Fonseca-Reyes Salvador, Romero-Velarde Enrique, Torres-Gudiño Edith, Illescas-Zarate Daniel, Forsyth-MacQuarrie Avril M
Instituto de Investigación Cardiovascular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Nuevo Hospital Civil de Guadalajara, Mexico.
Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Nuevo Hospital Civil de Guadalajara, Mexico.
Arch Cardiol Mex. 2018 Jan-Mar;88(1):16-24. doi: 10.1016/j.acmx.2017.01.005. Epub 2017 Feb 24.
The level of agreement between two blood pressure (BP) reading methods, auscultatory vs oscillometric, was examined using a mercury sphygmomanometer and an electronic device in children and adolescents with different levels of obesity. The readings were compared to determine their impact on the diagnosis of pre-hypertension/hypertension.
Blood pressure readings were taken in children with obesity (body mass index ≥ 95th percentile) and severe obesity (≥120% 95th percentile). Bland-Altman analysis and Intraclass Correlation Coefficient were used to determine the agreement between measurements.
The mercury sphygmomanometer readings were lower than those obtained with the electronic device for both systolic and diastolic BP (P=.01 and P=.001, respectively). The mean systolic and diastolic BP differences between the oscillometric vs first mercury reading were 4.2/10.2mmHg, respectively. A large difference was observed between the BP measurement methods. The ICC showed regular to moderate reliability for the systolic BP (.595), but poor for the diastolic BP (.330). Screening using the first of three mercury measurements showed that 10.4% of the children and adolescents had BPs within the pre-hypertension/hypertension range. This was reduced to 5.2% when the mean of three mercury readings was used.
Large discrepancies were observed in both the systolic and diastolic BP. These differences are not clinically acceptable as to consider the two instruments interchangeable. The electronic device readings were higher, and they overestimated the diagnosis of hypertension.
使用汞柱式血压计和电子设备，对不同肥胖程度的儿童和青少年，检查两种血压测量方法（听诊法与示波法）之间的一致性水平。比较测量结果以确定其对高血压前期/高血压诊断的影响。
对肥胖（体重指数≥第95百分位数）和重度肥胖（≥第95百分位数的120%）儿童进行血压测量。采用Bland-Altman分析和组内相关系数来确定测量结果之间的一致性。
汞柱式血压计测量的收缩压和舒张压读数均低于电子设备测量的读数（分别为P = 0.01和P = 0.001）。示波法与首次汞柱式测量之间的平均收缩压和舒张压差异分别为4.2/10.2mmHg。两种血压测量方法之间存在较大差异。组内相关系数显示收缩压的可靠性为中等（0.595），但舒张压的可靠性较差（0.330）。使用三次汞柱式测量中的第一次测量进行筛查显示，10.4%的儿童和青少年血压处于高血压前期/高血压范围内。当使用三次汞柱式测量的平均值时，这一比例降至5.2%。
收缩压和舒张压均存在较大差异。这些差异在临床上不能接受，不能认为这两种仪器可互换使用。电子设备测量的读数较高，且高估了高血压的诊断。
