Liu Justin, Brettler Jeffrey, Ramirez Uriel A, Walsh Sophie, Sangapalaarachchi Dona, Narita Keisuke, Byfield Rushelle L, Reynolds Kristi, Shimbo Daichi
Department of Medicine, Columbia Hypertension Lab, Columbia University Irving Medical Center, New York, New York, USA.
Southern California Permanente Medical Group, Department of Health Systems Science, Regional Hypertension Program, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA.
Am J Hypertens. 2025 Mar 17;38(4):193-202. doi: 10.1093/ajh/hpae151.
The diagnosis and management of hypertension have been based primarily on blood pressure (BP) measurement in the office setting. Higher out-of-office BP is associated with an increased risk of cardiovascular disease, independent of office BP. Home BP monitoring (HBPM) consists of the measurement of BP by a person outside of the office at home and is a validated approach for out-of-office BP measurement. HBPM provides valuable data for diagnosing and managing hypertension. Another validated approach, ambulatory BP monitoring (ABPM), has been considered to be the reference standard of out-of-office BP measurement. However, HBPM offers potential advantages over ABPM including being a better measure of basal BP, wide availability to patients and clinicians, evidence supporting its use for better office BP control, and demonstrated efficacy when using telemonitoring along with HBPM. This state-of-the-art review examines the current state of HBPM and includes discussion of recent hypertension guidelines on HBPM, advantages of using telemonitoring with HBPM, use of self-titration of antihypertensive medication with HBPM, validation of HBPM devices, best practices for conducting HBPM in the clinical setting, how HBPM can be used as an implementation strategy approach to improve BP control in the United States, health equity in HBPM use, and HBPM use among specific populations. Finally, research gaps and future directions of HBPM are reviewed.
高血压的诊断和管理主要基于诊室环境下的血压测量。诊室以外的血压升高与心血管疾病风险增加相关，与诊室血压无关。家庭血压监测（HBPM）是指由非诊室人员在家中测量血压，是一种经过验证的诊室以外血压测量方法。HBPM为高血压的诊断和管理提供了有价值的数据。另一种经过验证的方法，动态血压监测（ABPM），被认为是诊室以外血压测量的参考标准。然而，与ABPM相比，HBPM具有潜在优势，包括能更好地测量基础血压、患者和临床医生广泛可用、有证据支持其用于更好地控制诊室血压，以及在将远程监测与HBPM一起使用时已证明的疗效。这篇前沿综述探讨了HBPM的现状，包括对近期高血压指南中关于HBPM的讨论、将远程监测与HBPM一起使用的优势、使用HBPM进行抗高血压药物自我滴定、HBPM设备的验证、在临床环境中进行HBPM的最佳实践、HBPM如何作为一种实施策略方法在美国改善血压控制、HBPM使用中的健康公平性以及特定人群中的HBPM使用情况。最后，对HBPM的研究差距和未来方向进行了综述。
