Manto Audrey, Dzudie Anastase, Halle Marie Patrice, Aminde Léopold Ndemnge, Abanda Martin Hongieh, Ashuntantang Gloria, Blackett Kathleen Ngu
Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon.
Department of Medicine, Douala General Hospital, Douala, Cameroon.
Pan Afr Med J. 2018 Jan 24;29:71. doi: 10.11604/pamj.2018.29.71.12078. eCollection 2018.
home blood pressure measurement (HBPM) is not entirely capable of replacing ambulatory blood pressure (BP) measurement (ABPM), but is superior to office blood pressure measurement (OBPM). Although availability, cost, energy and lack of training are potential limitations for a wide use of HBPM in Sub-Saharan Africa (SSA), the method may add value for assessing efficacy and compliance in specific populations. We assessed the agreement between HBPM and ABPM in chronic kidney disease (CKD) patients in Douala, Cameroon.
from March to August 2014, we conducted a cross sectional study in non-dialyzed CKD patients with hypertension. Using the same devices and methods, the mean of nine office and eighteen home (during three consecutive days) blood pressure readings were recorded. Each patient similarly had a 24-hour ABPM. Kappa statistic was used to assess qualitative agreement between measurement techniques.
forty-six patients (mean age: 56.2 ± 11.4 years, 28 men) were included. The prevalence of optimal blood pressure control was 26, 28 and 32% for OBPM, HBPM and ABPM respectively. Compared with ABPM, HBPM was more effective than OBPM, for the detection of non-optimal BP control (Kappa statistic: 0.49 (95% CI: 0.36 - 0.62) vs. 0.22 (95%CI: 0.21 - 0.35); sensitivity: 60 vs 40%; specificity: 87 vs. 81%).
HBPM potentially averts some proportion of BP misclassification in non-dialyzed hypertensive CKD patients in Cameroon.
家庭血压测量（HBPM）并不能完全替代动态血压监测（ABPM），但优于诊室血压测量（OBPM）。尽管可用性、成本、精力和缺乏培训是撒哈拉以南非洲（SSA）广泛使用HBPM的潜在限制因素，但该方法可能对评估特定人群的疗效和依从性具有价值。我们评估了喀麦隆杜阿拉慢性肾脏病（CKD）患者中HBPM与ABPM之间的一致性。
2014年3月至8月，我们对未透析的高血压CKD患者进行了一项横断面研究。使用相同的设备和方法，记录九次诊室血压读数和连续三天的十八次家庭血压读数的平均值。每位患者同样进行了24小时ABPM。使用Kappa统计量评估测量技术之间的定性一致性。
纳入了46例患者（平均年龄：56.2±11.4岁，28名男性）。诊室血压测量（OBPM）、家庭血压测量（HBPM）和动态血压监测（ABPM）的最佳血压控制患病率分别为26%、28%和32%。与ABPM相比，HBPM在检测血压控制不佳方面比OBPM更有效（Kappa统计量：0.49（95%CI：0.36 - 0.62）对0.22（95%CI：0.21 - 0.35）；敏感性：60%对40%；特异性：87%对81%）。
HBPM可能避免了喀麦隆未透析的高血压CKD患者中一定比例的血压误分类。
