Institute of Applied Health Research, University of Birmingham, Edgbaston.
Nuffield professor of primary care health sciences.
Br J Gen Pract. 2020 Jul 30;70(697):e548-e554. doi: 10.3399/bjgp20X710381. Print 2020 Aug.
Home blood-pressure (BP) monitoring is recommended in guidelines and is increasingly popular with patients and health professionals, but the accuracy of patients' own monitors in real-world use is not known.
To assess the accuracy of home BP monitors used by people with hypertension, and to investigate factors affecting accuracy.
Cross-sectional, observational study in urban and suburban settings in central England.
Patients ( = 6891) on the hypertension register at seven practices in the West Midlands, England, were surveyed to ascertain whether they owned a BP monitor and wanted it tested. Monitor accuracy was compared with a calibrated reference device at 50 mmHg intervals between 0-280/300 mmHg (static pressure test); a difference from the reference monitor of +/-3 mmHg at any interval was considered a failure. Cuff performance was also assessed. Results were analysed by frequency of use, length of time in service, make and model, monitor validation status, purchase price, and any previous testing.
In total, 251 (76%, 95% confidence interval [95% CI] = 71 to 80%) of 331 tested devices passed all tests (monitors and cuffs), and 86% (CI] = 82 to 90%) passed the static pressure test; deficiencies were, primarily, because of monitors overestimating BP. A total of 40% of testable monitors were not validated. The pass rate on the static pressure test was greater in validated monitors (96%, 95% CI = 94 to 98%) versus unvalidated monitors (64%, 95% CI = 58 to 69%), those retailing for >£10 (90%, 95% CI = 86 to 94%), those retailing for ≤£10 (66%, 95% CI = 51 to 80%), those in use for ≤4 years (95%, 95% CI = 91 to 98%), and those in use for >4 years (74%, 95% CI = 67 to 82%). All in all, 12% of cuffs failed.
Patients' own BP monitor failure rate was similar to that demonstrated in studies performed in professional settings, although cuff failure was more frequent. Clinicians can be confident of the accuracy of patients' own BP monitors if the devices are validated and ≤4 years old.
家庭血压（BP）监测在指南中被推荐，并且越来越受到患者和卫生专业人员的欢迎，但是患者自己的监测器在实际使用中的准确性尚不清楚。
评估高血压患者使用的家庭 BP 监测器的准确性，并调查影响准确性的因素。
在英格兰中部的城市和郊区环境中进行的横断面、观察性研究。
在英格兰西米德兰兹郡的七个实践中，对高血压登记册中的患者（n=6891）进行了调查，以确定他们是否拥有血压监测器并希望对其进行测试。将监测器的准确性与校准的参考设备进行比较，在 0-280/300mmHg 之间以 50mmHg 的间隔进行静态压力测试（静态压力测试）；在任何间隔处与参考监测器的差异为+/-3mmHg 被认为是失败。还评估了袖口的性能。通过使用频率，使用时间，制造和型号，监测器验证状态，购买价格以及以前的任何测试来分析结果。
在总共 331 个接受测试的设备中，有 251 个（76%，95%置信区间[95%CI]=71-80%）通过了所有测试（监测器和袖口），有 86%（95%CI=82-90%）通过了静态压力测试；主要的缺陷是因为监测器高估了血压。可测试监测器中，有 40%未经过验证。在经过验证的监测器上，静态压力测试的通过率更高（96%，95%CI=94-98%），而未经过验证的监测器的通过率更低（64%，95%CI=58-69%），零售价格超过£10（90%，95%CI=86-94%），零售价格低于£10（66%，95%CI=51-80%），使用年限不超过 4 年（95%，95%CI=91-98%），使用年限超过 4 年（74%，95%CI=67-82%）。总共，有 12%的袖口失败。
患者自己的 BP 监测器的失败率与在专业环境中进行的研究中所显示的失败率相似，尽管袖口的失败率更高。如果设备经过验证且使用年限不超过 4 年，则可以确信患者自己的 BP 监测器的准确性。
