Ostchega Yechiam, Zhang Guangyu, Sorlie Paul, Hughes Jeffery P, Reed-Gillette Debra S, Nwankwo Tatiana, Yoon Sarah
Natl Health Stat Report. 2012 Oct 5(59):1-15.
The mercury sphygmomanometer has been the gold standard used for obtaining blood pressure (BP) for the National Health and Nutrition Examination Survey (NHANES) from 1960 to the present. However, due to environmental concerns and an increased use of automated oscillometric BP devices, NHANES has been exploring an alternative to using the standard mercury sphygmomanometer (mercury) to measure BP.
The accuracy of Omron HEM-907XL BP readings was compared with that of mercury BP device readings for gender, age group, race and ethnicity, and body mass index categories and cuff-size subgroups. Each person had three BP measurements per device recorded sequentially. The order of the devices and readers were randomly assigned. A total of 6,460 participants had three valid systolic readings, and 6,338 had three valid diastolic readings.
Omron and mercury measurements were correlated (r = 0.92, systolic BP; r = 0.79, diastolic BP). Overall, the mean between-device differences (Omron and mercury) were -1.6 mm Hg for systolic and -0.6 mm Hg for diastolic (p < 0.05 for both). The mean between-device differences were less than or about 2 mm Hg for each subgroup: gender, age group, race and ethnicity, and body mass index categories, and cuff-size subgroups. The exceptions were mean systolic between-device differences for those using the extra-large BP cuff (-3.1 mm Hg) and obese individuals (-2.6 mm Hg), and the mean diastolic between-device differences for the underweight group (-3.5 mm Hg). Assuming mercury to be the gold standard, between-device agreements for the frequency of high BP (140/90 mm Hg or more) and stage II high BP (160/100 mm Hg or more) were above chance (kappa = 0.72 for both). Omron underestimated the high BP frequency by 2.28% and stage II high BP frequency by 0.77%.
Lower estimates of high BP by the Omron device may require adjusting future national prevalence estimates accordingly to account for between-device differences.
自1960年至今，汞柱式血压计一直是美国国家健康与营养检查调查（NHANES）中用于测量血压（BP）的金标准。然而，出于环境方面的考虑以及自动示波血压测量设备使用的增加，NHANES一直在探索替代标准汞柱式血压计（汞）来测量血压的方法。
将欧姆龙HEM - 907XL血压读数的准确性与汞柱式血压计读数在性别、年龄组、种族和族裔、体重指数类别以及袖带尺寸亚组方面进行比较。每个人每种设备依次记录三次血压测量值。设备和测量者的顺序随机分配。共有6460名参与者有三次有效的收缩压读数，6338名有三次有效的舒张压读数。
欧姆龙和汞柱式测量结果具有相关性（收缩压r = 0.92；舒张压r = 0.79）。总体而言，两种设备之间的平均差异（欧姆龙和汞柱式）收缩压为 - 1.6毫米汞柱，舒张压为 - 0.6毫米汞柱（两者p < 0.05）。每个亚组（性别、年龄组、种族和族裔、体重指数类别以及袖带尺寸亚组）的两种设备之间的平均差异小于或约为2毫米汞柱。例外情况是使用超大号血压袖带者（ - 3.1毫米汞柱）和肥胖个体（ - 2.6毫米汞柱）的收缩压两种设备之间的平均差异，以及体重过轻者（ - 3.5毫米汞柱）的舒张压两种设备之间的平均差异。假设汞柱式血压计为金标准，两种设备在高血压（140/90毫米汞柱或更高）和二级高血压（160/100毫米汞柱或更高）频率方面的一致性高于随机水平（两者kappa = 0.72）。欧姆龙低估高血压频率2.28%，低估二级高血压频率0.77%。
欧姆龙设备对高血压的较低估计可能需要相应调整未来的全国患病率估计值，以考虑两种设备之间的差异。
