Springe auf Hauptinhalt Springe auf Hauptmenü Springe auf SiteSearch

Ambulantes 24-Stunden-Monitoring des diskontinuierlich und kontinuierlich gemessenen Blutdruckes während eines Arbeitstages*

Objectives: In a 24-hour study the applicability of continuous blood pressure (BP) measurement on a finger, a new parameter for the assessment of everyday cardiovascular stress, was to be checked and compared with the discontinuous BP measurement on the upper arm. Methods: Two well-defined blood pressure collectives, 20 normotensive and 20 hypertensive (not treated medicinally) men (age: 22 to 55 years), were examined on a working day during 24 hours. Arterial BP was registered simultaneously on two different parts of the body. The continuous BP measurement took place on the middle or ring finger of the left hand (finger BP: volume-clamp technology; device Portapres 2), the discontinuous BP measurement on the arteria brachialis of the right upper arm (brachial BP: auscultatory method; device TM 2420). Results: In the complete collective the correlations in all time periods indicate that brachial and finger BP are relatively independent, that is, the BP measured discontinuously and that determined continuously are independent parameters; the discontinuous determination of BP on the upper arm yielded higher values in both groups in all time periods — work, leisure time and sleep; hypertensives had significantly higher BP than normotensives with both methods. A circadian rhythm with clear nightly drop and morning increase in BP was shown with both methods in both groups of persons. Discussion and conclusions: Normally, the discontinuous measurement of blood pressure is sufficient for the assessment of everyday cardiovascular strain. With this method, the identification of “true“ normotensives and hypertensives during work and leisure time is more reliable. However, in specific situations involving short-term changes in the cardiovascular system the continuous measuring method is preferable because it permits detailed recording and assessment of the actual changes in blood pressure. It requires high compliance of the persons being examined and is more susceptible to disturbance; behaviour and environmental factors influence the measurements. The use of this method should therefore be confined to the examination of occupational groups with mainly mental work load. However, the diagnostic value of the method could be improved by provision of evaluation criteria and the introduction of a “correction factor“.