[家庭血压测量在高血压诊断和监测中的不同用途]

[Different uses of home blood pressure measurement in the diagnosis and monitoring of hypertension].

作者信息

Divisón Juan Antonio, Sanchis Doménech Carlos, Carrión Valero Lucinio, Massó Orozco Javier, Carbayo Herencia Julio, López de Coca Enrique, Artigao Luis Miguel, Rodríguez Paños Beatriz

机构信息

Grupo de Estudio de Enfermedades Vasculares de Albacete (GEVA), Albacete, España.

出版信息

Aten Primaria. 2006 Oct 31;38(7):399-404. doi: 10.1016/s0212-6567(06)70532-7.

DOI:10.1016/s0212-6567(06)70532-7

PMID:17173815

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7676175/

Abstract

OBJECTIVE

To find differences between measurements of clinical blood pressure and self-monitored home blood pressure measurement (HBPM).

DESIGN

Descriptive study developed in a general population census.

SETTING

Primary care.

SUBJECTS

A total of 1411 subjects > or =18 years old were selected by stratified randomized sampling.

METHODS

A skilled nurse made 3 clinical blood pressure (CBP) measurements, and trained patients or their relatives in HBPM, doing 12 in one day. CBP and HBPM employed an electronic device (OMRON 705CP).

RESULTS

A total of 12 HBPM from 1184 subjects (52% women) were completed, with a mean age of 47.6 (SD, 17.2); 195 subjects were known to have hypertension. White-coat effect was diagnosed in 14.9% of subjects with normal pressure, 22.3% of hypertense patients treated and 57.6% of subjects with suspicion of isolated clinical hypertension. Possible isolated clinical hypertension was diagnosed in 10% of subjects without hypertension. White Coat normal pressure was found in 2.3% of untreated subjects and 4.7% of subjects with treated hypertension. 20.7% of subjects with hypertension poorly controlled in the clinic were considered pseudo-refractory (11.4% at the end of dosage interval). 77% of subjects conducted HBPM on their own and 89% thought it easy to do so.

CONCLUSION

Incorporation of HBPM into daily medical practice could avoid 20%-30% of possible mistakes in diagnosis and monitoring of hypertense patients.

摘要

目的

找出临床血压测量与家庭自测血压（HBPM）之间的差异。

设计

在一次普通人群普查中开展的描述性研究。

地点

初级保健机构。

研究对象

通过分层随机抽样选取了1411名年龄≥18岁的受试者。

方法

由一名熟练的护士进行3次临床血压（CBP）测量，并对患者或其亲属进行家庭自测血压培训，一天内测量12次。临床血压测量和家庭自测血压均使用电子设备（欧姆龙705CP）。

结果

共完成了来自1184名受试者（52%为女性）的12次家庭自测血压，平均年龄为47.6岁（标准差为17.2）；已知195名受试者患有高血压。在血压正常的受试者中，14.9%被诊断为白大衣效应，接受治疗的高血压患者中22.3%有此效应，疑似单纯临床高血压的受试者中57.6%有此效应。在无高血压的受试者中，10%被诊断为可能的单纯临床高血压。在未治疗的受试者中，2.3%被发现有白大衣正常血压，在接受治疗的高血压患者中，4.7%有此情况。在诊所血压控制不佳的高血压患者中，20.7%被认为是假性难治性（在给药间隔结束时为11.4%）。77%的受试者自行进行家庭自测血压，89%的受试者认为操作容易。