Department of Medicine, Division of Cardiology, University of Toronto, Schulich Heart Centre, Toronto, Ontario, Canada.
J Hypertens. 2010 Apr;28(4):703-8. doi: 10.1097/HJH.0b013e328335d091.
To validate an algorithm for the interpretation of automated office blood pressure (AOBP) measurement based upon data from untreated patients referred by physicians in the community for 24-h ambulatory blood pressure monitoring (ABPM).
An algorithm for interpreting AOBP readings was developed taking into account the previously documented equivalence of AOBP and mean awake ambulatory BP (ABP; mmHg), which were each classified as optimum BP (<130/80), borderline BP (130-139/80-89) and hypertension (>or=140/90). This classification was applied to data derived from 254 untreated patients undergoing 24-h ABPM, AOBP and routine manual BP taken at the patient's own family physician's office.
The mean awake ABP (135.3 +/- 12.4/81.0 +/- 10.2) was similar to the mean AOBP (132.6 +/- 17.4/80.0 +/- 11.1) with both values being significantly (P < 0.001) lower than the routine manual BP (149.7 +/- 15.2/89.3 +/- 9.5). Of the 69 patients with a systolic AOBP at least 140, only five (7.3%) exhibited white-coat hypertension with a normal mean awake ambulatory systolic BP less than 130. Similarly, of the 47 patients with a diastolic AOBP at least 90, none had optimum BP (diastolic BP < 80 mmHg on ABPM). White-coat hypertension was significantly (P = 0.005/P = 0.006) more prevalent for systolic/diastolic BP (22.1%/13.4%) when routine, manual BP readings were analysed.
In contrast to routine manual office BP, a diagnosis of hypertension by AOBP is unlikely to be associated with an optimum awake ABP.
验证一种基于未经治疗的患者的社区医生转诊进行 24 小时动态血压监测（ABPM）的自动诊室血压（AOBP）测量数据的解释算法。
开发了一种解释 AOBP 读数的算法，考虑到先前记录的 AOBP 与清醒时的平均 ABPM（mmHg）等效，将其各自分类为最佳血压（<130/80）、边缘血压（130-139/80-89）和高血压（>或=140/90）。该分类应用于 254 名未经治疗的患者的数据，这些患者接受了 24 小时 ABPM、AOBP 和在患者自己的家庭医生办公室进行的常规手动血压测量。
清醒时的平均 ABPM（135.3 +/- 12.4/81.0 +/- 10.2）与平均 AOBP（132.6 +/- 17.4/80.0 +/- 11.1）相似，两者的值均显著低于常规手动血压（149.7 +/- 15.2/89.3 +/- 9.5）（P < 0.001）。在收缩压 AOBP 至少为 140mmHg 的 69 名患者中，仅有 5 名（7.3%）出现白大衣高血压，其平均清醒时 ABPM 收缩压正常，低于 130mmHg。同样，在舒张压 AOBP 至少为 90mmHg 的 47 名患者中，没有患者的血压为最佳（ABPM 时舒张压<80mmHg）。当分析常规手动血压读数时，收缩压/舒张压的白大衣高血压发生率显著更高（P = 0.005/P = 0.006）。
与常规手动诊室血压相比，AOBP 诊断的高血压不太可能与最佳清醒时 ABP 相关。
