Hypertension and Cardiovascular Disease Prevention Center, Evangelismos General Hospital, Athens, Greece.
J Clin Hypertens (Greenwich). 2020 Jan;22(1):32-38. doi: 10.1111/jch.13748. Epub 2019 Dec 1.
Automated office blood pressure (AOBP) measurement, attended or unattended, eliminates the white coat effect (WCE) showing a strong association with awake ambulatory blood pressure (ABP). This study examined the difference in AOBP readings, with and without 5 minutes of rest prior to three readings recorded at 1-min intervals. Cross-sectional data from 100 randomized selected hypertensives, 61 men and 39 women, with a mean age of 52.2 ± 10.8 years, 82% treated, were analyzed. The mean systolic AOBP values without preceding rest were 127.0 ± 18.2 mm Hg, and the mean systolic AOBP values with 5 minutes of preceding rest were 125.7 ± 17.9 mm Hg (P = .05). A significant order effect was observed for the mean systolic BP values when AOBP without 5 minutes of preceding rest was performed as the first measurement (130.0 ± 17.7 vs 126.5 ± 16.2, P = .008). When we used a target systolic AOBP ≥ 130 mm Hg, awake ABP yielded lower readings, while at a target systolic AOBP value of < 130 mm Hg higher awake ABP values were obtained. Our findings indicate that systolic AOBP can be initially checked without any preceding rest and if readings are normal can be accepted. Otherwise, when AOBP is ≥ 130 mm Hg, measurements should be rechecked with 5 minutes of rest.
自动诊室血压(AOBP)测量,无论是否有人在场,都可以消除白大衣效应(WCE),因为它与清醒动态血压(ABP)有很强的关联。本研究检查了在不休息和休息 5 分钟的情况下,三次 1 分钟间隔记录的 AOBP 读数之间的差异。分析了 100 名随机选择的高血压患者的横断面数据,其中男性 61 名,女性 39 名,平均年龄为 52.2±10.8 岁,82%接受治疗。不休息 5 分钟前的平均收缩压 AOBP 值为 127.0±18.2mmHg,休息 5 分钟前的平均收缩压 AOBP 值为 125.7±17.9mmHg(P=0.05)。当不休息 5 分钟时进行 AOBP 作为第一次测量时,观察到平均收缩压值的显著顺序效应(130.0±17.7 vs 126.5±16.2,P=0.008)。当我们使用目标收缩压 AOBP≥130mmHg 时,清醒时的 ABP 读数较低,而当目标收缩压 AOBP 值<130mmHg 时,清醒时的 ABP 读数较高。我们的研究结果表明,收缩压 AOBP 可以在不进行任何预先休息的情况下进行初步检查,如果读数正常可以接受。否则,当 AOBP≥130mmHg 时,应休息 5 分钟重新检查测量。