Hypertension and Cardiovascular Disease Prevention Center, Evangelismos General Hospital, Athens, Greece
Fourth Department of Internal Medicine, Evangelismos General Hospital, Athens, Greece.
J Am Heart Assoc. 2018 Apr 7;7(8):e008994. doi: 10.1161/JAHA.118.008994.
Automated office blood pressure (AOBP) measurement is superior to conventional office blood pressure (OBP) because it eliminates the "white coat effect" and shows a strong association with ambulatory blood pressure.
We conducted a cross-sectional study in 146 participants with office hypertension, and we compared AOBP readings, taken with or without the presence of study personnel, before and after the conventional office readings to determine whether their variation in blood pressure showed a difference in blood pressure values. We also compared AOBP measurements with daytime ambulatory blood pressure monitoring and conventional office readings. The mean age of the studied population was 56±12 years, and 53.4% of participants were male. Bland-Altman analysis revealed a bias (ie, mean of the differences) of 0.6±6 mm Hg systolic for attended AOBP compared with unattended and 1.4±6 and 0.1±6 mm Hg bias for attended compared with unattended systolic AOBP when measurements were performed before and after conventional readings, respectively. A small bias was observed when unattended and attended systolic AOBP measurements were compared with daytime ambulatory blood pressure monitoring (1.3±13 and 0.6±13 mm Hg, respectively). Biases were higher for conventional OBP readings compared with unattended AOBP (-5.6±15 mm Hg for unattended AOBP and oscillometric OBP measured by a physician, -6.8±14 mm Hg for unattended AOBP and oscillometric OBP measured by a nurse, and -2.1±12 mm Hg for unattended AOBP and auscultatory OBP measured by a second physician).
Our findings showed that independent of the presence or absence of medical staff, AOBP readings revealed similar values that were closer to daytime ambulatory blood pressure monitoring than conventional office readings, further supporting the use of AOBP in the clinical setting.
自动诊室血压（AOBP）测量优于传统诊室血压（OBP），因为它消除了“白大衣效应”，并与动态血压有很强的关联。
我们对 146 名诊室高血压患者进行了一项横断面研究，比较了在有或没有研究人员在场的情况下，在常规诊室血压测量前后进行的 AOBP 读数，以确定其血压变化是否显示出血压值的差异。我们还将 AOBP 测量值与日间动态血压监测和传统诊室读数进行了比较。研究人群的平均年龄为 56±12 岁，53.4%的参与者为男性。Bland-Altman 分析显示，在常规读数之前和之后，与未测血压相比， attended AOBP 的收缩压偏差（即差值的平均值）分别为 0.6±6mmHg 和 1.4±6mmHg 和 0.1±6mmHg。当与日间动态血压监测相比时，未测血压和 attended AOBP 的收缩压测量值也观察到较小的偏差（分别为 1.3±13mmHg 和 0.6±13mmHg）。与未测 AOBP 相比，常规 OBP 读数的偏差更高（未测 AOBP 和医生测量的示波法 OBP 为-5.6±15mmHg，未测 AOBP 和护士测量的示波法 OBP 为-6.8±14mmHg，未测 AOBP 和第二位医生测量的听诊法 OBP 为-2.1±12mmHg）。
我们的研究结果表明，无论是否有医务人员在场，AOBP 读数都显示出相似的数值，与日间动态血压监测相比，更接近常规诊室读数，进一步支持在临床环境中使用 AOBP。
