University of New Mexico College of Pharmacy, MSC 09 5360, Albuquerque, NM 87131, USA.
J Gen Intern Med. 2012 Jun;27(6):623-9. doi: 10.1007/s11606-011-1937-9. Epub 2011 Dec 8.
In 2005 the American Heart Association (AHA) released updated recommendations for blood pressure (BP) monitoring in order to ensure accurate BP measurements.
To determine if current methods of BP assessment in an ambulatory clinic result in significantly different BP measurements than those obtained by following the AHA recommendations and if these BP differences impact treatment decisions.
Randomized prospective analysis.
University of New Mexico Hospital Adult Internal Medicine clinic.
Forty adults with hypertension
Patient BPs were measured using both the traditional triage method and the AHA-recommended method in cross-over fashion in random order. Two complete medical profile summaries were then constructed for each patient: one for each BP measurement obtained by each technique. These profiles were then reviewed by a panel of providers who provided hypothetical hypertension treatment recommendations.
Individual BP results varied greatly between the two methods. SBP readings differed by ≥5 mmHg in either direction for 68% of patients while 78% of patient's DBP readings differed by ≥2 mmHg in either direction. Overall, 93% of patients had a BP difference of either ≥5 mmHg systolic or ≥2 mmHg diastolic. Five patients were determined to be at goal with the triage method, but were higher than their goal BP with the AHA method Significant differences were also seen in treatment recommendations for a given patient based on the differences seen between the two obtained BP readings. The number of patients with treatment variations between their two profiles ranged from 13% to 23% depending on the reviewing provider (p < 0.01 for all providers).
Inaccurate BP assessment is common and may impact hypertension treatment decisions.
2005 年，美国心脏协会（AHA）发布了更新的血压（BP）监测建议，以确保准确的 BP 测量。
确定在门诊诊所进行的当前 BP 评估方法是否会导致与遵循 AHA 建议获得的 BP 测量值有显著差异，以及这些 BP 差异是否会影响治疗决策。
随机前瞻性分析。
新墨西哥大学医院成人内科诊所。
40 名高血压成年患者。
患者的 BP 使用传统分诊方法和 AHA 推荐方法以交叉方式随机顺序测量。然后为每位患者构建两个完整的医疗概况摘要：一个用于每种技术获得的每个 BP 测量值。然后由一组提供者审查这些概况，他们提供了假设的高血压治疗建议。
两种方法之间个体 BP 结果差异很大。68%的患者 SBP 读数在两个方向上的差异均≥5mmHg，而 78%的患者 DBP 读数在两个方向上的差异均≥2mmHg。总体而言，93%的患者 BP 差异在收缩压≥5mmHg 或舒张压≥2mmHg 之间。有 5 名患者使用分诊方法达到目标，但使用 AHA 方法时高于其目标 BP。基于两个获得的 BP 读数之间的差异，还观察到了针对特定患者的治疗建议存在显著差异。两名审阅医生中，有 13%至 23%的患者在两种情况下存在治疗差异（所有医生均为 p<0.01）。
BP 评估不准确很常见，可能会影响高血压治疗决策。
