de Gaudemaris R, Chau N P, Mallion J M
Médecine Interne et Cardiologie, CHU, Grenoble, France.
J Hypertens. 1994 Jul;12(7):831-8.
A multicentre study was performed on 390 healthy subjects (210 male, 180 female) to evaluate home blood pressure versus office blood pressure.
The patients, aged 20-59 years, not on antihypertensive treatment, were not preselected by blood pressure levels. Blood pressure was measured in the doctor's office, using a mercury manometer at the fifth, sixth and seventh minute of rest, and at home by self-measurement using a validated electronic oscillometric device at the fifth, sixth and seventh minute of rest, in the morning and evening, on three consecutive days.
The analysis of office and home measurements at the fifth, sixth and seventh minute of rest showed a significant decrease in blood pressure, mostly between the fifth and sixth minute. There was no significant variation in home pressure over the three consecutive days of measurement. Blood pressures were significantly higher in the evening than in the morning; the mean differences were 3 mmHg for systolic and 1.5 mmHg for diastolic blood pressure. Compared with office blood pressure measurement, home measurement provided significantly lower systolic and diastolic blood pressure means. Of the subjects, 78% showed a higher systolic and 69.9% a higher diastolic blood pressure with office measurement than with home measurement. Systolic and diastolic blood pressure differences were non-significantly higher for females than for males and did not differ with age.
The comparison of the office and home measurement distributions allowed us to propose reference values for home blood pressure measurement. These were established by choosing blood pressure at the identical percentile for home measurement as we found for office measurement using the World Health Organization criteria (140/90 and 160/95 mmHg). Using this approach, the upper limit for normotension by home measurement would be 127/83 mmHg and for hypertension 147/86 mmHg. Although this approach has no prognostic value, it could be useful for the interpretation of home blood pressure.
对390名健康受试者（210名男性，180名女性）进行了一项多中心研究，以评估家庭血压与诊室血压。
研究对象为年龄在20 - 59岁、未接受抗高血压治疗的患者，未根据血压水平进行预先筛选。在医生办公室，使用汞柱式血压计在休息第5、6和7分钟时测量血压；在家中，使用经过验证的电子示波装置，在连续三天的早晨和晚上休息第5、6和7分钟时自行测量血压。
对休息第5、6和7分钟时的诊室和家庭测量值分析显示，血压显著下降，主要在第5和第6分钟之间。在连续三天的测量中，家庭血压没有显著变化。晚上的血压显著高于早晨；收缩压平均差值为3 mmHg，舒张压平均差值为1.5 mmHg。与诊室血压测量相比，家庭测量的收缩压和舒张压平均值显著更低。在这些受试者中，78%的人诊室测量的收缩压高于家庭测量，69.9%的人诊室测量的舒张压高于家庭测量。女性的收缩压和舒张压差值略高于男性，但无显著差异，且与年龄无关。
通过比较诊室和家庭测量分布，我们能够提出家庭血压测量的参考值。这些参考值是通过选择与根据世界卫生组织标准（140/90和160/95 mmHg）进行诊室测量时相同百分位数的家庭测量血压来确定的。采用这种方法，家庭测量正常血压的上限为127/83 mmHg，高血压的上限为147/86 mmHg。虽然这种方法没有预后价值，但可能有助于解释家庭血压。
