cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-2154Research ArticleОБЗОРЫREVIEWSСамоконтроль артериального давления в современной медицинской практикеHome blood pressure monitoring in modern clinical practiceГорбуновВ. М.GorbunovV. M.

руководитель лаборатории применения амбулаторных диагностических методов в профилактике хронических неинфекционных заболеваний

vgorbunov@gnicpm.ruГосударственный научно-исследовательский центр профилактической медицины, МоскваState Research Centre for Preventive Medicine, Moscow20102012201096121135Copyright © Горбунов В.М., 20102010Горбунов В.М.Gorbunov V.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2154

Статья содержит критический анализ Руководства по самоконтролю артериального давления (СКАД), Европейского Общества по изучению артериальной гипертонии 2008. Подробно рассмотрены теоретические вопросы, связанные с использованием метода: общая характеристика СКАД, прогностическое значение результатов, нормативы, показания к СКАД. Отдельно проанализирован метод СКАД. Освещены спорные моменты, отсутствующие в руководстве — “эффект первого измерения” и информативность длительного СКАД. Дана сравнительная характеристика двух основных современных методов измерения АД: СКАД и суточного мониторирования АД (СМАД). СКАД незаменим для рутинной оценки эффективности длительной антигипертензивной терапии. “Прерогативой” СМАД является оценка исходного уровня АД у пациентов с АГ, в т.ч. диагностика скрытой АГ, и обследование в “сложных” случаях недостаточной эффективности лечения. В целом, два метода являются взаимодополняющими. Выход русского перевода Руководства, несомненно, повысит интерес врачей к СКАД, поможет преодолеть сохраняющийся по отношению к этому методу скептицизм. В итоге все это будет способствовать повышению качества обследования и лечения больных АГ в России.

The paper presents a critical analysis of the guidelines on home blood pressure monitoring (HBPM) by the European Society of Hypertension (2008). Theoretical aspects, related to the clinical implementation of the method, are discussed in detail, including general HBPM description, prognostic value of its results, normal range of HBPM parameters, and indications for HBPM. In addition, problematic issues, not covered in the guidelines, are discussed, such as the “first measurement effect” and long-term HMPM informative value. Two major modern methods for blood pressure measurement are compared – HBPM and 24-hour ambulatory blood pressure monitoring (ABPM). HBPM is essential for routine assessment of long-term antihypertensive therapy effectiveness, while the focus of 24-hour ABPM is the baseline BP evaluation in hypertensive patients, including masked hypertension diagnostics, and additional BP assessment in the case of low response to antihypertensive therapy. Therefore, these two methods are complementary. Publication of the Russian translation of the guidelines will increase clinicians’ interest in HBPM, overcoming the current skeptical attitude towards this method, and, as a result, will help to improve the quality of arterial hypertension diagnostics and treatment in Russia.

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The authors declare that there are no conflicts of interest present.