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儿童慢性高血压的家庭血压监测

Home blood pressure monitoring in paediatric chronic hypertension.

作者信息

Furusawa E A, Filho U D, Koch V H

机构信息

Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

出版信息

J Hum Hypertens. 2009 Jul;23(7):464-9. doi: 10.1038/jhh.2008.167. Epub 2009 Mar 12.

Abstract

Blood pressure (BP) measurement is the basis for the diagnosis and management of arterial hypertension. The aim of this study was to compare BP measurements performed in the office and at home (home blood pressure monitoring, HBPM) in children and adolescents with chronic arterial hypertension. HBPM was performed by the patient or by his/her legal guardian. During a 14-day period, three BP measurements were performed in the morning or in the afternoon (daytime measurement) and in the evening (night-time measurement), with 1-min intervals between measurements, totalling six measurements per day. HBPM was defined for systolic blood pressure (SBP) and diastolic blood pressure (DBP) values. HBPM was evaluated in 40 patients (26 boys), mean age of 12.1 years (4-18 years). SBP and DBP records were analysed. The mean differences between average HBP and doctor's office BP were 0.6+/-14 and 4+/-13 mm Hg for SBP and DBP, respectively. Average systolic HBPM (daytime and night-time) did not differ from average office BP, and diastolic HBPM (daytime and night-time) was statistically lower than office BP. The comparison of individual BP measurements along the study period (13 days) by s.d. of differences shows a significant decline only for DBP values from day 5, on which difference tends to disappear towards the end of the study. Mean daytime and night-time SBP and DBP values remained stable throughout the study period, confirming HBPM as an acceptable methodology for BP evaluation in hypertensive children and adolescents.

摘要

血压测量是动脉高血压诊断和管理的基础。本研究的目的是比较慢性动脉高血压儿童和青少年在诊室和家中进行的血压测量(家庭血压监测,HBPM)。HBPM由患者或其法定监护人进行。在14天的时间里,于上午或下午(日间测量)以及晚上(夜间测量)进行三次血压测量,每次测量间隔1分钟,每天共测量六次。HBPM根据收缩压(SBP)和舒张压(DBP)值进行定义。对40例患者(26名男孩)进行了HBPM评估,平均年龄为12.1岁(4 - 18岁)。分析了SBP和DBP记录。平均家庭血压与诊室血压之间,SBP和DBP的平均差值分别为0.6±14和4±13 mmHg。平均收缩压HBPM(日间和夜间)与平均诊室血压无差异,而舒张压HBPM(日间和夜间)在统计学上低于诊室血压。通过差异标准差对研究期间(13天)的个体血压测量进行比较,结果显示仅从第5天起DBP值出现显著下降,且这种差异在研究结束时趋于消失。在整个研究期间,平均日间和夜间SBP和DBP值保持稳定,证实HBPM是评估高血压儿童和青少年血压的一种可接受的方法。

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