The position of the arm during blood pressure measurement in sitting position
The position of the arm during blood pressure measurement in sitting position
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DOI：
10.1097/01.mbp.0000218007.57957.56
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发表时间：
2006-12-01
影响因子：
1.3
通讯作者：
Thien, Theo
中科院分区：
文献类型：
--
作者：
Adiyaman, Ahmet;Verhoeff, Rutger;Thien, Theo
目的探讨坐位血压测量时手臂位置的影响。方法对128例门诊高血压患者（多数为高血压患者）在两种不同体位下同时进行双臂血压测量。首先，将双臂置于椅子支撑水平，休息10分钟后测量双臂血压三次。随后，当仍然保持在相同的筛选位置时，在双臂同时进行五次血压测量，其中一只手臂放置在桌子上，另一只手臂放置并支撑在心脏水平（胸骨中部）。以置于心脏水平的手臂为参考臂，随机选择置于桌面水平的手臂和置于心脏水平的手臂。平均（+/- SD）收缩压和舒张压比心脏水平的血压高6.1/5.7 +/- 4.6/3.1和9.3/9.4 +/- 5.4/3.4 mmHg，分别手臂位置之间的身高差异对血压读数的影响小于预测值（收缩压0.49 mmHg/cm和舒张压0.47 mmHg/cm）。不同臂位（桌位、心位）血压差异与年龄、性别、体重及基线血压无显著相关性。结论心位以下不同臂位对血压读数有显著影响。关于血压测量期间手臂位置的主要指南与Fracket研究中使用的手臂位置不一致，Fracket研究是最常用的风险估计研究。
Objective Determining the influence of the position of the arm on blood pressure measurement in the sitting position.Methods Blood pressure of 128 individuals (the majority being treated hypertensive patients) visiting the outpatient clinic was measured simultaneously on both arms with arms in two different positions. First, both arms were placed at the chair support level and blood pressure was measured three times on both arms after 10 min of rest. Subsequently, while still remaining in the same sifting position, five blood pressure measurements were made simultaneously at both arms with one arm placed on the desk and one arm placed and supported at heart level (mid-sternal). The arm placed at heart level served as the reference arm. The choice of which arm was placed at desk level and which arm was placed at heart level was randomized.Results Both at desk level and at chair support level, mean (+/- SD) systolic and diastolic blood pressures were higher than blood pressure at heart level by 6.1/5.7 +/- 4.6/3.1 and 9.3/9.4 +/- 5.4/3.4 mmHg, respectively. The effect of the height differences between the arm positions on the blood pressure readings was smaller than predicted (0.49 mmHg/cm systolic and 0.47 mmHg/cm diastolic). No significant correlation was found between blood pressure difference in the different arm positions (desk and heart level) and age, sex, weight or baseline blood pressure.Conclusions Different arm positions below heart level have significant effects on blood pressure readings. The leading guidelines about arm position during blood pressure measurement are not in accordance with the arm position used in the Framingham study, the most frequently used study for risk estimations.