Department of Paediatric Nephrology, Evelina London Children's Hospital, Guys & St Thomas' NHS Foundation Trust.
North Middlesex Hospital.
J Hypertens. 2024 Feb 1;42(2):308-314. doi: 10.1097/HJH.0000000000003602. Epub 2023 Oct 25.
We report data regarding systolic BP monitoring in children aged <5 years performed over a 2-week period by parents at home using a hand-held doppler device and aneroid sphygmomanometer for SBP measurements (HDBPM). Our objectives were to compare health professional measured office systolic BP by doppler device (Office-SBP Doppler ) with parent measured home systolic BP using the same doppler device (Home-SBP Doppler ). We also report data evaluating reliability and optimal number of days of measurement required.
We taught parents to measure systolic BP and assessed their technique using a hand-held doppler device and aneroid sphygmomanometer. We requested parents to perform three consecutive BP measurements twice daily (ideally morning and evening around similar times) when the child was awake, settled and cooperative.
Over a 3-year period, data from 48 of 62 children who underwent HDBPM measurements were evaluated with median (IQR) age of 1.9 (0.9, 3.6) years, 27 (56%) boys and 14 (29%) on antihypertensive medication. Office-SBP Doppler was 2.9 ± 8.9 mmHg [95% confidence interval (CI), -14.4 to 20.4, P = 0.026] higher than Home-SBP Doppler . Mean Home-SBP Doppler between Week-1 and Week-2 monitoring was similar -0.45 ± 3.5 mmHg (95% CI, -7.35 to 6.45, P = 0.41). Morning HDBPM measurements were lower than evening with a mean difference of -2.77 ± 3.92 mmHg, P < 0.001). Over Week-1, mean Home-SBP Doppler was closer to mean Office-SBP Doppler with increasing cumulative days of monitoring and with smaller standard deviations suggesting that readings become more reliable from day 4 onwards.
HDBPM is a reliable method for measuring systolic BP in young children with BP levels measured by parents comparable to those performed by health professional in clinic. HDBPM technique described here and performed by parents over a 7-day period with a minimum of 4-days, offers a reliable and reproducible technique to measure blood pressure at home.
我们报告了使用手持式多普勒设备和无液气压计在家中由父母对年龄<5 岁的儿童进行为期两周的收缩压监测（HDBPM）的数据。我们的目的是比较使用相同多普勒设备进行的健康专业人员测量的诊室收缩压（Office-SBP Doppler）与父母测量的家庭收缩压（Home-SBP Doppler）。我们还报告了评估可靠性和所需测量天数的最佳数据。
我们教授父母测量收缩压，并使用手持式多普勒设备和无液气压计评估他们的技术。我们要求父母在孩子清醒、安定和合作时，每天两次（理想情况下在早上和晚上的相似时间）进行三次连续血压测量。
在三年期间，对 48 名接受 HDBPM 测量的儿童的数据进行了评估，其中中位数（IQR）年龄为 1.9（0.9，3.6）岁，27 名（56%）男孩和 14 名（29%）正在服用抗高血压药物。Office-SBP Doppler 比 Home-SBP Doppler 高 2.9±8.9mmHg[95%置信区间（CI），-14.4 至 20.4，P=0.026]。第一周和第二周监测之间的平均 Home-SBP Doppler 相似，为-0.45±3.5mmHg（95%CI，-7.35 至 6.45，P=0.41）。早晨 HDBPM 测量值低于晚上，平均差值为-2.77±3.92mmHg，P<0.001）。在第一周，随着监测累计天数的增加，平均 Home-SBP Doppler 更接近平均 Office-SBP Doppler，标准偏差也更小，表明从第四天开始读数变得更加可靠。
HDBPM 是一种可靠的方法，可用于测量年轻儿童的收缩压，父母测量的血压水平与诊所健康专业人员测量的血压水平相当。此处描述的 HDBPM 技术由父母在 7 天内完成，至少 4 天，提供了一种可靠且可重复的在家测量血压的技术。
