2021年9月27日

没有比家更适合测量血压的地方了

Patient-preferences-for-monitoring-blood-pressure_2col.jpg

bwin国际活动 led by KPWHRI’s 贝弗利绿色 finds that patients prefer at-家庭监控 of blood pressure 

Adults who needed to track their blood pressure regularly to confirm or refute a hypertension diagnosis preferred monitoring blood pressure at home versus at a clinic, 亭, 或者24小时可穿戴设备, according to new research presented at the American Heart Association’s Hypertension 2021 conference, the premier scientific meeting focusing on recent advances in basic and clinical research on high blood pressure.

According to the American Heart Association, about 1 in every 2 U.S. 成年人有高血压或高血压. 超过三分之一的成年人可能不知道自己患有此病. High blood pressure is defined as having a systolic pressure (the top number in a reading) of 130 or higher, 或者舒张压(底部数字)为80或更高.

“Most hypertension is diagnosed and treated based on blood pressure measurements taken in a doctor’s office, 即使美国.S. Preventive Services Task Force and the American Heart Association recommend that blood pressure measurements be taken outside of the clinical setting to confirm the diagnosis before starting treatment,该bwin国际活动的主要作者说 贝弗利绿色,医学博士 英里每小时, senior investigator at bwin必赢移动版健康bwin国际活动所 and family physician at bwin必赢移动版 in Seattle. “It is the standard that blood pressure monitoring should be done either using home blood pressure monitoring or 24-hour ambulatory blood pressure monitoring prior to diagnosing hypertension.”

24小时动态血压监测装置, 日日夜夜戴着,连续记录血压读数, are generally considered the “gold standard” for out-of-office measurement to determine a diagnosis of high blood pressure. 然而, 用家用仪器测量血压, 用传统的血压袖带, 是否有更实用、更方便的方法.

Green and colleagues studied adherence to and acceptability of different blood pressure measuring methods among 510 adults who had elevated blood pressure yet had not been diagnosed with high blood pressure. They were participants in the Blood Pressure Checks for Diagnosing Hypertension (BP-CHECK) trial. Participants in the study were an average age of 59 years old; 75% were non-Hispanic white, 7%的非裔美国人, 6%的亚洲, 5%拉美裔白人, and 7% other; half were male; and the average blood pressure was 150/88. 他们没有服用降压药.

Participants were randomly assigned to 1 of 3 groups for determining a new diagnosis of hypertension: clinic measurements, 家庭监控, 或者是血压监测站.

Those in the group for clinic measurements were asked to return to the clinic for at least one additional blood pressure check, 这是临床上诊断高血压的常规方法. 家庭组收到了家庭血压仪, 训练过如何使用它们吗, and were asked to take their blood pressure twice a day with 2 measurements each time, 5天, 总共20次测量. The 亭 group was asked to take their blood pressure at a 亭 in their clinic or at a nearby pharmacy on 3 separate days, 每次测量3次, 总共9次测量. All participants were asked to complete their group-assigned diagnostic regimens within 3 weeks, and then to complete 24-hour ambulatory blood pressure monitoring.

bwin国际活动人员 measured adherence to monitoring by noting the percent of individuals in each group who completed their assigned measurement method as instructed. 他们用问卷调查来衡量接受度.

他们发现:

  • Overall acceptability was highest for the at-home group, followed by the clinic and 亭 groups. Twenty-four-hour ambulatory blood pressure monitoring was the least acceptable option.
  • Participants were least likely to adhere to the monitoring regimen in the 亭 group. Adherence was more than 90% among those in the home-testing group, 临床组超过87%, 接近68%的人选择了自助服务亭, and 91% for 24-hour ambulatory monitoring among all participants.

“首页 blood pressure monitoring was the most preferred option, 因为它很方便, 容易做到, 没有严重扰乱他们的日常生活或工作吗, 并且被认为是准确的,“绿色表示. “Participants reported that ambulatory blood pressure monitoring disturbed daily and work activities, 中断睡眠, 和不舒服.”

When asked which diagnostic testing regimen they would prefer, 超过一半的人选择了家庭血压监测, 特别是如果他们被分配到家庭小组, 几乎80%的人更喜欢家庭监控.

Green suggests health care professionals routinely offer home blood pressure monitoring to their patients with elevated blood pressure. 这可能包括提供家用血压计, 训练患者, and collecting and averaging several days of blood pressure readings.

“Health care professionals should work toward relying less on in-clinic visits to diagnose hypertension and supporting their patients in taking their blood pressure measurements at home,“绿色表示. “首页 blood pressure monitoring is empowering and improves our ability to identify and treat hypertension, 防止中风, 心脏病发作, 心脏衰竭, 和心血管死亡.”

这项bwin国际活动的局限性在于参与者主要是白人, which is not representative of all people who have high blood pressure. 根据美国心脏协会的统计数据, about 50% of white and Hispanic men and 40% of white and Hispanic women have high blood pressure, 而58%的黑人男性和女性都有.​​​​​​

合著者是 梅丽莎·安德森,女士; 詹妮弗·麦克卢尔博士; Matthew Thompson, MBChB, 英里每小时, DPhil; Kelly Ehrlich, MS; Yoshio Hall, MD, MS; Karen L Margolis, MD, 英里每小时; and Dwayne Joseph.

The study was funded by the Patient Centered Outcomes bwin国际活动 Institute (PCORI).

该系

梅丽莎·L. 安德森女士

生物统计学家三世
bwin必赢移动版健康bwin国际活动所

詹妮弗·B. 麦克卢尔博士

学院bwin国际活动主任 & Development; 高级调查员
bwin必赢移动版健康bwin国际活动所

bwin国际活动

BP-Check-blood-pressure-in-clinic-Bev-Green_1col.jpg

新的bwin国际活动发现了高血压诊断中的缺陷

KPWHRI investigator’s recent AHA presentations highlight problems in blood pressure readings.

新闻

bp-check-team_1col.jpg

Diagnosing high blood pressure: Who knew it could be so complicated?

高血压是众所周知的健康风险. 但是诊断它是很有挑战性的. With patient advisors, the BP-CHECK study aims to find an easier way.

bwin国际活动

Bev_Green-1col.jpg

How a physician-scientist studying blood pressure became a patient too

Dr. 贝弗利绿色, PCORI-funded BP-CHECK领袖, reflects on her professional interest in hypertension getting up close and personal.