带有位置传感器的经验证的腕部设备能否替代上臂设备用于家庭自测血压？一项以动态血压监测为参考的随机交叉试验。

Can validated wrist devices with position sensors replace arm devices for self-home blood pressure monitoring? A randomized crossover trial using ambulatory monitoring as reference.

作者信息

Stergiou George S, Christodoulakis George R, Nasothimiou Efthimia G, Giovas Periklis P, Kalogeropoulos Petros G

机构信息

Hypertension Center, Third University Department of Medicine, Sotiria Hospital, Athens, Greece.

出版信息

Am J Hypertens. 2008 Jul;21(7):753-8. doi: 10.1038/ajh.2008.176. Epub 2008 Apr 24.

DOI:10.1038/ajh.2008.176

PMID:18443566

Abstract

BACKGROUND

Electronic devices that measure blood pressure (BP) at the arm level are regarded as more accurate than wrist devices and are preferred for home BP (HBP) monitoring. Recently, wrist devices with position sensors have been successfully validated using established protocols. This study assessed whether HBP values measured with validated wrist devices are sufficiently reliable to be used for making patient-related decisions in clinical practice.

METHODS

This randomized crossover study compared HBP measurements taken using validated wrist devices (wrist-HBP, Omron R7 with position sensor) with those taken using arm devices (arm-HBP, Omron 705IT), and also with measurements of awake ambulatory BP (ABP, SpaceLabs), in 79 subjects (36 men and 43 women) with hypertension. The mean age of the study population was 56.7 +/- 11.8 years, and 33 of the subjects were not under treatment for hypertension.

RESULTS

The average arm-HBP was higher than the average wrist-HBP (mean difference, systolic 5.2 +/- 9.1 mm Hg, P < 0.001, and diastolic 2.2 +/- 6.7, P < 0.01). Twenty-seven subjects (34%) had a > or =10 mm Hg difference between systolic wrist-HBP and arm-HBP and twelve subjects (15%) showed similar levels of disparity in diastolic HBP readings. Strong correlations were found between arm-HBP and wrist-HBP (r 0.74/0.74, systolic/diastolic, P < 0.0001). However, ABP was more strongly correlated with arm-HBP (r 0.73/0.76) than with wrist-HBP (0.55/0.69). The wrist-arm HBP difference was associated with systolic ABP (r 0.34) and pulse pressure (r 0.29), but not with diastolic ABP, sex, age, arm circumference, and wrist circumference.

CONCLUSIONS

There might be important differences in HBP measured using validated wrist devices with position sensor vs. arm devices, and these could impact decisions relating to the patient in clinical practice. Measurements taken using arm devices are more closely related to ABP values than those recorded by wrist devices. More research is needed before recommending the widespread use of wrist monitors in clinical practice. American Journal of Hypertension doi:10.1038/ajh.2008.176American Journal of Hypertension (2008); 21, 7, 753-758. doi:10.1038/ajh.2008.176.

摘要

背景

在手臂水平测量血压（BP）的电子设备被认为比腕部设备更准确，是家庭血压（HBP）监测的首选。最近，带有位置传感器的腕部设备已通过既定方案成功验证。本研究评估了使用经过验证的腕部设备测量的HBP值是否足够可靠，可用于临床实践中做出与患者相关的决策。

方法

这项随机交叉研究比较了79名高血压患者（36名男性和43名女性）使用经过验证的腕部设备（腕部HBP，欧姆龙R7带位置传感器）、手臂设备（手臂HBP，欧姆龙705IT）测量的HBP，以及清醒动态血压（ABP，太空实验室）测量值。研究人群的平均年龄为56.7±11.8岁，33名受试者未接受高血压治疗。

结果

平均手臂HBP高于平均腕部HBP（平均差异，收缩压5.2±9.1毫米汞柱，P<0.001，舒张压2.2±6.7，P<0.01）。27名受试者（34%）收缩期腕部HBP与手臂HBP的差异≥10毫米汞柱，12名受试者（15%）舒张期HBP读数显示出类似程度的差异。手臂HBP与腕部HBP之间存在强相关性（r 0.74/0.74，收缩压/舒张压，P<0.0001）。然而，ABP与手臂HBP的相关性（r 0.73/0.76）比与腕部HBP的相关性（0.55/0.69）更强。腕部-手臂HBP差异与收缩期ABP（r 0.34）和脉压（r 0.29）相关，但与舒张期ABP、性别、年龄、上臂围和腕围无关。

结论

使用带有位置传感器的经过验证的腕部设备与手臂设备测量的HBP可能存在重要差异，这可能会影响临床实践中与患者相关的决策。使用手臂设备测量的值比腕部设备记录的值与ABP值的关系更密切。在推荐在临床实践中广泛使用腕部监测仪之前，还需要更多的研究。《美国高血压杂志》doi:10.1038/ajh.2008.176《美国高血压杂志》（2008年）；21卷，第7期，753 - 758页。doi:10.1038/ajh.2008.176