International Circulation: Is active intervention necessary for masked hypertension or a lifestyle adjustment is enough?
Cameron: Masked hypertension refers to those individuals who are hypertensive (by appropriate definition) during daily activities or at night but not when directly assessed in the clinic (ie the opposite of "white coat" hypertension).?Diagnosis of marked hypertension requires either regular home monitoring or repeated ambulatory blood pressure monitoring.?
Masked HT is important and should not be ignored. As with any individual when the diagnosis of hypertension is made lifestyle advice and modernization is the most important initial management prior to the instigation of drug therapy. Only when lifestyle management has been tried and found not sufficiently satisfactory should anti-hypertensive drugs be commenced. The decision for the physician is how long to persevere with lifestyle management along without adequate control and how long to wait between out-of-office BP assessments.
Unfortunately lifestyle management is commonly insufficient in many (most) cases and then masked hypertension should be treated the same as in other people classified as hypertensive.
《国际循环》:隐匿性高血压是否需要积极干预?单纯干预生活方式是否足够?
Cameron教授:隐匿性高血压是指在日常活动中或夜间出现的高血压,但是诊室直接测量时血压不高(对应着白大衣高血压)。隐匿性高血压的诊断需要规律的家庭血压监测或重复进行动态血压监测。隐匿性高血压是重要的,不应当被忽视。对于所有诊断为高血压的患者,给予生活方式建议是开始药物治疗之前最先采取的最为重要的管理步骤。只有进行生活方式干预之后效果不满意时,才应当开始药物治疗。医生需要做的决策是血压控制不佳时生活方式干预还需坚持多长时间,另外要决定诊室外血压监测的间隔是多长。不幸的是,大多数隐匿性高血压患者单纯给予生活方式干预是不够的,这些患者应当与其他高血压患者一样接受同样的治疗。