Ohkubo T, Imai Y, Tsuji I, Nagai K, Kato J, Kikuchi N, Nishiyama A, Aihara A, Sekino M, Kikuya M, Ito S, Satoh H, Hisamichi S
Department of Public Health, Tohoku University School of Medicine, Sendai, Japan.
J Hypertens. 1998 Jul;16(7):971-5. doi: 10.1097/00004872-199816070-00010.
To compare the predictive powers of self-measurement of blood pressure at home (home blood pressure measurement) and casual (screening) blood pressure measurement for mortality.
A prospective cohort study.
We obtained home and screening blood pressure measurements for 1789 subjects aged > or = 40 years who were followed up for a mean of 6.6 years. The prognostic significance of blood pressure for mortality was determined by the Cox proportional hazards regression model adjusted for age, sex, smoking status, past history of cardiovascular disease, and the use of antihypertensive medication.
When the home blood pressure values and the screening blood pressure values were simultaneously incorporated into the Cox model as continuous variables, only the average of multiple (taken more than three times) home systolic blood pressure values was significantly and strongly related to the cardiovascular mortality risk. The average of the two initial home blood pressure values was also better related to the mortality risk than were the screening blood pressure values.
Home blood pressure measurement had a stronger predictive power for mortality than did screening blood pressure measurement for a general population. This appears to be the first study in which the prognostic significances of home and screening blood pressure measurements have been compared.
比较家庭自测血压（家庭血压测量）和偶测（筛查）血压对死亡率的预测能力。
一项前瞻性队列研究。
我们获取了1789名年龄≥40岁受试者的家庭血压和筛查血压测量值，对其进行了平均6.6年的随访。通过Cox比例风险回归模型，在调整年龄、性别、吸烟状况、心血管疾病既往史以及抗高血压药物使用情况后，确定血压对死亡率的预后意义。
当家庭血压值和筛查血压值作为连续变量同时纳入Cox模型时，只有多次（超过三次）家庭收缩压值的平均值与心血管死亡风险显著且密切相关。最初两次家庭血压值的平均值与死亡风险的相关性也优于筛查血压值。
对于一般人群，家庭血压测量对死亡率的预测能力强于筛查血压测量。这似乎是第一项比较家庭血压测量和筛查血压测量预后意义的研究。
