Hypertension and Cardiovascular Disease Prevention Center, Athens Medical Group, Psychiko Clinic, Neo Psychiko, Greece.
J Clin Hypertens (Greenwich). 2020 Jul;22(7):1177-1183. doi: 10.1111/jch.13927. Epub 2020 Jul 9.
Automated office blood pressure measurement eliminates the white coat effect and is associated with awake ambulatory blood pressure. This study examined whether automated office blood pressure values at lower limits were comparable to those of awake and mean 24-hour ambulatory blood pressure. A total of 552 patients were included in the study, involving 293 (53.1%) men and 259 (46.9%) women, with a mean age 55.0 ± 12.5, of whom 36% were treated for hypertension. Both systolic and diastolic automated office blood pressures exhibited lower values compared to awake ambulatory blood pressure among 254 individuals with systolic automated office blood pressure <130 mm Hg (119 ± 8 mm Hg vs 125 ± 11 mm Hg, P < .0001 and 75 ± 9 mm Hg vs 79 ± 9 mm Hg, P < .0001 for systolic and diastolic BPs, respectively). Furthermore, the comparison of systolic automated office blood pressure to the mean 24-hour ambulatory blood pressure levels also showed lower values (119 ± 8 vs 121 ± 10, P = .007), whereas the diastolic automated office blood pressure measurements were similar to 24-hour ambulatory blood pressure values. Our findings show that when automated office blood pressure readings express values <130/80 mm Hg in repeated office visits, further investigation should be performed only when masked hypertension is suspected; otherwise, higher automated office blood pressure values could be used for the diagnosis of uncontrolled hypertension, especially in individuals with organ damage.
自动化诊室血压测量消除了白大衣效应，并与清醒动态血压相关。本研究旨在探讨自动化诊室血压的下限值是否与清醒和平均 24 小时动态血压值相当。共有 552 例患者纳入本研究，其中男性 293 例（53.1%），女性 259 例（46.9%），平均年龄为 55.0±12.5 岁，其中 36%的患者患有高血压。在 254 例收缩压<130mmHg 的患者中，收缩压和舒张压的自动化诊室血压均低于清醒动态血压，分别为（119±8mmHg 比 125±11mmHg，P<0.0001 和 75±9mmHg 比 79±9mmHg，P<0.0001）。此外，与平均 24 小时动态血压水平相比，收缩压自动化诊室血压也显示出较低的值（119±8mmHg 比 121±10mmHg，P=0.007），而舒张压自动化诊室血压测量值与 24 小时动态血压值相似。我们的研究结果表明，当自动化诊室血压读数在多次就诊时表示<130/80mmHg 时，只有在怀疑存在隐匿性高血压时才应进一步进行检查；否则，可将较高的自动化诊室血压值用于诊断未控制的高血压，尤其是在有器官损伤的患者中。
