Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Department of Continuing Education, University of Oxford, Oxford, UK.
Curr Hypertens Rep. 2021 Jan 15;23(1):4. doi: 10.1007/s11906-020-01118-1.
Automated office blood pressure (AOBP) measurements may provide more accurate estimation of blood pressure (BP) than manual office blood pressure (MOBP) measurements. This systematic review investigated the diagnostic performance of AOBP and MOBP using ambulatory blood pressure measurement (ABPM) as reference. Several databases including MEDLINE, Embase, Scopus, and China Academic Journals were searched. Data were extracted, double-checked by two investigators, and were analysed using a random effects model.
A total of 26 observational studies were included. The mean systolic/diastolic BP obtained by AOBP was not significantly different from that obtained by ABPM. The sensitivity and specificity of AOBP to detect elevated BP were approximately 70%. Fewer participants had white-coat hypertension on AOBP measurement than on MOBP measurement (7% versus 14%); however, about 13% had masked hypertension on AOBP measurement. The width of the limit of agreement comparing (i) AOBP and ABPM and (ii) MOBP and ABPM was comparable. AOBP may reduce the rate of the observed white-coat effect but undermine masked hypertension. The current recommendation, however, is limited by the absence of high-quality studies and the high heterogeneity of our results. More high-quality studies using different AOBP machines and in different population are therefore needed.
自动化诊室血压（AOBP）测量可能比手动诊室血压（MOBP）测量更准确地估计血压（BP）。本系统评价使用动态血压监测（ABPM）作为参考，调查了 AOBP 和 MOBP 的诊断性能。检索了 MEDLINE、Embase、Scopus 和中国学术期刊全文数据库等多个数据库。提取数据，由两名研究人员进行双重检查，并使用随机效应模型进行分析。
共纳入 26 项观察性研究。AOBP 测量的平均收缩压/舒张压与 ABPM 测量的结果无显著差异。AOBP 检测升高的血压的敏感性和特异性约为 70%。AOBP 测量的白大衣高血压患者比例（7%）低于 MOBP 测量的白大衣高血压患者比例（14%）；然而，AOBP 测量的隐匿性高血压患者比例约为 13%。比较（i）AOBP 与 ABPM 和（ii）MOBP 与 ABPM 的（差值）一致性界限的宽度是可比的。AOBP 可能会降低观察到的白大衣效应的发生率，但会破坏隐匿性高血压。然而，目前的建议受到高质量研究的缺乏和结果高度异质性的限制。因此，需要更多使用不同 AOBP 机器和不同人群的高质量研究。
