Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
Blood Press Monit. 2021 Oct 1;26(5):321-327. doi: 10.1097/MBP.0000000000000536.
Unattended automated office blood pressure (AOBP) may be a better estimate of true blood pressure (BP) than conventional office BP by physicians or nurses. However, measurement of AOBP is cumbersome in general clinical practice. We compared unattended AOBP by the patients themselves using the rigid cuff in the waiting room with attended AOBP and home BP (HBP) (N = 72).
Unattended AOBP by patients was measured in the waiting room using a rigid cuff with the fully automated device (Omron, HEM-907, triple BP readings taken at 1-min intervals after 5 min of rest). Attended AOBP was measured using a soft cuff by a physician in an examination room without specific resting time. HBP was measured for 5 consecutive days.
The mean age was 76.5 ± 8.6 years. The mean systolic unattended AOBP by patients, attended AOBP and HBP were 139.3 ± 16.6, 144.8 ± 17.1 and 139.1 ± 14.4 mmHg, respectively. Unattended AOBP by patients was significantly related to attended AOBP (r = 0.798; P < 0.01) and to HBP (r = 0.404; P < 0.001). It was significantly lower than attended AOBP (difference 5.5 ± 10.7 mmHg; P < 0.001) and comparable with HBP (difference 0.26 ± 17.0 mmHg; P = 0.90) in Bland-Altman plots. However, 22% of patients had a difference of over 20 mmHg between unattended AOBP by patients and HBP. Multivariate regression demonstrated older age (B = -0.73; P = 0.002) to be related to the difference between unattended AOBP by patients and HBP.
The mean unattended AOBP by patients was lower than attended AOBP and comparable with HBP, but older age affected the difference between unattended AOBP by patients and HBP.
与医生或护士进行的常规诊室血压（OBP）相比，患者自行进行的无人值守自动诊室血压（AOBP）可能更能准确估计真实血压（BP）。然而，在一般临床实践中，AOBP 的测量较为繁琐。我们比较了 72 名患者在候诊室使用刚性袖带自行进行的无人值守 AOBP、诊室有医护人员参与的 AOBP 和家庭血压（HBP）。
使用全自动设备（欧姆龙，HEM-907，在休息 5 分钟后 1 分钟间隔测量 3 次血压读数）在候诊室使用刚性袖带测量患者的无人值守 AOBP。诊室无特定休息时间，由医生使用软袖带测量有医护人员参与的 AOBP。连续 5 天测量 HBP。
患者的平均年龄为 76.5±8.6 岁。患者的无人值守 AOBP、有医护人员参与的 AOBP 和 HBP 的平均收缩压分别为 139.3±16.6、144.8±17.1 和 139.1±14.4mmHg。患者的无人值守 AOBP 与有医护人员参与的 AOBP（r=0.798；P<0.01）和 HBP（r=0.404；P<0.001）显著相关。它显著低于有医护人员参与的 AOBP（差值 5.5±10.7mmHg；P<0.001），与 HBP 相当（差值 0.26±17.0mmHg；P=0.90），在 Bland-Altman 图中。然而，22%的患者的患者自行进行的 AOBP 和 HBP 差值超过 20mmHg。多元回归分析表明，年龄较大（B=-0.73；P=0.002）与患者自行进行的 AOBP 和 HBP 之间的差值有关。
患者的平均无人值守 AOBP 低于有医护人员参与的 AOBP，与 HBP 相当，但年龄较大会影响患者自行进行的 AOBP 和 HBP 之间的差值。
