Health Management Center, General Practice Center, West China Hospital, Sichuan University, Chengdu, China.
Biliary Surgery, West China Hospital, Sichuan University, Chengdu, China.
Front Public Health. 2023 Jan 11;10:985730. doi: 10.3389/fpubh.2022.985730. eCollection 2022.
Current studies have found that the incidence of masked hypertension is high in Asian countries, but the use of ambulatory blood pressure monitoring (ABPM) in Asian countries is very limited, especially in primary health care. We compared the ABPM and office blood pressure (OBP) in primary health care of a high-risk population of hypertension.
The study included participants with at least one risk factor for hypertension who received primary health care. Demographic data, present medical history, personal history, and family history were collected by questionnaire.
A total of 823 subjects were included in the study. There were 531 (64.5%) subjects with hypertension by ABPM and 316 patients (38.4%) by OBP. A paired chi-square test showed that the positive rate of ABPM in the diagnosis of hypertension was significantly higher than that of OBP (chi-square value 174.129, < 0.0001). There were 24 (2.9%) patients with white coat hypertension, 239 (29.0%) with masked hypertension, 504 (52.9%) with a non-dipping pattern, 135 (16.9%) with nocturnal hypertension and 18 (2.2%) with high ambulatory BP variability. Concordance correlation coefficient showed there was a poor correlation between OBP and awake average BP. Scatter plot displayed there was a positive correlation between OBP and awake average BP, but the degree of fitting was not high. The Bland Altman plot showed that OBP and awake average BP were consistent.
Although OBP and ABPM have some consistency, ABPM can screen for masked hypertension and nocturnal hypertension in primary care of populations at high risk of hypertension. Therefore, ABPM is necessary in the primary health care of populations at high risk of hypertension and can be used as a routine screening.
目前的研究发现，亚洲国家的掩蔽性高血压发病率很高，但亚洲国家对动态血压监测（ABPM）的使用非常有限，尤其是在初级保健中。我们比较了高血压高危人群初级保健中的 ABPM 和诊室血压（OBP）。
该研究纳入了至少有一个高血压危险因素并接受初级保健的参与者。通过问卷收集人口统计学数据、现病史、个人史和家族史。
共有 823 名受试者纳入研究。ABPM 诊断为高血压的患者有 531 例（64.5%），OBP 诊断为高血压的患者有 316 例（38.4%）。配对卡方检验显示，ABPM 诊断高血压的阳性率明显高于 OBP（卡方值 174.129， < 0.0001）。有 24 例（2.9%）患者为白大衣性高血压，239 例（29.0%）为掩蔽性高血压，504 例（52.9%）为非杓型，135 例（16.9%）为夜间高血压，18 例（2.2%）为高动态血压变异性。一致性相关系数显示，OBP 与清醒平均血压之间相关性较差。散点图显示，OBP 与清醒平均血压呈正相关，但拟合程度不高。Bland-Altman 图显示，OBP 和清醒平均血压之间存在一致性。
尽管 OBP 和 ABPM 有一定的一致性，但 ABPM 可以在高血压高危人群的初级保健中筛查出掩蔽性高血压和夜间高血压。因此，ABPM 对高血压高危人群的初级保健是必要的，可以作为常规筛查。
