Ambulatory blood pressure diagnostic criteria

Dynamic blood pressure is a type of blood pressure and an important indicator to determine whether a person is healthy. For people with abnormal blood pressure, dynamic blood pressure is generally tested regularly, and the patient's health problems are diagnosed based on the specific values ​​of dynamic blood pressure. So, what are the diagnostic criteria for ambulatory blood pressure? The following will introduce the relevant knowledge of dynamic blood pressure!

1. Average blood pressure

Use an ambulatory blood pressure monitor to measure and record blood pressure multiple times within 24 hours to dynamically detect changes in blood pressure. Generally, measurements are taken every 15 to 20 minutes during the day and every 30 minutes to 1 hour at night. The number of successful measurements should reach more than 80%. Dynamic blood pressure monitoring can provide us with parameters such as average blood pressure, nocturnal blood pressure drop rate, blood pressure variability and hypertension burden.

Average blood pressure is the main basis for diagnosing hypertension. The criteria for diagnosing hypertension through dynamic blood pressure monitoring are: 24-hour average blood pressure ≥130/80 mmHg, daytime ≥135/85 mmHg, and nighttime ≥120/70 mmHg.

2. Nighttime blood pressure drop rate

Due to the changes in the normal circadian rhythm of blood pressure, blood pressure should be reduced to a certain extent at night. In dynamic blood pressure monitoring, the average nighttime blood pressure should be lower than 90% of the average daytime blood pressure, and the decrease rate should be between 10% and 20%. At this time, the blood pressure curve appears to be "dipper-shaped". If the nighttime blood pressure drops by less than 10%, a "non-dipper" curve is formed; if it drops by more than 20%, it is a "super-dipper" curve; if the nighttime blood pressure is higher than the daytime blood pressure, it is a "reverse dipper" curve.

3. Blood pressure variability and hypertension burden

Blood pressure variability reflects the fluctuation of blood pressure, which mainly depends on the standard deviation of the mean blood pressure; hypertension load is the proportion of blood pressure that exceeds normal values ​​in daytime and nighttime blood pressure measurements. This repeated increase in blood pressure can cause damage to the target organs of hypertension, such as the heart, brain, kidneys, and peripheral blood vessels. Generally speaking, blood pressure load should be treated if it exceeds 15%. The blood pressure load value is calculated based on systolic blood pressure and diastolic blood pressure respectively, and the standards are: daytime systolic blood pressure>140 mmHg, diastolic blood pressure>90 mmHg, nighttime systolic blood pressure>120 mmHg, diastolic blood pressure>70 mmHg.