Role of Ambulatory and Home Blood Pressure Monitoring in Clinical Practice: A Narrative Review.
Role of Ambulatory and Home Blood Pressure Monitoring in Clinical Practice: A Narrative Review.
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DOI：
10.7326/m15-1270
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发表时间：
2015-11-03
影响因子：
39.2
通讯作者：
Muntner P
中科院分区：
文献类型：
--
作者：
Shimbo D;Abdalla M;Falzon L;Townsend RR;Muntner P
高血压是一种常见的心血管疾病（CVD）风险因素，通常根据临床环境中获得的血压读数进行诊断和治疗。在诊所内测量血压与在诊所外测量血压可能有很大差异。在过去的几十年里，已经积累了两种方法来测量门诊血压的证据：动态血压监测（ABPM）和家庭血压监测（HBPM）。ABPM和HBPM上的血压测量值与CVD结局的相关性均强于门诊血压。对于ABPM或HBPM在估计CVD风险方面是否具有上级优势，以及在何种情况下应在临床实践中使用这些方法评估门诊血压，存在争议。本综述介绍了ABPM和HBPM程序，血压表型措施，可以确定，并支持使用每种方法来测量门诊血压的证据。本文还介绍了在临床实践中成功实施ABPM和HBPM的障碍，提出了这些程序的核心能力，并强调了未来研究的重要领域。
Hypertension, a common cardiovascular disease (CVD) risk factor, is usually diagnosed and treated based on blood pressure readings obtained in the clinic setting. Blood pressure may differ considerably when measured in the clinic versus outside of the clinic setting. Over the past several decades, evidence has accumulated on two approaches for measuring out-of-clinic blood pressure: ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM). Blood pressure measures on ABPM and HBPM each have a stronger association with CVD outcomes than clinic blood pressure. Controversy exists whether ABPM or HBPM is superior for estimating CVD risk, and under what circumstances these methods should be used in clinical practice for assessing out-of-clinic blood pressure. This review describes ABPM and HBPM procedures, the blood pressure phenotypic measures that can be ascertained, and the evidence that supports the use of each approach to measure out-of-clinic blood pressure. This review also describes barriers to the successful implementation of ABPM and HBPM in clinical practice, proposes core competencies for the conduct of these procedures, and highlights important areas for future research.