Agreement between attended home and ambulatory blood pressure measurements in adolescents with chronic kidney disease.
Agreement between attended home and ambulatory blood pressure measurements in adolescents with chronic kidney disease.
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DOI：
10.1007/s00467-022-05479-4
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发表时间：
2022-10
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影响因子：
--
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中科院分区：
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本研究旨在比较家庭血压（BP）测量（HBPM）与动态血压监测仪（ABPM）读数，并检查测量模式之间的一致性水平是否存在总体差异和亚组差异。这是一项针对11-19岁（平均15岁，SD=2.7）慢性肾脏疾病儿童的2年多中心观察性研究数据的次要分析。参与者有3个标准化的静息血压测量的家庭BP由工作人员采取，然后在家庭BP的2周内进行24小时ABPM。计算平均三次参加HBPM和平均ABPM测量的BP指数（测量BP/95% ile BP）。使用线性回归（具有稳健标准误）比较5次研究访视中任何一次的成对HBPM和ABPM测量值。广义估计方程为基础的逻辑回归确定的灵敏度，特异性，阴性和阳性预测值与ABPM作为金标准。对该组总体和亚组进行分析。103名参与者提供了251个配对测量值。HBPM和日间APBM之间的收缩压指数无差异（平均差异-0.002; 95% CI：-0.006，0.003）;舒张压指数差异极小（平均差异-0.033; 95% CI：-0.040，-0.025）。HBPM和24小时ABPM在识别异常血压方面的总体一致性较高（81.8%）。HBPM的敏感性（87.5%）高于特异性（77.4%），阴性预测值（89.8%）高于阳性预测值（73.3%），且各亚组的结果一致。当ABPM不可用时，参加HBPM可能是监测BP的合理方法。参与HBPM的更大可及性和可行性可能有助于改善高危青年的BP控制。
This study aimed to compare attended home blood pressure (BP) measurements (HBPM) with ambulatory BP monitor (ABPM) readings and examine if level of agreement between measurement modalities differs overall and by subgroup. This was a secondary analysis of data from a 2-year, multicenter observational study of children 11–19 years (mean 15, SD=2.7) with chronic kidney disease. Participants had 3 standardized resting oscillometric home BPs taken by staff followed by 24-hour ABPM within 2 weeks of home BP. BP indices (measured BP/95%ile BP) were calculated for mean triplicate attended HBPM and mean ABPM measurements. Paired HBPM and ABPM measurements taken during any of 5 study visits were compared using linear regression with robust standard errors. Generalized estimating equation-based logistic regression determined sensitivity, specificity, negative, and positive predictive values with ABPM as the gold standard. Analyses were conducted for the group overall and by subgroup. 103 participants contributed 251 paired measurements. Indexed systolic BP did not differ between HBPM and daytime APBM (mean difference −0.002; 95% CI: −0.006, 0.003); the difference in indexed diastolic BP was minimal (mean difference −0.033; 95% CI: −0.040, −0.025). Overall agreement between HBPM and 24-hour ABPM in identifying abnormal BP was high (81.8%). HBPM had higher sensitivity (87.5%) than specificity (77.4%) and greater negative (89.8%) than positive (73.3%) predictive value, and findings were consistent in subgroups. Attended HBPM may be reasonable for monitoring BP when ABPM is unavailable. The greater accessibility and feasibility of attended HBPM may potentially help improve BP control among at-risk youth.
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DOI：
10.1136/bmj.d3621
发表时间：
2011-06-24
期刊：
BMJ (Clinical research ed.)
影响因子：
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作者：
Hodgkinson J;Mant J;Martin U;Guo B;Hobbs FD;Deeks JJ;Heneghan C;Roberts N;McManus RJ
通讯作者：
McManus RJ
影响因子：
1.8
作者：
Llisterri, JL;Gil, VF;Merino, J
通讯作者：
Merino, J
影响因子：
5.1
作者：
Mitsnefes, Mark M.;Kimball, Thomas R.;Daniels, Stephen R.
通讯作者：
Daniels, Stephen R.
影响因子：
3.6
作者：
Eaton, Cyd K.;Eakin, Michelle N.;Riekert, Kristin A.
通讯作者：
Riekert, Kristin A.
DOI：
10.1161/hyp.0000000000000007
发表时间：
2014-05
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Flynn JT;Daniels SR;Hayman LL;Maahs DM;McCrindle BW;Mitsnefes M;Zachariah JP;Urbina EM;American Heart Association Atherosclerosis, Hypertension and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young
通讯作者：
American Heart Association Atherosclerosis, Hypertension and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young