不同测量方法的血压变异性,Medicine

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不同测量方法的血压变异性
Medicine ( IF 1.3 ) Pub Date : 2019-07-01 , DOI: 10.1097/md.0000000000016347
Rosaria Del Giorno ₁ , Lorenzo Balestra ₁ , Pascal Simon Heiniger ₂ , Luca Gabutti _{1,

3}

Affiliation

摘要血压变异性（BPV）是高血压患者的独立心血管危险因素。量化 BPV 的最佳方法仍然是一个争论的对象。假设存在不同的 BPV 模式，特别是与年龄和动脉僵硬度相关的。我们的目标是：i) 使用不同的血压 (BP) 测量方法比较 BPVii) 比较不同的计算方法iii) 分析 BPV 的预测因子。108 例老年高血压住院患者的横断面研究。每位患者接受了 5 种不同方式的血压测量：24 小时血压和脉搏波速度 (PWV) 监测 (24hBPM)、护士或医生测量、自我测量和逐搏监测。最大值和最小值之间的差异（ΔBP），计算连续值 (ARV) 和变异系数 (CV) 之间的绝对差的平均值。ΔBP 显示出更广泛的值分散（Δ 收缩压 (SBP)：66.4 ± 22.9 和 Δ 舒张压 [DBP]：45.0 ± 13.5 mmHg）。ARV 和 CV 在护士测量值中最高（SBP-ARV 9.2 ± 6.2；DBP-ARV 6.9 ± 5.2；SBP-CV 7.6 ± 5.3；DBP-CV 9.6 ± 5.5）。比较医生的 SBP 测量值和 24hBPM ARVs 发现最强的相关性 (R2 0.23, P <.05)。多变量分析中的 24hBPM ΔSBP 与年龄 (β -3.85, SE 0.83; P <.001) 和 PWV (β 20.29, SE 3.70; P <.001) 显着相关。钙拮抗剂与较低的 ΔSBP 相关（β -14.6，SE 6.1，P <.05），而利尿剂和 α 受体阻滞剂显着增加（β 14.4 SE 5.4，P <.01；β 26.9 SE 11.7，P <.05）。 05)。年龄，PWV、利尿剂、α-受体阻滞剂以及护士获得的测量值会增加血压变异性，而钙拮抗剂会降低它。老年住院患者的血压曲线可能提供重要信息；但是，应谨慎解释它们。

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Blood pressure variability with different measurement methods

Abstract Blood pressure variability (BPV) is an independent cardiovascular risk factor in hypertensive patients. The best method for quantifying BPV is still an object of debate. The existence of different BPV patterns, particularly age and arterial stiffness related, is postulated. Our aims were: i) to compare BPV using different blood pressure (BP) measurement methodsii) to compare different calculation approachesiii) to analyze the predictors of BPV. Cross-sectional study in 108 elderly hypertensive hospitalized patients. Each patient underwent blood pressure measurements with 5 different modalities: 24 hour BP and pulse wave velocity (PWV) monitoring (24hBPM), measurement by nurses or physicians, self-measurement and beat-to-beat monitoring. Differences between maximum and minimum values (ΔBP), averages of the absolute differences between consecutive values (ARV) and coefficients of variation (CV) were calculated. ΔBP showed the wider values’ dispersion (Δ systolic blood pressure (SBP): 66.4 ± 22.9 and Δ diastolic blood pressure [DBP]: 45.0 ± 13.5 mmHg). ARV and CV were highest with nurses’ measurements (SBP-ARV 9.2 ± 6.2; DBP-ARV 6.9 ± 5.2; SBP-CV 7.6 ± 5.3; DBP-CV 9.6 ± 5.5). The strongest correlation was found comparing physicians’ SBP measurements and 24hBPM ARVs (R2 0.23, P <.05). 24hBPM ΔSBP in a multivariate analysis was significantly associated with age (β −3.85, SE 0.83; P <.001) and PWV (β 20.29, SE 3.70; P <.001). Calcium antagonists were associated with a lower ΔSBP (β −14.6, SE 6.1, P <.05) while diuretics and alpha-blockers with a significant increase (β 14.4 SE 5.4, P <.01; β 26.9 SE 11.7, P <.05). Age, PWV, diuretics, alpha-blockers, but also measurements obtained by nurses, increase BP variability while calcium antagonists reduce it. BP profiles in elderly in-hospital patients potentially provide important information; they should, however, be interpreted cautiously.

更新日期：2019-07-01

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