Use of automated home blood pressure monitoring in pregnancy: Is it safe?
Use of automated home blood pressure monitoring in pregnancy: Is it safe?
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DOI：
10.1067/mob.2002.126847
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发表时间：
2002-11-01
影响因子：
9.8
通讯作者：
North, RA
中科院分区：
文献类型：
--
作者：
Lo, C;Taylor, RS;North, RA
目的：探讨日本东京欧姆龙HEM-705CP全自动血压计测量的血压与正常血压和子痫前期孕妇血压值的关系。研究设计：对101例健康孕妇分别在妊娠10~14周、19~22周、27~30周、35~37周及产后5~9周进行血压监测。在助产士常规的汞血压记录后，先兆子痫妇女(n=45名妇女)使用欧姆龙HEM-705CP监测仪(n=212次记录)测量自己的血压。在纵向队列中，计算怀孕期间血压水平的平均值+/-2SD。研究人员测定了怀孕期间居家欧姆龙减去办公室汞的个体差异。在先兆子痫患者中，两种方法测量的背靠背血压被关联并量化为5、10和15毫米汞柱。结果：在妊娠10~14周、19~22周、27~30周、35~37周时，欧姆龙HEM-705CP监护仪测量的正常收缩压上限分别为132、130、133、138 mm Hg，舒张压上限分别为82、79、81、88 mm Hg。对于血压正常并患有先兆子痫的女性(尽管汞血压计和欧姆龙HEM-705CP监测仪的组平均血压值相似)，两种设备之间存在显著的个体差异(！40 mm Hg)。在先兆子痫患者中，配对欧姆龙监护仪和水银收缩压和舒张压水平分别为47%、73%和82%，在5、10和15毫米汞范围内，分别为56%、78%和92%。欧姆龙血压计发现了90%的轻度高血压(140/90 mm Hg)，但通过水银血压计漏掉了血压水平为>；160/100 mm Hg的高血压的三分之一。结论：临床医生应该意识到水银血压计和欧姆龙HEM-705CP血压计测量妊娠期血压的潜在差异。欧姆龙HEM-705CP监护仪不应用于监测子痫前期患者的高血压。
OBJECTIVE: The purpose of this study was to investigate the relationship between blood pressure that is measured with the automated blood pressure monitor, Omron HEM-705CP (Omron Corporation, Tokyo, Japan), and mercury sphygmomanometry in normotensive and preeclamptic pregnant women.STUDY DESIGN: Healthy pregnant women (n = 101 women) underwent mercury and home Omron HEM-705CP monitor blood pressure measurements at 10 to 14, 19 to 22, 27 to 30, and 35 to 37 weeks of gestation and 5 to 9 weeks after delivery. After routine mercury blood pressure recordings that were taken by midwives, women with preeclampsia (n = 45 women) measured their own blood pressure using an Omron HEM-705CP monitor (n = 212 recordings). In the longitudinal cohort, mean +/- 2 SD were calculated for blood pressure levels throughout pregnancy. Individual variation in home Omron minus office mercury throughout pregnancy was determined. In preeclampsia, back-to-back blood pressure measurements by the two methods were correlated and quantified as being within 5, 10, and 15 mm Hg. Bland-Altman plots were calculated, and the sensitivity of the Omron HEM-705CP monitor to detect hypertension that was identified by mercury sphygmomanometry was evaluated.RESULTS: At 10 to 14, 19 to 22, 27 to 30, and 35 to 37 weeks of gestation, the upper limits for normal systolic blood pressure levels with the use of home Omron HEM-705CP monitor measurements were 132, 130, 133, and 138 mm Hg and for diastolic blood pressure levels were 82, 79, 81, and 88 mm Hg, respectively. For women who were normotensive and had preeclampsia (although group mean blood pressure values by mercury sphygmomanometry and Omron HEM-705CP monitor were similar), there were marked individual differences (! 40 mm Hg) between the devices. In preeclampsia, paired Omron monitor and mercury systolic and diastolic blood pressure levels were within 5, 10, and 15 mm Hg in 47%, 73%, and 82%, and 56%, 78%, and 92%, respectively. The Omron monitor identified > 90% of mild hypertension (140/90 mm Hg) but missed one third of hypertension with a blood pressure level of > 160/100 mm Hg by mercury sphygmomanometry.CONCLUSION: Clinicians should be aware of the potential differences between blood pressure measurements with mercury sphygmomanometers and Omron HEM-705CP monitors in pregnancy. The Omron HEM-705CP monitor should not be used to monitor hypertension in preeclampsia.