Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Los Angeles Medical Center, Kaiser Permanente Southern California, Los Angeles, CA, USA.
J Clin Hypertens (Greenwich). 2018 Jan;20(1):174-182. doi: 10.1111/jch.13159. Epub 2018 Jan 12.
Pediatric practice guidelines call for repeating an elevated office blood pressure (BP) at the same visit, but there are few data available to support this recommendation. We compared the visit results in children aged 3 to 17 years with a BP reading ≥95th percentile (n = 186 732) based on the initial BP and the mean of two BP readings, using electronic medical records from 2012-2015. Failure to repeat an initial BP reading ≥95th percentile would lead to a false "hypertensive" visit result in 54.1% of children who would require follow-up visits. After an initial visit result indicating hypertension, hypertension stage I or stage II was sustained in 2.3% and 11.3% of youth during their next visits, respectively. In conclusion, only approximately half of the pediatric patients would be correctly classified based on their initial BP. The recommendation to repeat high BP during the same visit needs to be emphasized because it saves unnecessary follow-up visits.
儿科实践指南呼吁在同一就诊时重复测量升高的门诊血压（BP），但支持这一建议的数据有限。我们比较了 2012-2015 年电子病历中根据初始 BP 和两次 BP 读数平均值，对年龄在 3 至 17 岁、BP 读数≥第 95 百分位的 186732 例儿童的就诊结果。如果不重复测量初始 BP 读数≥第 95 百分位，将导致 54.1%需要随访的儿童出现错误的“高血压”就诊结果。在初始就诊结果显示高血压后，分别有 2.3%和 11.3%的青少年在随后的就诊中持续处于高血压 1 期或 2 期。总之，仅约一半的儿科患者可根据其初始 BP 正确分类。需要强调的是，在同一就诊时重复测量高血压的建议，因为这可以避免不必要的随访就诊。
