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优化临床血压测量中观察者的表现:柳叶刀高血压委员会的立场声明。

Optimizing observer performance of clinic blood pressure measurement: a position statement from the Lancet Commission on Hypertension Group.

机构信息

Department of Medicine, University of Alberta, Edmonton.

Department of Medicine, Physiology and Pharmacology and Community Health Sciences, O'Brien Institute for Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.

出版信息

J Hypertens. 2019 Sep;37(9):1737-1745. doi: 10.1097/HJH.0000000000002112.

Abstract

: High blood pressure (BP) is a highly prevalent modifiable cause of cardiovascular disease, stroke, and death. Accurate BP measurement is critical, given that a 5-mmHg measurement error may lead to incorrect hypertension status classification in 84 million individuals worldwide. This position statement summarizes procedures for optimizing observer performance in clinic BP measurement, with special attention given to low-to-middle-income settings, where resource limitations, heavy workloads, time constraints, and lack of electrical power make measurement more challenging. Many measurement errors can be minimized by appropriate patient preparation and standardized techniques. Validated semi-automated/automated upper arm cuff devices should be used instead of auscultation to simplify measurement and prevent observer error. Task sharing, creating a dedicated measurement workstation, and using semi-automated or solar-charged devices may help. Ensuring observer training, and periodic re-training, is critical. Low-cost, easily accessible certification programs should be considered to facilitate best BP measurement practice.

摘要

高血压(BP)是一种普遍存在的可改变的心血管疾病、中风和死亡的原因。由于 5mmHg 的测量误差可能导致全球 8400 万人的高血压状态分类错误,因此准确测量血压至关重要。本立场声明总结了优化临床血压测量中观察者表现的程序,特别关注资源有限、工作量大、时间限制和缺乏电力的中低收入环境,这些因素使测量更加具有挑战性。适当的患者准备和标准化技术可以最大限度地减少许多测量误差。应使用经过验证的半自动/自动上臂袖带设备代替听诊来简化测量并防止观察者错误。任务分担、创建专用测量工作站以及使用半自动或太阳能充电设备可能会有所帮助。确保观察者培训和定期再培训至关重要。应考虑提供低成本、易于获得的认证计划,以促进最佳血压测量实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de4c/6686964/ce022fbd35d2/jhype-37-1737-g001.jpg

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