Measurement of Blood Pressure in Humans A Scientific Statement From the American Heart Association
Measurement of Blood Pressure in Humans A Scientific Statement From the American Heart Association
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DOI：
10.1161/hyp.0000000000000087
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发表时间：
2019-05-01
期刊：
影响因子：
8.3
通讯作者：
Wright, Jackson T., Jr.
中科院分区：
文献类型：
--
作者：
Muntner, Paul;Shimbo, Daichi;Wright, Jackson T., Jr.
血压的准确测量对于高血压的诊断和治疗至关重要。这篇文章提供了美国心脏协会关于人体血压测量的最新科学声明。在办公室环境中，许多血压计设备已经过验证，可以准确测量血压，同时减少与听诊方法相关的人为错误。全自动血压测量设备即使在没有观察者在场的情况下也能够获得多个读数，这可能比听诊提供更准确的血压测量。研究表明，在办公室外测量血压与在办公室测量血压有很大差异。门诊血压监测被认为是门诊血压评估的参考标准，当门诊血压监测不可用或不能耐受时，家庭血压监测是一种替代方法。与持续血压正常（即，办公室内外的非高血压血压水平）的患者相比，尚不清楚白大衣高血压（即，办公室内而非办公室外的高血压水平）的成年人是否增加了心血管疾病的风险，而那些隐性高血压（即，办公室外而非办公室内的高血压水平）的风险大幅增加。此外，夜间高血压与心血管疾病风险增加有关。血压计和听诊法均被认为可用于测量儿童和青少年的血压。无论用于测量BP的方法如何，技术人员和医疗保健提供者的初始和持续培训以及使用经过验证和校准的设备对于获得准确的BP测量值至关重要。
The accurate measurement of blood pressure (BP) is essential for the diagnosis and management of hypertension. This article provides an updated American Heart Association scientific statement on BP measurement in humans. In the office setting, many oscillometric devices have been validated that allow accurate BP measurement while reducing human errors associated with the auscultatory approach. Fully automated oscillometric devices capable of taking multiple readings even without an observer being present may provide a more accurate measurement of BP than auscultation. Studies have shown substantial differences in BP when measured outside versus in the office setting. Ambulatory BP monitoring is considered the reference standard for out-of-office BP assessment, with home BP monitoring being an alternative when ambulatory BP monitoring is not available or tolerated. Compared with their counterparts with sustained normotension (ie, nonhypertensive BP levels in and outside the office setting), it is unclear whether adults with white-coat hypertension (ie, hypertensive BP levels in the office but not outside the office) have increased cardiovascular disease risk, whereas those with masked hypertension (ie, hypertensive BP levels outside the office but not in the office) are at substantially increased risk. In addition, high nighttime BP on ambulatory BP monitoring is associated with increased cardiovascular disease risk. Both oscillometric and auscultatory methods are considered acceptable for measuring BP in children and adolescents. Regardless of the method used to measure BP, initial and ongoing training of technicians and healthcare providers and the use of validated and calibrated devices are critical for obtaining accurate BP measurements.