Seidlerová Jitka, Ceral Jiří, Mateřánková Markéta, König Petr, Řiháček Ivan, Vysočanová Petra, Souček Miroslav, Filipovský Jan
a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic.
b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic.
Blood Press. 2019 Feb;28(1):34-39. doi: 10.1080/08037051.2018.1540260. Epub 2018 Nov 25.
Unattended automated office blood pressure (uAutoOBP) has attracted more attention since SPRINT trial had been published. However, its long-term relationship to attended office blood pressure (AuscOBP) is not known.
Stable treated hypertensive subjects were examined in four Czech academic hypertension centers. All subjects attended four clinical visits three months apart. uAutoOBP was measured with the BP Tru device; AuscOBP was measured three times with auscultatory method by the physician. 24-hour ambulatory blood pressure monitoring (ABPM) was performed within one week from the second clinical visit.
Data on 112 subjects aged 65.6 ± 10.8 years with mean AuscOBP 128.2 ± 12.2/78.5 ± 10.3 mm Hg are reported. Across the four clinical visits, the uAutoOBP was by 10.1/3.7 mm Hg lower than AuscOBP and the mean difference was similar during all four visits (P≥.061). Both uAutoOBP and AuscOBP had similar intra-individual variability during study follow-up as demonstrated by similar intraclass correlation coefficients (ICC, for systolic ICC = 0.50, for diastolic ICC = 0.72). However, the intra-individual variability of the systolic AuscOBP and uAutoOBP difference was high as demonstrated by low ICCs for absolute (ICC = 0.17 [95%CI, 0.09 - 0.25]) and low κ coefficients for categorized differences (κ ≤ 0.16). The main determinant of AuscOBP-uAutoOBP difference was AuscOBP level. The AuscOBP-uAutoOBP difference was poor tool to identify hypertension control categories defined on the basis of AuscOBP and ABPM.
Although mean AuscOBP-uAutoOBP differences were relatively similar across the four clinical visits, intra-individual variability of this difference was high. The AuscOBP-uAutoOBP difference was poor tool to identify hypertension control categories defined on the basis of AuscOBP and ABPM. Therefore, uAutoOBP cannot be used as a replacement for ABPM.
自SPRINT试验发表以来，无人值守自动诊室血压（uAutoOBP）受到了更多关注。然而，其与人工测量诊室血压（AuscOBP）的长期关系尚不清楚。
在捷克的四个学术性高血压中心对接受稳定治疗的高血压患者进行检查。所有受试者均参加了相隔三个月的四次临床就诊。使用BP Tru设备测量uAutoOBP；医生采用听诊法对AuscOBP进行三次测量。在第二次临床就诊后的一周内进行24小时动态血压监测（ABPM）。
报告了112名年龄为65.6±10.8岁、平均AuscOBP为128.2±12.2/78.5±10.3 mmHg的受试者的数据。在四次临床就诊中，uAutoOBP比AuscOBP低10.1/3.7 mmHg，且在所有四次就诊期间平均差异相似（P≥0.061）。在研究随访期间，uAutoOBP和AuscOBP具有相似的个体内变异性，这通过相似的组内相关系数得到证明（ICC，收缩压ICC = 0.50，舒张压ICC = 0.72）。然而，收缩压AuscOBP和uAutoOBP差值的个体内变异性较高，这通过绝对差值的低ICC（ICC = 0.17 [95%CI，0.09 - 0.25]）和分类差值的低κ系数（κ≤0.16）得到证明。AuscOBP - uAutoOBP差值的主要决定因素是AuscOBP水平。AuscOBP - uAutoOBP差值是根据AuscOBP和ABPM定义来识别高血压控制类别的较差工具。
尽管在四次临床就诊中AuscOBP - uAutoOBP的平均差异相对相似，但这种差异的个体内变异性较高。AuscOBP - uAutoOBP差值是根据AuscOBP和ABPM定义来识别高血压控制类别的较差工具。因此，uAutoOBP不能替代ABPM。
