Kawabe Hiroshi, Saito Ikuo
Health Center, Keio University, Tokyo, Japan.
Clin Exp Hypertens. 2008 Jan;30(1):79-85. doi: 10.1080/10641960701815911.
In spite of the recent recognition of the usefulness of home blood pressure (BP) measurement, there are no clear guidelines for which measurements should be used for clinical evaluation. Therefore, the present study examined the correlation of repeated measurements of home BP on one occasion and the diagnosis of hypertension (HT) or normotension (NT). Home BP was measured with 700 volunteers aged 20 years or older (468 male and 232 female, mean age 40.6 years) in a sitting position three times each in the morning and evening for seven consecutive days. Excluding the measurements on the first day, the mean values were calculated for the first measurement (group A), second measurement (group B), the mean of the first and second measurements (group C), and the mean of the second and third measurements (group D). The correlation with the frequency of diagnosis of HT (>/=135/85 mmHg) and NT (<125/80 mmHg) was studied. Home BP in the morning and evening were both highest in group A (morning: 122.1 +/-0.6 (SEM)/75.9 +/-0.4 mmHg, evening: 120.4 +/-0.6/71.8 +/-0.4 mmHg) and lowest in group D (morning: 119.5 +/-0.6 / 75.2 +/-0.4 mmHg, evening: 117.5 +/-0.6/70.6 +/-0.4 mmHg). Using morning home BP, HT was diagnosed more often in group A (27.4%) than in group D (24.7%), with a lower frequency of NT diagnosis (55.7% vs. 61.7%; p = 0.06). With regard to the diagnosis made from evening home BP, HT was diagnosed more often and NT was diagnosed less often in group A (HT/NT: 18.4%/61.4%) than in group D (13.7%/68.0%), with statistical significance (p = 0.02). In conclusion, when the clinical diagnosis was made from seven-day home BP, the diagnosis of HT was made more frequently and NT diagnosis was made less frequently using the first measurement than the mean of the second and third measurements. This trend was more pronounced when diagnosis was made from evening home BP.
尽管最近人们认识到家庭血压测量的有用性，但对于临床评估应采用哪些测量值尚无明确指南。因此，本研究探讨了一次重复测量家庭血压与高血压（HT）或正常血压（NT）诊断之间的相关性。对700名20岁及以上的志愿者（468名男性和232名女性，平均年龄40.6岁）进行家庭血压测量，他们在连续七天内每天早晚各坐着测量三次。排除第一天的测量值后，计算第一次测量值（A组）、第二次测量值（B组）、第一次和第二次测量值的平均值（C组）以及第二次和第三次测量值的平均值（D组）。研究了这些值与HT（收缩压/舒张压≥135/85 mmHg）和NT（收缩压/舒张压＜125/80 mmHg）诊断频率的相关性。早晚家庭血压在A组中均最高（早晨：122.1±0.6（标准误）/75.9±0.4 mmHg，晚上：120.4±0.6/71.8±0.4 mmHg），在D组中最低（早晨：119.5±0.6 / 75.2±0.4 mmHg，晚上：117.5±0.6/70.6±0.4 mmHg）。使用早晨家庭血压时，A组诊断为HT的比例（27.4%）高于D组（24.7%），而NT诊断频率较低（55.7%对61.7%；p = 0.06）。关于根据晚上家庭血压做出的诊断，A组诊断为HT的比例更高，诊断为NT的比例更低（HT/NT：18.4%/61.4%），高于D组（13.7%/68.0%），具有统计学意义（p = 0.02）。总之，当根据七天的家庭血压进行临床诊断时，与使用第二次和第三次测量值的平均值相比，使用第一次测量值时HT诊断更频繁，NT诊断更不频繁。当根据晚上家庭血压进行诊断时，这种趋势更为明显。
