Nasothimiou E G, Karpettas N, Dafni M G, Stergiou G S
Hypertension Center, Third University Department of Medicine, Sotiria Hospital, Athens, Greece.
J Hum Hypertens. 2014 Apr;28(4):224-9. doi: 10.1038/jhh.2013.104. Epub 2013 Oct 24.
Patient's preference might influence compliance with antihypertensive treatment and thereby long-term blood pressure (BP) control. This study compared patients' preference in using ambulatory (ABPM) versus home BP monitoring (HBPM). Subjects referred for hypertension were evaluated with 24-h ABPM and 7-day HBPM. Participants filled a questionnaire including demographics and Likert scale questions regarding their acceptance, preference, disturbance, activity restriction and feasibility of using ABPM and HBPM. A total of 119 patients were invited and 104 (87%) were included (mean age 51±11 years, 58% men, 38% time to work >8 h). A total of 82% reported a positive overall opinion for HBPM versus 63% for ABPM (P<0.05). 62% considered ABPM as more reliable than HBPM but 60% would choose HBPM for their next BP evaluation (P<0.05 for both comparisons). Moderate to severe discomfort from ABPM was reported by 55% and severe restriction of their daily activities by 30% compared with 13% and 7%, respectively, from HBPM (P<0.001 for both comparisons). The overall score for HBPM and ABPM (range 4-25; higher score indicating worse performance) was 6.6±2.5 and 10±4.0 (mean difference 4.4±4.6, P<0.001), respectively. In binary logistic regression models, neither previous experience with BP monitoring nor demographic characteristics appeared to influence patients' preference. These data suggest that HBPM is superior to ABPM in terms of overall acceptance and preference by hypertensive patients. Patients' preference deserves further research and should be taken into account in decision making in clinical practice.
患者的偏好可能会影响其对降压治疗的依从性，进而影响长期血压控制。本研究比较了患者对动态血压监测（ABPM）和家庭血压监测（HBPM）的偏好。对因高血压转诊的受试者进行了24小时ABPM和7天HBPM评估。参与者填写了一份问卷，内容包括人口统计学信息以及关于他们对使用ABPM和HBPM的接受程度、偏好、干扰、活动限制和可行性的李克特量表问题。共邀请了119名患者，其中104名（87%）被纳入研究（平均年龄51±11岁，男性占58%，工作时间>8小时的占38%）。共有82%的患者对HBPM总体评价为正面，而对ABPM的这一比例为63%（P<0.05）。62%的患者认为ABPM比HBPM更可靠，但60%的患者会选择HBPM进行下一次血压评估（两项比较P均<0.05）。报告称ABPM有中度至重度不适的患者占55%，日常活动受到严重限制的患者占30%，而HBPM的这两个比例分别为13%和7%（两项比较P均<0.001）。HBPM和ABPM的总体评分（范围4 - 25；分数越高表示表现越差）分别为6.6±2.5和10±4.0（平均差值4.4±4.6，P<0.001）。在二元逻辑回归模型中，既往血压监测经验和人口统计学特征似乎均未影响患者的偏好。这些数据表明，在高血压患者的总体接受度和偏好方面，HBPM优于ABPM。患者的偏好值得进一步研究，在临床实践决策中应予以考虑。
