Conventional versus automated measurement of blood pressure in primary care patients with systolic hypertension: randomised parallel design controlled trial
Conventional versus automated measurement of blood pressure in primary care patients with systolic hypertension: randomised parallel design controlled trial
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DOI：
10.1136/bmj.d286
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发表时间：
2011-02-07
影响因子：
105.7
通讯作者：
Kaczorowski, Janusz
中科院分区：
文献类型：
--
作者：
Myers, Martin G.;Godwin, Marshall;Kaczorowski, Janusz
目的以清醒时动态血压为金标准，比较人工血压测量和自动血压测量的质量和准确性。地点群集随机对照试验。设置加拿大东部五个城市的初级保健实践。参与者555例收缩期高血压患者，在67个实践中的88名初级保健医生的护理下，干预实践被随机分配到正在使用手动办公室血压（对照组）或使用BpTRU设备的自动办公室血压（干预组）。在入组前，从每例患者的病历中获得最后一次常规手动办公室血压（mm Hg）。比较干预组和对照组入组前后的诊室血压读数;所有读数与清醒时动态血压进行比较，主要结果测量清醒时动态血压减去自动诊室血压与清醒时动态血压减去手动诊室血压之间的收缩压差异（252例患者）进行手动诊室血压测量，36例（303例患者）进行自动诊室血压测量。最近一次常规手动办公室血压（149.5（SD 10.8）/81.4（8.3））高于自动办公室血压（135.6（17.3）/77.7（10.9））（P
Objective To compare the quality and accuracy of manual office blood pressure and automated office blood pressure using the awake ambulatory blood pressure as a gold standard.Design Multi-site cluster randomised controlled trial.Setting Primary care practices in five cities in eastern Canada.Participants 555 patients with systolic hypertension and no serious comorbidities under the care of 88 primary care physicians in 67 practices in the community.Interventions Practices were randomly allocated to either ongoing use of manual office blood pressure (control group) or automated office blood pressure (intervention group) using the BpTRU device. The last routine manual office blood pressure (mm Hg) was obtained from each patient's medical record before enrolment. Office blood pressure readings were compared before and after enrolment in the intervention and control groups; all readings were also compared with the awake ambulatory blood pressure.Main outcome measure Difference in systolic blood pressure between awake ambulatory blood pressure minus automated office blood pressure and awake ambulatory blood pressure minus manual office blood pressure.Results Cluster randomisation allocated 31 practices (252 patients) to manual office blood pressure and 36 practices (303 patients) to automated office blood pressure measurement. The most recent routine manual office blood pressure (149.5 (SD 10.8)/81.4 (8.3)) was higher than automated office blood pressure (135.6 (17.3)/77.7 (10.9)) (P