Brueren M M, Schouten H J, de Leeuw P W, van Montfrans G A, van Ree J W
Department of General Practice, Maastricht University.
Br J Gen Pract. 1998 Sep;48(434):1585-9.
Several studies have reported overdiagnosis and overtreatment of hypertensive patients, especially in borderline hypertensives.
To find a blood pressure measurement procedure that reduces the risk of misclassification to an acceptable level.
Comparative, prospective study over seven months of primary care patients with elevated initial blood pressures. Blood pressure measurements made by general practitioners (GPs), practice nurses, and patients were compared with ambulatory blood pressure measurements.
Ninety-nine patients completed the study. Mean differences (systolic blood pressure) between different measurement procedures and ambulatory measurement ranged from +10 mmHg (doctor) to -1 mmHg (patient), and (diastolic) from +4 mmHg (doctor) to -2 mmHg (patient). Standard deviations of mean differences ranged from 12 mmHg (doctor/systolic) to 10 mmHg (patient/systolic), and from 8 mmHg (doctor/diastolic) to 7 mmHg (patient/diastolic).
Self-measurements by the patient appear to be a reliable alternative to ambulatory blood pressure measurement. In diagnosing and managing mild hypertension, we recommend the use of a valid self-measuring device.
多项研究报告了高血压患者，尤其是临界高血压患者的过度诊断和过度治疗情况。
寻找一种能将误诊风险降低至可接受水平的血压测量方法。
对初始血压升高的基层医疗患者进行为期七个月的比较性前瞻性研究。将全科医生（GP）、执业护士和患者所测血压与动态血压测量结果进行比较。
99名患者完成了研究。不同测量方法与动态测量之间的平均差异（收缩压）范围为+10 mmHg（医生测量）至 -1 mmHg（患者测量），（舒张压）范围为+4 mmHg（医生测量）至 -2 mmHg（患者测量）。平均差异的标准差范围为12 mmHg（医生测量/收缩压）至10 mmHg（患者测量/收缩压），以及8 mmHg（医生测量/舒张压）至7 mmHg（患者测量/舒张压）。
患者自行测量似乎是动态血压测量的可靠替代方法。在诊断和管理轻度高血压时，我们建议使用有效的自我测量设备。
