Ulteriori informazioni
In addition to standardized casual blood pressure readings, ambulatory blood pressure monitoring (ABPM) - using automatic noninvasive (= indirect) devices for home readings and fully automated monitors for 24-h profiles - have become a widely used necessary tool in clinical research. This book summarizes the state of the art in the whole field of indirect blood pressure monitoring. It is based on two international meetings and on invited papers. We have divided the subject matter into two main areas: 1) Automatic blood pressure devices for discontinuous registration, and 2) Portable, fully automated programmable monitors for continuous monitoring. The availability of all new technologies is described in detail and current technical and physiological problems have been covered in depth. Both topics have been subdivided into a) Methods and Techniques, and b) Clinical Applications. Both parts are updated and have critically evaluated available automatic sphygmomanometers and portable computers equipped with different techni ques (e. g. , auscultation, oscillometry, plethysmography). Reliability in the intensiv Care unit as well as in outpatients management, common clinical problems, clinical relevance compared to casual blood pressure are described in the first part. In the second part, ten years of experience on fully automated noninvasive methodology - compared to intraarterial techniques - have been elaborated by international experts; the possibilities and limitations are clearly demonstrated. Analyses in different clinical fields in the diagnosis of primary and secondary hypertension are given. Different statistical analyses of blood pressure variability and circadian rhythms are discussed.
Sommario
1. Automatic Blood Pressure Devices.- Methods and Techniques.- Automatic detection of Korotkoff sounds, markers for systolic and diastolic blood pressure in automated instruments.- Testing the accuracy of automated and semi-automated sphygmomanometers designed for home use.- Automatic oscillometric noninvasive blood pressure: theory and practice.- Plethysmographic (volume-oscillometric) method of non - invasive monitoring ambulatory blood pressure.- The use of piezofilms for noninvasive measurements of blood pressure.- Automatic registration of Korotkoff sounds: clinical experiences with automatic blood pressure measurement devices as compared to the auscultatory method.- Direct and indirect blood pressure measurement - rheologic and pathophysiologic considerations.- Clinical Applications - a critical review.- Ambulatory blood pressure monitoring: use in clinical practice and in research.- How reliable are indirect blood pressure measurement devices in the intensive care unit (ICU)?.- Common clinical problems of measuring arterial pressure in the elderly.- Clinical relevance of casual blood pressure readings versus self-measurement.- 2. Ambulatory 24-h Blood Pressure Monitoring.- Methods and Techniques.- History of telemetric automatic long-term blood pressure recording.- The direct intra-arterial method for ambulatory blood pressure recording: present status and future applications.- Non-invasive ambulatory blood pressure recording.- Methodological developments and problems of recorders for automatic, indirect, ambulatory 24-hour monitoring of blood pressure.- Analysis of circadian blood pressure profiles: some remarks from a statistician.- Ambulatory blood pressure - direct and indirect.- Finapres, continuous noninvasive finger arterial pressure based on themethod of Peñáz.- Clinical Application for Diagnosis.- Diagnostic and therapeutic aspects of 24-h blood pressure measurement.- Circadian variation of blood pressure in postoperative coarctation patients.- Spontaneity and reactivity of autonomic control systems in patients with end-stage renal disease: a new integrative approach.- Reversed circadian variation of blood pressure in heart transplant patients?.- Variability of arterial blood pressure in normal and in hypertensive pregnancy.- Blood pressure variability during athletics.- Blood pressure variability and reactivity in the natural environment.- Diurnal blood pressure rhythm: dependence on internal and external time triggers.- Clinical Application for Therapy.- Blood pressure in normal subjects.- Casual readings, self-measurements, and indirect 24-hour profile of blood pressure in the assessment of an antihypertensive combination therapy. Results of a multicenter trial.- Casual, ergometric and 24-h blood pressure in hypertensives after physical training.- Antihypertensive effect of the new agent carvedilol: evaluation by 24-hour indirect blood pressure monitoring.- Chronobiologic blood pressure assessment with a cardiovascular summary, the sphygmochron.- Prediction of cardiovascular morbidity from ambulatory blood pressure monitoring.
