Comparison between unattended automated office blood pressure and conventional office blood pressure under the environment of health checkup among Japanese general population
Comparison between unattended automated office blood pressure and conventional office blood pressure under the environment of health checkup among Japanese general population
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DOI：
10.1111/jch.14008
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发表时间：
2020-08-15
影响因子：
2.8
通讯作者：
Hasebe，Naoyuki
中科院分区：
文献类型：
--
作者：
Sakuma，Hirofumi;Nakagawa，Naoki;Hasebe，Naoyuki
在最近的加拿大和美国临床实践指南中，无人值守自动办公室血压（AOBP）测量已被认可为首选的办公室测量模式。然而，在健康检查的环境下，AOBP和常规办公室血压（CBP）之间的差异仍不清楚。我们的目的是确定AOBP的临床意义相比，CBP的环境下的健康检查。有491名参与者（333名女性，平均年龄62.5岁）至少20岁，包括179名先前诊断为高血压的参与者。平均AOBP为131.8 ± 20.9/76.6 ± 11.7 mm Hg，CBP为135.6 ± 21.6/77.3 ± 11.5 mm Hg。AOBP和CBP之间的收缩压（SBP）差异为3.9 mm Hg，舒张压差异为0.8 mm Hg。在所有参与者中，SBP和脉压以及白色大衣效应（WCE）随年龄增长而增加。CBP和AOBP的临界值分别为140/90 mm Hg和135/85 mm Hg，WCE和隐蔽高血压效应（MHE）的患病率分别为12.4%和14.1%。即使在一般人群的健康检查环境中，AOBP和CBP之间也存在差异，并且在有高血压病史的老年人中观察到更强的WCE，这表明AOBP与CBP的组合可能有助于在包括健康检查在内的所有临床场景中检测WCE和MHE，并有助于解决不仅在日本而且在世界各地的“高血压悖论”。
Unattended automated office blood pressure (AOBP) measurement has been endorsed as the preferred in‐office measurement modality in recent Canadian and American clinical practice guidelines. However, the difference between AOBP and conventional office blood pressure (CBP) under the environment of a health checkup remains unclear. We aimed to identify the clinical significance of AOBP as compared to CBP under the environment of a health checkup. There were 491 participants (333 females, mean age of 62.5 years) who were at least 20 years old, including 179 participants who were previously diagnosed with hypertension. Mean AOBPs were 131.8 ± 20.9/76.6 ± 11.7 mm Hg, and CBPs were 135.6 ± 21.6/77.3 ± 11.5 mm Hg. There was a difference of 3.9 mm Hg in systolic blood pressure (SBP) and 0.8 mm Hg in diastolic BP between AOBP and CBP. In all participants, SBP and pulse pressure, as well as the white coat effect (WCE), increased with age. The cutoff value used was 140/90 mm Hg for CBP and 135/85 mm Hg for AOBP, and the prevalence of WCE and masked hypertension effect (MHE) was 12.4% and 14.1%, respectively. Even in a health checkup environment of the general population, there was a difference between the AOBP and CBP, and the WCE was observed more strongly in the elderly with a history of hypertension, suggesting that a combination of AOBP with CBP may be useful in detecting WCE and MHE in all clinical scenarios including health checkups, and help solve the “hypertension paradox” not only in Japan but in all over the world.