Metabolic Unit, University Department of Medical Sciences, Western General Hospital, Edinburgh, UK.
J Hum Hypertens. 2010 Dec;24(12):801-6. doi: 10.1038/jhh.2010.15. Epub 2010 Feb 18.
The European Society of Hypertension (ESH), the American Heart Association (AHA) and the American Society of Hypertension (ASH) have published guidelines for self-monitoring of blood pressure (SBPM). We aimed to demonstrate the equivalence of SBPM with ambulatory blood pressure monitoring (ABPM) in the assessment of hypertension. A total of 87 consecutive subjects referred from primary care for standard ABPM underwent a 1-week period of SBPM, as defined by the ESH guidelines, either before or after ABPM. There was no difference in mean blood pressure (BP): SBPM 142/87 mm Hg, daytime average ABPM 141/86 mm Hg. The intra-class correlation coefficient was 0.72 and 0.89 for systolic and diastolic pressure, respectively. SBPM is concordant with ABPM in classifying subjects as hypertensive or normotensive in 87% of cases (κ=0.56). The coefficient of variation of SBPM compared with ABPM was 5%. In answer to a direct question 81% of subjects preferred SBPM to ABPM. The current self-monitoring schedule recommended by the ESH, AHA and ASH is valid. The mean BP obtained from SBPM is equivalent to awake-time BP on ABPM, the accepted reference standard for 'out of office' BP measurement. SBPM is simpler to carry out, preferred by patients and should be considered on a par with ABPM.
欧洲高血压学会（ESH）、美国心脏协会（AHA）和美国高血压学会（ASH）已经发布了血压自我监测（SBPM）指南。我们旨在证明 SBPM 在评估高血压方面与动态血压监测（ABPM）具有等效性。共有 87 名连续就诊的患者因常规 ABPM 从初级保健机构转诊，他们在 ABPM 之前或之后按照 ESH 指南进行了为期 1 周的 SBPM。平均血压（BP）没有差异：SBPM 为 142/87mmHg，白天平均 ABPM 为 141/86mmHg。收缩压和舒张压的组内相关系数分别为 0.72 和 0.89。在 87%的情况下，SBPM 在将受试者分类为高血压或正常血压方面与 ABPM 一致（κ=0.56）。与 ABPM 相比，SBPM 的变异系数为 5%。在直接询问的情况下，81%的患者更喜欢 SBPM 而不是 ABPM。ESH、AHA 和 ASH 目前推荐的自我监测方案是有效的。从 SBPM 获得的平均 BP 与 ABPM 上的清醒时间 BP 等效，后者是“非就诊时”BP 测量的公认参考标准。SBPM 更易于实施，患者更喜欢，应与 ABPM 同等考虑。
