Stergiou George S, Kollias Anastasios, Zeniodi Marilena, Karpettas Nikos, Ntineri Angeliki
Hypertension Center, STRIDE Hellas-7, Third University Department of Medicine, Sotiria Hospital, 152 Mesogion Avenue, Athens, 11527, Greece,
Curr Hypertens Rep. 2014 Aug;16(8):462. doi: 10.1007/s11906-014-0462-8.
In the last two decades, considerable evidence on home blood pressure monitoring has accumulated and current guidelines recommend its wide application in clinical practice. First, several outcome studies have shown that the ability of home blood pressure measurements in predicting preclinical target organ damage and cardiovascular events is superior to that of the conventional office blood pressure measurements and similar to that of 24-hour ambulatory monitoring. Second, cross-sectional studies showed considerable agreement of home blood pressure measurements with ambulatory monitoring in detecting the white-coat and masked hypertension phenomena, in both untreated and treated subjects. Third, studies have shown larger blood pressure decline by using home blood pressure monitoring instead of office measurements for treatment adjustment. Fourth, in treated hypertensives, home blood pressure monitoring has been shown to improve long-term adherence to antihypertensive drug treatment and thus, has improved hypertension control rates. These data suggest that home blood pressure should no longer be regarded as only a screening tool that requires confirmation by ambulatory monitoring. Provided that an unbiased assessment is obtained according to current recommendations, home blood pressure monitoring should have primary role in diagnosis, treatment adjustment, and long-term follow-up of most cases with hypertension.
在过去二十年中，关于家庭血压监测的大量证据不断积累，当前指南推荐其在临床实践中广泛应用。首先，多项结局研究表明，家庭血压测量在预测临床前靶器官损害和心血管事件方面的能力优于传统诊室血压测量，与24小时动态血压监测相当。其次，横断面研究显示，在未治疗和已治疗的受试者中，家庭血压测量与动态血压监测在检测白大衣高血压和隐匿性高血压现象方面具有相当高的一致性。第三，研究表明，使用家庭血压监测而非诊室测量来调整治疗可使血压下降幅度更大。第四，在已治疗的高血压患者中，家庭血压监测已被证明可提高长期抗高血压药物治疗的依从性，从而提高高血压控制率。这些数据表明，家庭血压不应再仅被视为一种需要通过动态血压监测来确认的筛查工具。只要根据当前建议获得无偏倚的评估，家庭血压监测在大多数高血压病例的诊断、治疗调整和长期随访中应发挥主要作用。
