Reliability of Office, Home, and Ambulatory Blood Pressure Measurements and Correlation With Left Ventricular Mass.
Reliability of Office, Home, and Ambulatory Blood Pressure Measurements and Correlation With Left Ventricular Mass.
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办公室、家庭和动态血压测量的可靠性及其与左心室质量的相关性。
DOI：
10.1016/j.jacc.2020.10.039
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发表时间：
2020-12-22
影响因子：
24
通讯作者：
Shimbo D
中科院分区：
文献类型：
--
作者：
Schwartz JE;Muntner P;Kronish IM;Burg MM;Pickering TG;Bigger JT;Shimbo D
确定办公室血压（OBP），动态血压（ABP）和家庭血压（HBP）的可靠性和预测有效性可以告知哪种最适合诊断高血压和估计心血管疾病风险。评价OBP、HBP和ABP的可靠性，并评价其与未经治疗个体的左心室质量指数（LVMI）的关系。改善高血压检测（IDH）研究是一项以社区为基础的观察性研究，招募了408名参与者，他们在三次访视时进行了OBP评估，并完成了三周的HBP，两次24小时ABP记录和2D超声心动图。平均±SD年龄为41.2±13.1岁，59.5%为女性，25.5%为非洲裔美国人，64.0%为西班牙裔。一周HBP、三次门诊水银血压计和24小时ABP的可靠性分别为收缩压0.938、0.894和0.846，舒张压0.918、0.847和0.843。经回归稀释偏倚校正后，OBP、HBP和ABP之间的相关性为0.74-0.89。多变量校正后，包括OBP和24小时ABP，收缩压和舒张压升高10 mm Hg分别与LVMI升高5.07（标准误[SE]：1.48）和3.92（SE：2.14）g/m2相关。校正HBP后，收缩压、舒张压和ABP均与LVMI无关。OBP、HBP和ABP评估不同的参数。与OBP（3次访视）或24小时ABP相比，收缩压和舒张压（1周）更可靠，与LVMI的相关性更强。这些数据表明，一周的HBP监测可能是诊断高血压的最佳方法。我们分析了办公室、家庭和动态血压的可靠性，以及它们与左心室质量指数（LVMI）的关系。家庭血压的1周平均值比办公室血压（3次访视的平均值）或清醒、睡眠或24小时动态血压的平均值更可靠。我们表明，办公室，家庭和动态BP不会是等同的，即使每一个都可以评估与完美的可靠性。在调整年龄、性别、种族、BMI和其他血压指标后，家庭血压（而非办公室血压或动态血压）与LVMI独立相关。家庭BP可能是测量BP的最佳方法。在一项严格的研究中，与办公室测量和动态血压监测相比，家庭血压监测更可靠，与亚临床心血管疾病的关联更强
Determining the reliability and predictive validity of office blood pressure (OBP), ambulatory BP (ABP), and home BP (HBP) can inform which is best for diagnosing hypertension and estimating cardiovascular disease risk. To assess the reliability of OBP, HBP and ABP, and evaluate their associations with left ventricular mass index (LVMI) in untreated individuals. The Improving the Detection of Hypertension (IDH) study, a community-based observational study, enrolled 408 participants who had OBP assessed at three visits, and completed three weeks of HBP, two 24-hour ABP recordings and a 2D echocardiogram. Mean±SD age was 41.2±13.1 years, 59.5% were women, 25.5% African American, and 64.0% Hispanic. The reliability of one week of HBP, three office visits with mercury sphygmomanometry, and 24-hr ABP were 0.938, 0.894, and 0.846 for systolic and 0.918, 0.847, and 0.843 for diastolic BP, respectively. The correlations among OBP, HBP, and ABP, corrected for regression dilution bias, were 0.74–0.89. After multivariable adjustment including OBP and 24-hr ABP, 10 mm Hg higher systolic and diastolic HBP was associated with 5.07 (standard error [SE]: 1.48) and 3.92 (SE: 2.14) g/m2 higher LVMI, respectively. After adjustment for HBP, neither systolic or diastolic OBP nor ABP were associated with LVMI. OBP, HBP and ABP assess somewhat distinct parameters. Compared with OBP (3 visits) or 24-hour ABP, systolic and diastolic HBP (1 week) were more reliable and more strongly associated with LVMI. These data suggest one week of HBP monitoring may be the best approach for diagnosing hypertension. We analyzed the reliability of office, home and ambulatory blood pressures, and their associations with left ventricular mass index (LVMI). The 1-week mean of home BP was more reliable than office BP (averaged over 3 visits) or mean awake, asleep, or 24-hr ambulatory BP. We show that office, home and ambulatory BP would not be equivalent, even if each could be assessed with perfect reliability. Home BP – not office or ambulatory BP – was independently associated with LVMI after adjustment for age, sex, race/ethnicity, BMI, and the other BP measures. Home BP may be the best approach for measuring BP. In a rigorous research study, home blood pressure monitoring was more reliable and had a stronger association with sub-clinical cardiovascular disease compared with office measurements and ambulatory blood pressure monitoring
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影响因子：
3.2
作者：
Brueren, MM;vanLimpt, P;vanRee, JW
通讯作者：
vanRee, JW
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe
影响因子：
1.3
作者：
Mattu, GS;Heran, BS;Wright, JM
通讯作者：
Wright, JM
影响因子：
1.3
作者：
Coleman, Andrew;Steel, Stephen;Shennan, Andrew
通讯作者：
Shennan, Andrew
影响因子：
5.9
作者：
Grant, Sabrina;Hodgkinson, James A.;Greenfield, Sheila M.
通讯作者：
Greenfield, Sheila M.