Department of Vascular Medicine, Amsterdam UMC location Academic Medical Center, Amsterdam, The Netherlands.
Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
J Hum Hypertens. 2020 Feb;34(2):176-183. doi: 10.1038/s41371-019-0256-1. Epub 2019 Sep 23.
Self-measurement of blood pressure (BP) is regularly used to diagnose hypertension and to monitor BP at home. We recently showed that self-measurement of BP may elicit a pressor or 'auto-cuff' response. In this study we examined whether the pressor response is different between self-initiated and fully-automated BP measurement. We performed two randomized crossover studies in outpatients visiting a hypertension clinic. The first cohort of 52 participants performed six unattended self-initiated and six fully-automated BP measurements, while continuously monitoring BP and central haemodynamics using finger photoplethysmography. The second cohort consisted of 120 patients who performed three self-initiated and three fully-automated BP measurements. In the first cohort (mean age 61.2 ± 10.4 years, mean office BP 142.0 ± 19.9/82.5 ± 12.2 mmHg, 36.7% female) average systolic and diastolic BP increased by 7.3 ± 8.5/3.3 ± 4.0 mmHg in the group with self-initiated BP measurements, while BP increased by 3.3 ± 6.3/1.4 ± 3.0 mmHg during fully-automated measurements (p = 0.002/p = 0.002 for difference between groups). The higher BP increase during self-initiated BP measurements resulted from an increase in heart rate and cardiac output. In the second cohort (mean age 58.0 ± 14.1 years, mean office BP 153.6 ± 23.8/86.3 ± 14.0 mmHg, 44.1% female) self-initiated BP measurement resulted in a 2.1 ± 6.8/0.9 ± 4.0 mmHg higher systolic and diastolic BP compared with fully-automated self-measurement (p = 0.001/0.018). In conclusion, our findings suggest that self-initiated BP measurement using a fully-automated method results in a more reliable BP compared with a self-initiated semi-automated method by attenuating the auto-cuff response. These findings may have implications for the self-measurement of BP.
自我测量血压（BP）常用于诊断高血压和在家中监测血压。我们最近发现，自我测量血压可能会引起升压或“自动袖带”反应。在这项研究中，我们研究了自我启动和全自动血压测量之间的升压反应是否不同。我们在高血压诊所就诊的门诊患者中进行了两项随机交叉研究。第一组 52 名参与者进行了 6 次无人值守的自我启动和 6 次全自动血压测量，同时使用手指光体积描记法连续监测血压和中心血液动力学。第二组由 120 名患者组成，他们进行了 3 次自我启动和 3 次全自动血压测量。在第一组（平均年龄 61.2±10.4 岁，平均诊室血压 142.0±19.9/82.5±12.2mmHg，36.7%为女性）中，与全自动血压测量组相比，自我启动血压测量组的收缩压和舒张压平均升高 7.3±8.5/3.3±4.0mmHg，而全自动测量组的血压升高 3.3±6.3/1.4±3.0mmHg（组间差异 p=0.002/p=0.002）。自我启动 BP 测量时 BP 升高幅度较大是由于心率和心输出量增加所致。在第二组（平均年龄 58.0±14.1 岁，平均诊室血压 153.6±23.8/86.3±14.0mmHg，44.1%为女性）中，与全自动自我测量相比，自我启动 BP 测量导致收缩压和舒张压升高 2.1±6.8/0.9±4.0mmHg（p=0.001/0.018）。总之，我们的研究结果表明，与半自动自我启动方法相比，使用全自动方法进行自我启动 BP 测量可通过减弱自动袖带反应，产生更可靠的 BP。这些发现可能对 BP 的自我测量有影响。
