Hypertension and Cardiovascular Disease Prevention Center, Athens Medical Group, Psychiko Clinic, Athens, Greece.
J Clin Hypertens (Greenwich). 2020 Apr;22(4):555-559. doi: 10.1111/jch.13837. Epub 2020 Feb 28.
This evidence-based article endorses the use of automated office blood pressure (AOBP). AOBP is the most favorable office blood pressure (BP) measuring technique as it provides accurate readings with 3-15 mm Hg lower values than the casual conventional office measurements with auscultatory or semi-automated oscillometric devices and relates closely to awake ABP readings. The AOBP technique seems to be superior to conventional office BP in predicting hypertension-mediated organ damage and appears to be equally reliable to awake ABP in the prediction of cardiovascular (CV) disease. AOBP readings should be obtained either unattended, with the patient alone in the examination room, or attended with the presence of personnel in the room but with no talking to the patient, although this recommendation is not frequently followed in routine clinical practice. To optimize office BP readings, the type of device, the rest period before AOBP measurements (preceding rest), and the time intervals between measurements were evaluated. As AOBP readings have the advantage of removing many confounding factors, the authors propose to perform measurements with a preceding rest in all patients at the initial visit; if AOBP readings remain <130 mm Hg in subsequent visits, measurements could be accepted, otherwise, if are higher, patients should be evaluated by out-of-office BP measurements.
这篇基于证据的文章支持使用自动化诊室血压（AOBP）。AOBP 是最有利的诊室血压（BP）测量技术，因为它提供的读数比听诊法或半自动示波法的常规诊室测量值准确，且低 3-15mmHg，与清醒时的 ABP 读数密切相关。AOBP 技术在预测高血压介导的器官损伤方面似乎优于常规诊室 BP，并且在预测心血管（CV）疾病方面与清醒时的 ABP 同样可靠。AOBP 读数可在无人值守的情况下，即患者独自在检查室内获得，也可在有人陪同的情况下获得，但患者与测量人员不能交谈，尽管这一建议在常规临床实践中并未经常得到遵循。为了优化诊室 BP 读数，评估了设备类型、AOBP 测量前的休息时间（前期休息）以及测量之间的时间间隔。由于 AOBP 读数具有消除许多混杂因素的优势，作者建议在所有患者的首次就诊时进行前期休息的测量；如果随后的就诊中 AOBP 读数仍<130mmHg，则可接受测量值；否则，如果读数更高，则应通过诊室外 BP 测量对患者进行评估。
