninvasive measurement of real-time-based intra-arterial blood pressure and dynamic compliance of blood vessel. Both VLDT and TCM are based upon the decoupling theory to cause the arterial pulsation without the influence from surrounding tissues and measure the variations of the vascular diameter at critical depth. Meanwhile, the AC part of blood pressure is lost, that is, the reference pressure for AC controller is absent as well. To remedy this problem, VLDT employs Step-Hold control rules and cubic spline curve fitting technique to estimate the reference pressure, identify the impedance of blood vessel, and calculate the AC control gain at Hold stage, then track the AC part of blood pressure and compute the real-time arterial blood pressure at Step stage by turns, which makes the real time measurement feasible;moreover, the dynamic compliance of blood vessel can be extracted from real-time impedances of blood vessel. Since the compliance of blood vessel is decoupled from surrounding tissues, it is valuable for diagnosing the severity of vascular sclerosis. The simulation results showed that the VLDT approach is superiority over TCM. This could provide new prospective to circulatory medicine research.展开更多
目的探讨动态血压变异性(ABPV)与冠状动脉病变范围和程度的相关性。方法对本院收治的114例患者行320排动态容积CT冠状动脉造影检查和24 h动态血压监测(24 h ABPM),同时收集患者的年龄、性别血脂、血糖、血压、吸烟等临床指标。根据冠状...目的探讨动态血压变异性(ABPV)与冠状动脉病变范围和程度的相关性。方法对本院收治的114例患者行320排动态容积CT冠状动脉造影检查和24 h动态血压监测(24 h ABPM),同时收集患者的年龄、性别血脂、血糖、血压、吸烟等临床指标。根据冠状动脉CT结果分为冠状动脉狭窄组、冠状动脉非狭窄组,分析两组的临床指标和各血压变异性参数的差异,分析血压变异性参数与冠脉病变程度(SSS)的相关性。结果年龄、LDL是显著性影响冠脉病变的危险因素(P<0.05),而HDL则是显著性影响冠脉病变的保护因素(P<0.05)。相比冠状动脉非狭窄组,冠状动脉狭窄组的24 h收缩压标准差、白昼舒张压标准差和白昼收缩压标准差明显升高(P<0.05)。年龄和24 h舒张压标准差与SSS值之间呈正相关关系(P<0.05)。冠心病患者随着冠脉病变的狭窄程度和范围增大,血压变异性显著升高。结论血压变异性与冠状动脉狭窄及SSS评分密切相关,是冠状动脉粥样硬化性心脏病的一项重要预测指标。展开更多
文摘This article is a review of 25 publications on ambulatory blood pressure monitoring(ABPM) and the importance of its results in everyday clinical practice. These studies, published in 2008-2011, were selected from the Scopus database, but are also available in Pubmed. They were prepared by researchers from around the world, concerned with the problems of proper control of blood pressure(BP), and of abnormalities in the circadian pattern of BP in patients with arterial hypertension, diabetes mellitus or renal failure. In the first part of this article, I analyse publications focused on some nuances in the methodology of ABPM and recommend ways to avoid some traps, related not only to the individual patient but also to the device used and the technical staff. The next section is devoted to the advantages of ABPM as a diagnostic tool which enables clinicians to learn about patients' BP during sleep, and emphasizes the practical implications of this information for so-called chronotherapy. This section also presents some new studies on the prognostic value of ABPM in patients with cardiovascular(CV) risk. Some recent articles on the results of various methods of pharmacological treatment of arterial hypertension in different agegroups are then described. The observations presented in this article may be helpful not only for researchers interested in the chronobiology of the CV system, but also for general practitioners using ABPM.
文摘Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems （renin-angiotensin-aldosterone system, sympathetic nervous system, release of vasopressin）, and resistance to vasopressors. The vasodilatory state is mediated through adrenomedullin, calcitonin generelated peptide, nitric oxide, and other vasodilators, and is most pronounced in the splanchnic area. This constitutes an effective （although relative） counterbalance to increased arterial blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension （essential, secondary） may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most likely includes the combination of vasodilatation and vasoconstriction in parallel.
文摘This paper presents a decoupling theory named as Vascular Loading Decoupling Technique (VLDT), extended from the beat-based Tissue Control Method (TCM), for noninvasive measurement of real-time-based intra-arterial blood pressure and dynamic compliance of blood vessel. Both VLDT and TCM are based upon the decoupling theory to cause the arterial pulsation without the influence from surrounding tissues and measure the variations of the vascular diameter at critical depth. Meanwhile, the AC part of blood pressure is lost, that is, the reference pressure for AC controller is absent as well. To remedy this problem, VLDT employs Step-Hold control rules and cubic spline curve fitting technique to estimate the reference pressure, identify the impedance of blood vessel, and calculate the AC control gain at Hold stage, then track the AC part of blood pressure and compute the real-time arterial blood pressure at Step stage by turns, which makes the real time measurement feasible;moreover, the dynamic compliance of blood vessel can be extracted from real-time impedances of blood vessel. Since the compliance of blood vessel is decoupled from surrounding tissues, it is valuable for diagnosing the severity of vascular sclerosis. The simulation results showed that the VLDT approach is superiority over TCM. This could provide new prospective to circulatory medicine research.
