McKay D W, Campbell N R, Parab L S, Chockalingam A, Fodor J G
Division of Basic Medical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St John's, Canada.
J Hum Hypertens. 1990 Dec;4(6):639-45.
This study was performed to determine the blood pressure measuring techniques and accuracy of sphygmomanometers used by physicians in ambulatory care clinics on the Avalon Peninsula of Newfoundland. Of the 114 participating physicians, no physician completely followed all the recommended BP measuring techniques of the American Heart Association. Almost all physicians supported the patient's arm at heart level to measure BP. Fewer physicians used the following recommended techniques; palpation to initially assess systolic BP (38%), measurement of BP in both arms (23%), an appropriate rate of cuff deflation (18%), measurement of BP in recommended patient positions (10%), the appropriate length of rest (4%) or use of a cuff of appropriate size (3%). Approximately 8% of mercury sphygmomanometers were out of calibration by at least 4 mmHg but none were out by more than 6 mmHg. Forty percent of aneroid sphygmomanometers were out of calibration by at least 4 mmHg and of these 30% were out by 10 mmHg or more. Mercury and aneroid sphygmomanometers were used by 60% of physicians. Aneroid sphygmomanometers were used exclusively by 34% of physicians, while 5% of physicians relied solely on mercury devices. Standardized techniques for BP measurement are not used and inaccurate sphygmomanometers are common; these factors may lead to misclassification of blood pressure and inappropriate treatment of patients.
本研究旨在确定纽芬兰阿瓦隆半岛门诊护理诊所医生使用的血压测量技术及血压计的准确性。在114名参与研究的医生中，没有一位医生完全遵循美国心脏协会推荐的所有血压测量技术。几乎所有医生在测量血压时都会将患者手臂支撑至心脏水平。较少医生采用以下推荐技术：通过触诊初步评估收缩压（38%）、测量双臂血压（23%）、以适当速率放气袖带（18%）、在推荐的患者体位测量血压（10%）、保证适当的休息时长（4%）或使用尺寸合适的袖带（3%）。约8%的水银血压计校准误差至少达4 mmHg，但无一台误差超过6 mmHg。40%的无液血压计校准误差至少达4 mmHg，其中30%误差达10 mmHg或更高。60%的医生使用水银和无液血压计。34%的医生仅使用无液血压计，而5%的医生仅依赖水银设备。血压测量未采用标准化技术，不准确的血压计很常见；这些因素可能导致血压误分类及患者治疗不当。
