Graves John W, Nash Carol A, Grill Diane E, Bailey Kent R, Sheps Sheldon G
Division of Nephrology and Hypertension, Department of Biostatistics, Mayo Clinic School of Medicine, Rochester, Minnesota 55905, USA.
Blood Press Monit. 2005 Aug;10(4):169-74. doi: 10.1097/01.mbp.0000170920.47788.ed.
To assess the ability of limited ambulatory blood pressure monitoring as a valid replacement for office blood pressure measurement done to American Heart Association criteria in diagnosing hypertension.
In all, 105 adults, who had been referred for limited ambulatory blood pressure monitoring, participated in the study. Limited ambulatory blood pressure monitoring consisted of 6 h of blood pressure measurement while ambulatory at the Mayo Clinic, using a SpaceLabs 90207 (SpaceLabs Medical, Issaquah, Washington, USA) collecting six readings per hour for the period of observation. The study participants gave consent for three additional consecutive office blood pressure measurements, using a validated aneroid device, done to American Heart Association criteria, by a single hypertension nurse specialist.
Mean systolic blood pressure by limited ambulatory blood pressure monitoring was 137.9+/-14.2 mmHg and for the nurse, 137.9+/-20.1 mmHg. Mean diastolic blood pressure by limited ambulatory blood pressure monitoring was 81.5+/-9.7 mmHg and for the nurse, 74.3+/-11.9 mmHg. The intermethod difference for systolic blood pressure was 0.03+/-12.5 mmHg and diastolic blood pressure, -7.2+/-8.0 mmHg. Using <140/90 as criteria factor, limited ambulatory blood pressure monitoring and the trained nurse agreed 77% of the time on whether the patient was hypertensive. This agreement increased to 81% if the participant's referral blood pressure was >or=140/90.
Limited ambulatory blood pressure monitoring is an excellent replacement for office blood pressure, done to American Heart Association criteria, in diagnosing hypertension. This avoids issues of variability introduced by the observers, such as digit preference and bias, and increases reproducibility of blood pressure measurements. The appropriate normal value for limited ambulatory blood pressure monitoring is <140/90 mmHg compared with <135/85 mmHg used in 24-h ambulatory blood pressure monitoring.
评估有限动态血压监测作为按照美国心脏协会标准进行的诊室血压测量的有效替代方法，用于诊断高血压的能力。
共有105名被转诊进行有限动态血压监测的成年人参与了该研究。有限动态血压监测包括在梅奥诊所进行6小时的血压测量，使用SpaceLabs 90207（美国华盛顿州伊斯萨夸的SpaceLabs Medical公司），在观察期间每小时收集6次读数。研究参与者同意由一名高血压专科护士使用经过验证的无液式血压计，按照美国心脏协会标准，连续额外进行三次诊室血压测量。
有限动态血压监测测得的平均收缩压为137.9±14.2 mmHg，护士测量的为137.9±20.1 mmHg。有限动态血压监测测得的平均舒张压为81.5±9.7 mmHg，护士测量的为74.3±11.9 mmHg。收缩压的方法间差异为0.03±12.5 mmHg，舒张压的差异为-7.2±8.0 mmHg。以<140/90为标准因素，有限动态血压监测与经过培训的护士在判断患者是否患有高血压方面有77%的时间达成一致。如果参与者的转诊血压≥140/90，这一一致性将提高到81%。
有限动态血压监测是按照美国心脏协会标准进行的诊室血压测量在诊断高血压方面的优秀替代方法。这避免了观察者引入的变异性问题，如数字偏好和偏差，并提高了血压测量的可重复性。有限动态血压监测的合适正常值为<140/90 mmHg，而24小时动态血压监测使用的是<135/85 mmHg。
