269例高血压患者家庭血压自测值与诊断测量值的比较分析

Analysis on home blood pressure monitoring in 269 patients with hypertension:comparison with clinic's value

目的探讨高血压患者家庭自测血压和诊所测量的差异,为高血压的控制提供参考。方法对北京市利康医院2015年1月—10月接收的正在服用降压药的269例高血压患者进行家庭自测血压指导和诊所血压测量,家庭自测血压为3 d及以上并患者最后2 d读数的均值,诊所测量血压为患者最近两次就诊时测量血压读数的均值。应用调查问卷收集患者的基本信息,计算血压控制正常、隐蔽性高血压、白大衣高血压及血压未控制的比例并进行相应的患者信息的比较分析。结果家庭测量和诊所测量的收缩压和舒张压的差异有统计学意义(P<0.05);血压控制正常、隐蔽性高血压、白大衣高血压和血压未控制的比例为26.0%、19.0%、23.8%和31.2%;年龄、体质量指数在四组间不完全相同(P<0.05)。结论家庭自测血压在一定程度上可以筛查出隐蔽性高血压及白大衣高血压,帮助患者及医师对病情的认识及判断。

Objective To explore the difference of blood pressure tested out clinic and within clinic in order to provide reference on control of hypertension. Methods About 269 hypertensive patients receiving antihypertensive treatment were obtained from Beijing LiKang hospital from January to October,2015 enrolled in this study. They were taught the gnidanee on home blood pressure set-measurey and got the clinic blood pressure measurey. The average of the last two days＂ home blood pressure,which measured at least three days,was taken as the home blood pressure value and the average of blood pressure measured by the doctors in the last two visits was taken as the clinic blood pressure value. The information on patients was collected by questionnaire. The rates of controlled hypertension,masked uncontrolled hypertension,treated white-coat hypertension and uncontrolled hypertension was calculated and the comparative analysis between the four groups was done. Results The systolic and diastolic blood pressure between home measurement and clinic measured value were with significant difference（P〈0.05）. The rates of controlled hypertension,masked uncontrolled hypertension,treated white- coat hypertension and uncontrolled hypertension were 26.0%,19.0%,23.8% and 31.2% respectively. Age and body mass index were not identical within the four groups. Conclusion To some extent,home blood pressure measurement could help to conceal the masked uncontrolled hypertension and treated white-coat hypertension and help patients as well as doctors understand and diagnose hypertension.