Is a series of blood pressure measurements by the general practitioner or the patient a reliable alternative to ambulatory blood pressure measurement? A study in general practice with reference to short-term and long-term between-visit variability
Is a series of blood pressure measurements by the general practitioner or the patient a reliable alternative to ambulatory blood pressure measurement? A study in general practice with reference to short-term and long-term between-visit variability
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DOI：
10.1016/s0895-7061(97)00125-8
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发表时间：
1997-08-01
影响因子：
3.2
通讯作者：
vanRee, JW
中科院分区：
文献类型：
--
作者：
Brueren, MM;vanLimpt, P;vanRee, JW
我们研究了全科医生（GP）和患者的一系列血压测量的再现性与动态血压测量（ABPM）相比，参考短期和长期的访问之间的变异性，使用前瞻性，比较诊断研究。研究组为88例潜在高血压初级保健患者（初始收缩压[SEP]在160和200 mm Hg之间或舒张压[DBP]在95和115 mm Hg之间）。在2个单独的日期测量ABPM（间隔6个月）。测量了医生（间隔1至6个月）和患者（间隔1周）的两个系列测量值。计算两个连续系列测量值之间以及两个ABPM之间的平均差和平均差的标准差（SDD）。使用Wilcoxon符号秩检验比较这些标准差。平均初始诊室血压为161（SEP）和102（DBP）mmHg。长期访视间变异性（由GP测量）大于短期访视间变异性：SDD为16 v 11 mm Hg（SEP）和10 v 8 mm Hg（DBP）。连续ABPM之间以及连续系列GP办公室测量和患者家庭测量之间的平均SEP和DBP差异无统计学意义。GP和患者的两个系列测量值之间以及两个ABPM之间的平均差异为0 +/- 1 mm Hg。连续ABPM与GP和患者的一系列测量值之间的SDD范围为8至11 mmHg（SEP），6 mmHg（DBP）。研究的测量程序（SEP和DBP）的SDD之间无统计学显著差异。在我们的研究中，动态血压测量的可重复性并不比GP或患者的一系列四次重复测量更好。长期（间隔6个月）访视间变异性大于短期（间隔1周）访视间变异性。(C)1997年美国高血压杂志有限公司
We studied the reproducibility of a series of blood pressure measurements by general practitioner (GP) and patient in comparison with that of ambulatory blood pressure measurement (ABPM), with reference to short-term and long-term between-visit variability using a prospective, comparative diagnostic study. The study group was 88 potentially hypertensive primary care patients (initial systolic blood pressure [SEP] between 160 and 200 mm Hg or with diastolic blood pressure [DBP] between 95 and 115 mm Hg). ABPMs were measured on 2 separate days (at a 6 month interval). Two series of measurements by the doctor (at 1 to 6 month intervals), and the patient (at a 1 week interval) were measured. Mean differences and standard deviations of mean differences (SDD) between two successive series of measurements, and between two ABPMs were computed. The Wilcoxon signed-ranks test was used to compare these standard deviations. Mean initial office-blood pressures were 161 (SEP) and 102 (DBP) mm Hg. Long-term between-visit variability (measurements by GP) was larger than short-term between-visit variability: SDDs were 16 v 11 mm Hg (SEP), and 10 v 8 mm Hg (DBP). The differences in average SEP and DBP between successive ABPMs and between successive series of office measurements by GP and home measurements by patient were not statistically significant. Mean differences between two series of measurements by GP and patient, and between two ABPMs, were 0 +/- 1 mm Hg. SDDs between successive ABPMs and series of measurements by GP and patient ranged from 8 to 11 mm Hg (SEP), and were 6 mm Hg (DBP). No statistically significant differences were found between the SDDs of the studied measurement procedures (SEP and DBP). In our study the reproducibility of ambulatory blood pressure measurement was not found to be better than that of a series of four duplicate measurements by GP or patient. Long-term (6 months interval) between-visit variability was larger than the shortterm (1 week interval) between-visit variability. (C) 1997 American Journal of Hypertension, Ltd.