Short-term reproducibility of ambulatory blood pressure measurements: a systematic review and meta-analysis of 35 observational studies.
Short-term reproducibility of ambulatory blood pressure measurements: a systematic review and meta-analysis of 35 observational studies.
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DOI：
10.1097/hjh.0000000000002522
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发表时间：
2020-11
影响因子：
4.9
通讯作者：
Lee EK
中科院分区：
文献类型：
--
作者：
Bo Y;Kwok KO;Chung VC;Yu CP;Tsoi KK;Wong SY;Lee EK
目前尚未对动态血压测量（ABPM）的可重复性进行系统评价。这项荟萃分析比较了24小时/白天/夜间收缩压和舒张压平均值以及有或无高血压的abpm参与者的收缩压/舒张压夜间下降状态。在Ovid MEDLINE、EMBASE和CINAHL完整数据库中检索2019年5月3日之前发表的文章。纳入了在1个月内至少重复一次24小时ABPM的符合条件的研究。比较测量第一天和第二天的平均白天和夜间/24小时血压值、夜间下沉百分比和非下沉比例，并使用随机效应模型估计下沉状态不一致的参与者的比例。基于人群的分析发现，第一次和第二次ABPM对24小时/白天/夜间收缩压和舒张压的差异为0-1.1 mmHg，夜间收缩压/舒张压下降百分比为0-0.5%。在第一次和第二次ABPM中，非浸水者的比例没有差异。个体内分析发现收缩压/舒张压的95%一致限（LOA）较宽，日间收缩压的95%一致限（LOA）为- 16.7至18.4 mmHg，是诊断高血压的常用参考。同样，32%的参与者有不一致的夜间饮酒状态。ABPM在种群水平上具有良好的重复性，有利于其研究应用；但24小时ABPM的个体内血压值和下降状态的可重复性有限。由于缺乏高质量的研究和对非西方人群的研究，现有的证据有限。
A systematic review on the reproducibility of ambulatory blood pressure measurements (ABPM) has not yet been conducted. This meta-analysis compared 24-h/daytime/night-time SBP and DBP mean values and SBP/DBP nocturnal dipping status from ABPMs in participants with or without hypertension. Ovid MEDLINE, EMBASE, and CINAHL Complete databases were searched for articles published before 3 May 2019. Eligible studies reporting a 24-h ABPM repeated at least once within 1 month were included. The mean daytime/night-time/24-h BP values, percentage of nocturnal dipping, and proportion of nondippers were compared between the first and second day of measurements, and the proportion of participants with inconsistent dipping status were estimated using a random effect model. Population-based analysis found a 0–1.1 mmHg difference between the first and second ABPM for 24-h/daytime/night-time SBP and DBP and 0–0.5% for percentage of SBP/DBP nocturnal dipping. The proportion of non-dippers was not different between the first and second ABPM. Intra-individual analysis found that the 95% limit of agreements (LOA) for SBP/DBP were wide and the 95% LOA for daytime SBP, common reference to diagnose hypertension, ranged −16.7 to 18.4 mmHg. Similarly, 32% of participants had inconsistent nocturnal dipping status. ABPM had excellent reproducibility at the population level, favouring its application for research purposes; but reproducibility of intra-individual BP values and dipping status from a 24-h ABPM was limited. The available evidence was limited by the lack of high-quality studies and lack of studies in non-Western populations.