從二十四小時動態血壓監測的觀點探討高血壓的運動處方

Using twenty-four hour ambulatory blood pressure monitoring to investigate exercise prescription of hypertension

高血壓是一種極為常見且嚴重的慢性疾病，其對整體社會經濟負擔及健康之影響甚鉅。然而，目前高血壓患者的自知率、服藥率與控制率仍然屬於不理想的狀態。規律的運動是預防和治療高血壓的策略之一，但仍有25%左右的患者在從事身體活動後並沒有呈現血壓下降的反應，且目前仍有幾個有關於運動在高血壓防治效果上的問題亟待解答，這些問題可以進一步透過24小時動態血壓（ambulatory blood pressure,ABP）監測來加以釐清。24小時ABP監測因可多重連續測量，能夠客觀的反應人體日常活動期間的血壓變化，且相較於臨床血壓亦具有較高的準確性和較小的變異性，與目標器官損害的相關性也較高，因此對於高血壓的診斷和防治具有十分重要的意義。因此，本文擬從24小時ABP監測的觀點來探討高血壓防治的最適運動處方。

Hypertension is an extremely common and serious chronic disease, and its influence on total social economy and health is enormously. However, the rates of perceived self-knowledge, medicine taking and hypertension controlling, remain sub-optimal at present. Even though regular exercise is recommended as a part of hypertension prevention, treatment and control, approximately 25% of hypertensive patients do not exhibit blood pressure reduction associated with exercise training. In addition, several questions regarding the effects of exercise on prevention and treatment of hypertension need to be clarified. These questions can be resolved through twenty-four hour ambulatory blood pressure (ABP) monitoring. Twenty-four hour ABP monitoring plays a significance role in diagnosis, and prevention of hypertension because it provides a repeated measure of hypertension as well as reflects blood pressure fluctuates of activities of daily living. Furthermore, higher relationship has been found between ABP and hypertensive target organ damage as compared to conventional blood pressure. The major aim of this review paper was therefore to investigate exercise prescription of hypertension using 24-hour ABP monitoring.