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高血压自我报告的准确性:年龄、性别和酒精依赖史的影响。

Accuracy of self-reported hypertension: Effect of age, gender, and history of alcohol dependence.

机构信息

Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.

Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

J Clin Hypertens (Greenwich). 2020 May;22(5):842-849. doi: 10.1111/jch.13854. Epub 2020 Apr 10.

Abstract

Patient awareness of medical conditions may influence treatment seeking and monitoring of these conditions. Accurate awareness of hypertension reported to clinicians evaluating patients for whom clinical history is limited, such as in emergency care, can aid in diagnosis by revealing whether measured hypertension is typical or atypical. Measurement of blood pressure in a laboratory study was assessed at rest, immediately before phlebotomy, and within 10 minutes after. The resting measure was used to determine the accuracy of self-reported hypertension in 283 adults. Parametric analyses were conducted to identify potential variables influencing accuracy of self-reported hypertension. Sensitivity, specificity, and the kappa coefficient of agreement were calculated to determine the influence of alcohol dependence (AD), sex, age, and cigarette smoking on hypertension awareness. Self-report was mildly sensitive, correctly identifying individuals with hypertension in approximately 37% of the cases, but was highly specific (95%) in identifying individuals without hypertension. Similar sensitivities were found in analyses separated by sex. Sensitivity was greater in those over age 55 (53%) in comparison with those <54, as well as in those who were not smoking. Comparison of those with and without a history of AD revealed that both groups show similar accuracy in reporting hypertension. Absence of hypertension can be accurately determined with self-report data in those without hypertension. A significant proportion of those with measured hypertension report an absence of hypertension.

摘要

患者对自身疾病状况的了解可能会影响其对疾病的治疗和监测。在为临床病史有限的患者(如在急救护理中)进行评估时,医生如果能准确了解患者对高血压的认知,就能通过发现所测血压是典型还是非典型来辅助诊断。在一项实验室研究中,在休息时、采血前即刻和采血后 10 分钟测量血压。利用静息血压来确定 283 名成年人自我报告高血压的准确性。进行了参数分析,以确定可能影响自我报告高血压准确性的潜在变量。计算了敏感性、特异性和kappa 一致性系数,以确定酒精依赖症 (AD)、性别、年龄和吸烟对高血压认知的影响。自我报告的敏感性较低,仅能正确识别约 37%的高血压患者,但在识别非高血压患者方面具有高度特异性(95%)。按性别进行的分析中也发现了类似的敏感性。与<54 岁的人相比,55 岁以上的人(53%)敏感性更高,不吸烟的人敏感性也更高。将有和无 AD 病史的人进行比较后发现,两组在报告高血压方面的准确性相似。在无高血压病史的人群中,可通过自我报告数据准确确定其无高血压。在有测量血压的高血压患者中,有相当一部分人报告自己没有高血压。

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