The Columbia Hypertension Center and Lab, Columbia University Irving Medical Center, New York, New York, USA.
Department of Biomedical Engineering, Columbia University, New York, New York, USA.
Am J Hypertens. 2022 May 10;35(5):380-387. doi: 10.1093/ajh/hpac017.
Hypertension is associated with more end-organ damage, cardiovascular events, and disability-adjusted life years lost in the United States compared with all other modifiable risk factors. Several guidelines and scientific statements now endorse the use of out-of-office blood pressure (BP) monitoring with ambulatory BP monitoring or home BP monitoring to confirm or exclude hypertension status based on office BP measurement. Current ambulatory or home BP monitoring devices have been reliant on the placement of a BP cuff, typically on the upper arm, to measure BP. There are numerous limitations to this approach. Cuff-based BP may not be well-tolerated for repeated measurements as is utilized with ambulatory BP monitoring. Furthermore, improper technique, including incorrect cuff placement or use of the wrong cuff size, may lead to erroneous readings, affecting diagnosis and management of hypertension. Compared with devices that utilize a cuff, cuffless BP devices may overcome challenges related to technique, tolerability, and overall utility in the outpatient setting. However, cuffless devices have several potential limitations that limit its routine use for the diagnosis and management of hypertension. The review discusses the different approaches for determining BP using various cuffless devices including engineering aspects of cuffless device technologies, validation protocols to test accuracy of cuffless devices, potential barriers to widespread implementation, and future areas of research. This review is intended for the clinicians who utilize out-of-office BP monitoring for the diagnosis and management of hypertension.
在美国，与其他所有可改变的危险因素相比，高血压与更多的终末器官损害、心血管事件和丧失残疾调整生命年有关。现在有几个指南和科学声明支持使用非诊室血压（BP）监测与动态血压监测或家庭血压监测来根据诊室血压测量结果来确认或排除高血压状态。目前的动态血压或家庭血压监测设备一直依赖于血压袖带的放置，通常在上臂上，以测量血压。这种方法有许多局限性。袖带式 BP 可能无法像动态血压监测那样耐受重复测量。此外，包括袖带放置不正确或使用错误的袖带尺寸在内的不当技术，可能会导致读数错误，影响高血压的诊断和治疗。与使用袖带的设备相比，无袖带 BP 设备可能克服了与技术、耐受性和门诊环境中的整体实用性相关的挑战。然而，无袖带设备有几个潜在的局限性，限制了其在高血压的诊断和管理中的常规使用。本综述讨论了使用各种无袖带设备确定 BP 的不同方法，包括无袖带设备技术的工程方面、测试无袖带设备准确性的验证方案、广泛实施的潜在障碍以及未来的研究领域。本综述面向使用非诊室 BP 监测来诊断和治疗高血压的临床医生。
