Altunkan Sekip, Genç Yasemin, Altunkan Erkan
Hypertension Division, Metropol Medical Center, Nisan Sokak, No: 7, 06400, Dikmen, Ankara, Turkey.
Eur J Intern Med. 2007 Mar;18(2):118-23. doi: 10.1016/j.ejim.2006.09.018.
Self-measurements of blood pressure (BP) and 24-hour BP measurements are better predictors of cardiovascular mortality and morbidity than office BP measurements. The objective of this study was to compare the accuracy and precision of a wrist BP monitor with a position sensor (Omron 637IT) and of an ambulatory BP measuring monitor (ABPM; Nissei DS-250) with a mercury sphygmomanometer.
A total of 139 patients (69 women and 70 men) were included in the study. The BP of each subject was first measured with a mercury device using the same (left) arm. After this, the wrist monitor was used for BP measurement. Upon completion of the BP readings, 24-hour BP monitoring was performed using Nissei DS-250 monitors. Mean and standard deviations were calculated for all devices. In order to assess the agreement between the measurement methods, the Bland-Altman method and graphics were utilized.
The mean systolic BP measured by the mercury device was 133.2+/-18.4 mmHg and the diastolic BP was 85.4+/-12.5 mmHg, whereas the digital device measured systolic BP as 135.7+/-17.2 mmHg and diastolic BP as 87.0+/-12.5 mmHg. The 24-hour BP measurement was 134.6+/-16.6 mmHg for systolic BP and 85.6+/-11.1 mmHg for diastolic BP. The difference with regard to systolic BP between the mercury and the Omron devices was -2.5+/-5.3 mmHg, which is within the AAMI standard. However, while the mean values of the differences between the mercury and ABPM devices remained under 5 mmHg, their standard deviation was above +/- 8 mmHg. For diastolic BP, the difference between all of the devices was below 5+/-8 mmHg.
The wrist BP monitor produced results consistent with those of the mercury sphygmomanometer when both were compared with the results of the ABPM. As BP measurement with these devices is a practical and repeatable method, they can be used instead of ABPM in the diagnosis and monitoring of hypertension. However, there is a need for further comparative studies.
与诊室血压测量相比，自测血压和24小时血压测量能更好地预测心血管疾病的死亡率和发病率。本研究的目的是比较带有位置传感器的腕式血压监测仪（欧姆龙637IT）和动态血压监测仪（ABPM；日精DS - 250）与水银血压计的准确性和精确性。
共有139名患者（69名女性和70名男性）纳入本研究。首先使用水银装置对每个受试者的同一（左）臂进行血压测量。之后，使用腕式监测仪测量血压。完成血压读数后，使用日精DS - 250监测仪进行24小时血压监测。计算所有设备的平均值和标准差。为了评估测量方法之间的一致性，采用了布兰德 - 奥特曼方法和图表。
水银装置测量的平均收缩压为133.2±18.4 mmHg，舒张压为85.4±12.5 mmHg，而数字装置测量的收缩压为135.7±17.2 mmHg，舒张压为87.0±12.5 mmHg。24小时血压测量的收缩压为134.6±16.6 mmHg，舒张压为85.6±11.1 mmHg。水银装置与欧姆龙装置之间收缩压的差异为 -2.5±5.3 mmHg，在AAMI标准范围内。然而，虽然水银装置与ABPM装置之间差异的平均值保持在5 mmHg以下，但其标准差高于±8 mmHg。对于舒张压，所有装置之间的差异均低于5±8 mmHg。
当将腕式血压监测仪与ABPM的结果进行比较时，其结果与水银血压计的结果一致。由于使用这些设备进行血压测量是一种实用且可重复的方法，因此在高血压的诊断和监测中可以使用它们来替代ABPM。然而，仍需要进一步的比较研究。
