家庭自测血压的可靠性

目的 通过对3种血压测量方法 进行比较,为家庭自测血压用于临床和科研积累经验和科学数据.方法 利用"代用盐对高血压患者及其家庭成员降压效果随机双盲对照试验研究"中收集的同一研究对象(n=220)不同方法 获得血压(门诊血压、家庭自测血压和动态血压)测量数据,以动态血压数据作为参照,比较家庭血压及门诊血压与动态血压的一致性.干预前,217人3种血压测量方法 数据均合格;干预结束时,189人3种血压测量方法 数据均合格;将干预前和干预结束时测量合格的数据合并分析(n=406).利用Bland-Altman对3种测量方法 测得的血压水平进行组内一致性检验,并进行Person相关性分析;利用McNemar卡方检验比较3种方法 的个体内一致率.结果 门诊血压、动态血压和家庭自测血压3种方法 测得的血压水平(收缩压/舒张压)分别为(149.5±16.4)/(87.2±9.5)、(137.8±17.1)/(83.2±10.3)和(138.0±14.2)/(82.4±9.3)mm Hg.家庭血压与动态血压的相关性优于门诊血压与动态血压的相关性,相关系数(收缩压/舒张压)分别为(0.55/0.62)和(0.36/0.46).以动态血压为参照,家庭自测血压水平与动态血压(收缩压/舒张压)差异无统计学意义(-0.2/-0.7 mm Hg,P＞0.05),而门诊血压水平显著高于动态血压水平(11.7/4.0 mm Hg,P＜0.05);家庭自测血压的收缩压个体内差异显著优于门诊血压(≤|5| mm Hg为28.3% vs 16.5%,P＜0.05;≤|10| mm Hg为49.7% vs 33.5%,P＜0.05),舒张压个体差异略高于门诊血压,但差异无统计学意义(P＞0.05).结论 与动态血压测量值相比,家庭自测血压比门诊血压更准确.     

老年隐性高血压患者家庭自测血压变异性与颈动脉粥样硬化的相关性

目的探讨老年隐性高血压患者家庭自测血压变异性与颈动脉粥样硬化及尿微量白蛋白(MAU)的关系。方法选择老年体检者197例,根据受试者诊室血压及7d家庭自测血压测定结果,将受试者分为血压正常组62例、隐性高血压组62例及高血压组73例。所有受试者均进行颈动脉内膜中层厚度(IMT)、硬化系数β值及MAU检测。结果隐性高血压组和高血压组诊室收缩压、自测收缩压、自测舒张压、收缩压变异性、舒张压变异性、IMT、硬化系数β值、MAU明显高于血压正常组(P<0.05,P<0.01);隐性高血压组诊室收缩压、诊室舒张压、自测收缩压、硬化系数β值明显低于高血压组(P<0.05,P<0.01)。隐性高血压患者自测血压变异性与IMT、硬化系数β值及MAU呈正相关。收缩压变异性是IMT、硬化系数β值及MAU的独立影响因素。结论老年隐性高血压患者家庭自测血压变异性升高,并与颈动脉粥样硬化及MAU相关。     

老年轻中度原发性高血压患者家庭自测血压变异与冷加压试验的相关性

目的探讨老年轻中度原发性高血压患者家庭自测血压变异与冷加压试验的相关性。方法于2012年5月~2013年8月自山东省临沂市兰山区高血压社区管理的高血压患者中,筛选老年轻中度原发性高血压患者259例,所有入选受试者均进行7d家庭血压自测,计算后6d连续的收缩压及舒张压变异性相关指标及平均心率;采用冷加压试验以刺激全身交感神经兴奋,并将冷加压试验阳性作为阳性组116例,冷加压试验阴性作为阴性组143例。结果阳性组早间舒张压、收缩压标准差、舒张压标准差、最高收缩压、最高舒张压、早-晚收缩压差、早-晚舒张压差、最高-最低收缩压差、最高-最低舒张压差,平均心率均高于阴性组(P<0.05)。阳性组晚间收缩压、晚间舒张压低于阴性组(P<0.05)。回归分析显示,即刻及60s收缩压变化幅度始终是影响收缩压标准差、舒张压标准差、早-晚收缩压差、早-晚舒张压差、最高-最低收缩压差及最高-最低舒张压差的主要因素。结论老年轻中度原发性高血压患者的家庭自测血压变异与冷加压试验反应相关,冷加压试验反应越强,血压变异越大。     

预约就诊对诊室血压测量值的影响

目的 探讨预约就诊对诊室血压测量值的影响。方法 连续选取2015年1月至2016年6月间于郑州大学人民医院心内科门诊就诊的符合入组条件的患者869例,按照是否预约就诊分为2组,采用T检验比较诊室内血压值与家庭自测血压值组间的差异,并采用有序多分类Logistic回归分析进行相关影响因素分析。结果 1.诊室收缩压及舒张压测量值均高于家庭自测舒张压及收缩压测量值（141.97±19.94 mmHg vs 132.07±16.38 mmHg,P＜0.01;87.50±13.38mmHg vs 83.50±12.09mmHg,P＜0.01）;2.未预约就诊组患者诊室内收缩压（OSBP）及其与家庭自测收缩压（HSBP）的差值绝对值（|△SBP|）的平均值均明显高于预约就诊组（143.47±20.36mmHg vs 140.03±16.09mmHg,P＜0.01;13.54±13.87mmHg vs 8.52±12.06 mmHg,P＜0.01）。有序多分类Logistic回归分析提示,在校正年龄、性别、心率、BMI等因素后,预约就诊（OR=0.532,95%CI 0.403～0.704）与|△SBP|相关。结论 1.诊室收缩压及舒张压测量值均高于家庭自测值;2.预约就诊可减少OSBP测量值与HSBP的差异。     

家庭自测血压管理对老年高血压病人血压控制和改善生活质量的效果分析

目的探讨家庭自测血压管理对老年高血压病人血压控制的干预效果。方法收集362例老年高血压病人,随机分为2组,每组181例。家庭自测血压组进行家庭自测血压干预6月,每日定时测量3次,每周门诊测量血压1次,血压140/90 mm Hg视为达标,对照组未进行家庭自测血压。记录干预期间病人高血压并发症的发生情况。干预前后分别进行病人生活质量评分,并在干预后进行依从性评分。结果研究结束时,家庭自测血压组还有病人160例,对照组有168例。干预后,家庭自测血压组的收缩压(P=0.011)、舒张压(P=0.038)较对照组显著降低,血压达标率显著高于对照组(P0.001),并发症发生率显著低于对照组(P0.001)。干预后,家庭自测血压组病人的遵医行为、服药行为、日常生活管理、烟酒嗜好以及总评分显著高于对照组(P0.05);生活质量评分结果提示,其生理机能、心理职能、一般健康状态、精神健康评分亦高于对照组(P0.05)。结论家庭自测血压是协助降压治疗的有效手段,可提高病人依从性,减少并发症发生,提高病人生活质量。     

电子血压计与水银血压计重复测量血压的研究

目的比较电子血压计与水银血压计重复测量的稳定性,评价吴博士RG-BPⅡ5800型脉搏波电子血压计准确性。方法使用标准台式水银血压计与吴博士RG-BPⅡ5800型电子血压计对270名受试者同臂同步重复连续测量血压5次,比较两种血压计测量的数值的差异以及合适测量次数。结果以水银血压计测量值为参照,电子血压计偏差为0.8 mm Hg/0.2 mm Hg(收缩压/舒张压),电子血压计测量值偏差的标准差为4.5 mm Hg/6.2 mm Hg(收缩压/舒张压)。心力衰竭患者使用电子血压计测量时舒张压值低于水银血压计1.0 mm Hg(P=0.036)。在测量收缩压时,电子血压计测得前三次的数值呈递减趋势,从第三次开始数值趋于稳定,水银血压计测得第一次数值高于后四次测量数值,后四次数值变化趋势不稳定,差异有统计学意义(均为P<0.05)。在测量舒张压时,电子血压计第一次数值高于后四次测量数值,水银血压计五次测量值之间差异无统计学意义(均为P<0.05)。结论吴博士RG-BPⅡ5800型脉搏波电子血压计测量血压具有较好的准确性,在临床应用中可代替水银汞柱血压计使用,心力衰竭的患者使用脉搏波电子血压计测量血压时收缩压读数相差1 mm Hg以内,电子血压计重复测量收缩压稳定性较水银血压计好。     

食堂按人限量投放食盐对就餐者血压影响的研究

目的探讨集体食堂就餐者膳食含盐量与血压的相关性,通过食堂按人限量投放食盐,减少人均食盐量,降低就餐者血压水平,能否减低高血压患病率.方法第一阶段,整群抽取驻哈尔滨市某部队9个食堂,全体就餐人员,统计每个食堂2日6餐投放的食盐量及食用的酱菜量与当日就餐人数,计算人均日消耗食盐量.选用经培训后的调查员在调查日消耗盐量的同日早餐、晚餐前赴食堂,为全部就餐者测量血压并记录.按各食堂分组统计日人均投放食盐量与血压,全部数据输入计算机,进行显著性与相关性检验.第二阶段,向卫生行政部门通报调查结果.通过卫生队对部队进行健康教育,自觉的接受合理膳食.对各食堂炊事人员进行日消耗食盐量计算培训,限定人均食盐量,按平日人均9g,强化体能训练时12g标准投放烹饪食盐.第三阶段,于次年同月按前述方法测量9个食堂就餐者血压并记录,进行统计分析.结果限盐前9个食堂就餐者年龄、性别、入伍时间、生活环境一致,日平均食用食盐量9.01～24.6g,两日全部6餐均在食堂就餐并测量血压者578人,血压≥140/90 mm Hg者21人(3.6%),其中最高收缩压165 mm Hg分布在第9组,最高舒张压110mm Hg分布在第8组,各组日人均摄入食盐量差异有显著性P＜0.01,各组间收缩压差异显著P＜0.01.各组间舒张压差异有显著性P＜0.01.日人均摄入食盐量与收缩压及舒张压水平显著相关P＜0.01.限盐后调查人员与对象基本同前,调查人数613例,全年日平均食用食盐量9.0～12.0g,测其血压≥140/90 mm Hg者16人(2.6%),虽然各组日人均摄入食盐量一致,因8、9组有高血压患者分布,平均血压仍高于其他组,但血压较限盐前收缩压与舒张压均有显著性的降低,P＜0.05.各组平均收缩压由(116.2±9.3)mm Hg降至(108.4±8.6)mm Hg,平均舒张压由(69.1±7.4)mm Hg降至(63.4±6.2)mm Hg,血压≥140/90 mm Hg者由21人(3.6%)降至16人(2.6%).日人均摄入食盐量与收缩压及舒张压水平显著相关P＜0.01.结论通过集体控制膳食盐量,可降低人群的平均血压水平,达到减低高血压发病率的目的.建议卫生主管部门对集体食堂、社区食品店、餐馆等大众集体就餐单位从业人员进行减盐教育与管理.广泛进行健康教育,提高人群营养知识,接受减少食盐摄入量,自觉的接受合理膳食,从而降低高血压患病率.     

老年人群体位性高血压的变异性

目的评估个体体位性高血压单日内和连续周间、相隔1年的变异性。方法 2013年6~7月对广东省佛山市某街道3所老人院居住者162例进行调查,年龄60~98岁。以站立3 min时收缩压(SBP)升高≥20 mm Hg和(或)舒张压(DBP)升高≥10 mm Hg判断为体位性高血压。第1天测量4次体位性血压,第8、15天、1年后分别测量1次体位性血压。结果直立后3 min SBP变化均值为10.0 mm Hg,极差101 mm Hg,四分位数间距18 mm Hg,标准差为14.5 mm Hg,变异系数(CV)为145.0%。第1天4次测量符合1次,2次,3次,4次体位性高血压标准的患者依次有32例,35例,17例,25例。相隔1 w 3次测量符合1次,2次,3次体位性高血压标准的患者依次有41例,34例,22例。112例居民1年后复测体位性血压变化,32例(28.6%)存在体位性高血压,其中12例在1年前第1天测量达到体位性高血压标准。结论个体体位性高血压变异大,多次测量对确定个体体位性高血压是必需的。     

家庭自测清晨血压对社区老年高血压患者的管理意义观察

目的研究家庭自测清晨血压在社区老年高血压患者中的应用价值。方法以2015年01月-2016年01月我院门诊部就诊的100例高血压病患为研究对象,并利用电脑随机双盲法将之随机分成观察组、对照组两组,各组均50例。两组都予以常规降压治疗+健康教育,观察组同时加用家庭自测清晨血压法。观察两组的血压改善情况,比较血压达标率等指标。结果观察组干预1年后的舒张压、收缩压分别是(80.9±7.5)mm Hg、(136.1±5.9)mm Hg,对照组是(85.3±9.0)mm Hg、(143.8±6.4)mm Hg。观察组明显低于对照组,P0.05。观察组清晨血压达标率、门诊血压达标率与患者满意度均明显高于对照组,P0.05。结论于社区老年高血压中合理引入家庭自测清晨血压法,可显著提高患者血压控制的效果。     

家庭自测血压的可靠性

目的通过对3种血压测量方法进行比较，为家庭自测血压用于临床和科研积累经验和科学数据。方法利用“代用盐对高血压患者及其家庭成员降压效果随机双盲对照试验研究”中收集的同一研究对象（n=220）不同方法获得血压（门诊血压、家庭自测血压和动态血压）测量数据，以动态血压数据作为参照，比较家庭血压及门诊血压与动态血压的一致性。干预前，217人3种血压测量方法数据均合格；干预结束时，189人3种血压测量方法数据均合格；将干预前和干预结束时测量合格的数据合并分析（n=406）。利用Bland-Altman对3种测量方法测得的血压水平进行组内一致性检验，并进行Person相关性分析；利用McNemar卡方检验比较3种方法的个体内一致率。结果门诊血压、动态血压和家庭自测血压3种方法测得的血压水平（收缩压／舒张压）分别为（149，5&#177;16．4）／（87．2&#177;9，5）、（137．8&#177;17．1）／（83．2&#177;10．3）和（138．O&#177;14，2）／（82．4&#177;9．3）mmHg。家庭血压与动态血压的相关性优于门诊血压与动态血压的相关性，相关系数（收缩压／舒张压）分别为（0.55／0.62）和（0.36／0.46）。以动态血压为参照，家庭自测血压水平与动态血压（收缩压／舒张压）差异无统计学意义（-0.2／-0.7mmHg，P〉0.05），而门诊血压水平显著高于动态血压水平（11．7／4．0mmHg，P〈0.05）；家庭自测血压的收缩压个体内差异显著优于门诊血压（≤｜5｜mmHg为28．3％vs16．5％，P〈0.05；≤｜10｜mmHg为49．7％vs33．5％，P〈0.05），舒张压个体差异略高于门诊血压，但差异无统计学意义（P〉0.05）。结论与动态血压测量值相比，家庭自测血压比门诊血压更准确。     

Weekly Variation of Home and Ambulatory Blood Pressure and Relation Between Arterial Stiffness and Blood Pressure Measurements in Community-Dwelling Hypertensives

Although blood pressure (BP) is a major determinant of pulse wave velocity (PWV), some treatments have independent effects on BP and arterial stiffness. Although both ambulatory BP (ABP) and self-measured BP at home (HBP) have become important measures for the diagnosis and management of hypertension, single day recordings may be insufficient for a proper diagnosis of hypertension or the evaluation of treatment efficacy. To evaluate weekly variations in BP using 7-day HBP and 7-day ABP monitoring and to determine the relation between arterial stiffness and BP measurements in community-dwelling patients with hypertension. We enrolled 68 community-dwelling hypertensive subjects in this study. Significant weekly variations in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were found in the awake ABP data (p < .01, respectively), while no significant weekly variations in the asleep ABP or the morning and evening HBP data were observed. In untreated subjects, significant correlations were obtained between the brachial-ankle PWV and the average awake SBP, the average asleep SBP and the average SBP measured by HBP in the evening. In treated subjects, only the average SBP measured by HBP in the morning was significantly correlated with the baPWV. Differences in the weekly variations in BP were observed between HBP and ABP monitoring. In addition, the morning systolic HBP was not correlated with arterial stiffness in untreated subjectswith hypertension but was correlated in treated subjects. Relations between the morning HBP and arterial stiffness might be attributed to morning surges in BP and/or trough levels of antihypertensive drugs.     

Blood pressure control and cardiovascular risk in hypertensive patients with type 2 diabetes: The German T2Target registry

Blood pressure control in patients with type 2 diabetes and hypertension is poor. It is unclear how effectively general practitioners assess and treat such patients. T2Target included hypertensive patients with type 2 diabetes mellitus who had undergone ambulatory blood pressure monitoring within the past 3 months. Recordings were analyzed by the general practitioner and an independent center and the conclusions were compared. Nighttime hypertension was reported less frequently by the general practitioner in comparison with central assessment (43.9% vs 77.9%, P<.001), as were masked (4.0% vs 13.1%, P<.001) and isolated office (4.4% vs 8.8%, P<.001) hypertension. A total of 13.9% of patients were deemed to have controlled blood pressure (ambulatory blood pressure monitoring). For the 784 patients with uncontrolled blood pressure, 40.7% underwent no change to their antihypertensive treatment. Cardiovascular risk was underestimated, with 11.1% deemed to be at very high risk, in contrast to the 97.0% of patients by central assessment. In conclusion, blood pressure control in hypertensive patients with type 2 diabetes mellitus is poor and not accurately assessed by office‐based general practitioners, despite the use of ambulatory blood pressure monitoring.     

Poor Blood Pressure and Urinary Albumin Excretion Responses to Home Blood Pressure-Based Antihypertensive Therapy in Depressive Hypertensive Patients

J Clin Hypertens (Greenwich). There has been no report comparing the changes in home blood pressure (HBP) and target organ damage between depressive and nondepressive hypertensives receiving antihypertensive therapy based on HBP monitoring. This study was a multicenter prospective study conducted by 7 doctors at 2 institutions. The authors prospectively studied 42 hypertensive patients with home systolic blood pressure >135 mm Hg. Participants were divided into a depression group (Beck Depression Inventory score >10; n=21) and a nondepression group (Beck Depression Inventory score <9, matched for HBP level; n=21). The authors performed antihypertensive therapy to reduce home systolic blood pressure to below 135 mm Hg and, 6 months later, evaluated the urinary albumin/creatinine ratio (UACR). Although patients in the depression group tended to require the addition of a greater number of medications than those in the nondepression group (2.3±1.0 vs 1.7±1.0 drugs, P<.05), HBP was reduced similarly in both groups at 6 months (depression group: 150±17/78±11 mm Hg to 139±11/73±8 mm Hg, P<.001; nondepression group: 150±11/76±9 mm Hg to 135±9/70±8 mm Hg, P<.01). The reduction of UACR was smaller in the depression group than in the nondepression group (2.4 vs 10.1 mg/gCr, P<.05). Depressive hypertensive patients required a larger number of antihypertensive drugs to control HBP, and showed a smaller reduction in UACR than nondepressive hypertensives.     

2型糖尿病合并原发性高血压患者的动态血压及脉压和左心室结构功能的关系

目的 :探讨 2型糖尿病 (DM)、原发性高血压 (EH)及DM +EH时 2 4小时动态血压和脉压的变化特点及与左心室结构和功能的关系。　　方法 :将 2 45例患者分为DM组 (n =72 )、EH组 (n =96)及DM +EH组 (n =77) ,进行动态血压及超声心动图检查。　　结果 :DM +EH组全天收缩压、全天脉压、左心室重量显著大于DM组及EH组 (P <0 0 5 )。左心室射血分数、短轴缩短率、舒张早期血流峰值速度 /舒张晚期血流峰值速度 (E/A)值、等容舒张时间 3组间无显著差异。相关分析表明 ,DM组左心室重量和全天脉压相关 (P <0 0 1) ;EH组左心室重量和全天收缩压相关 (P <0 0 5 ) ;DM +EH组左心室重量和全天收缩压及全天脉压相关 (P <0 0 5 )。 3组左心室舒张功能异常患者的全天收缩压、全天脉压均显著高于左心室舒张功能正常患者 (P均 <0 0 5～ 0 0 1) ,左心室的收缩功能正常患者和异常患者比较 ,2 4小时动态血压和脉压值均无显著差异 (P均 >0 0 5 )。　　结论 :DM组、EH组和DM +EH组 3组患者全天收缩压、全天脉压及左心室重量有显著差异 ,左心室重量和血压及脉压的相关性在 3组患者中不完全一致 ,可能与 3组患者体液及压力因素在左心室肥厚中的作用各不相同有关。     

A Home Blood Pressure Monitor Equipped With a Graphic Function Facilitates Faster Blood Pressure Control than the Conventional Home Blood Pressure Monitor

In this study, we evaluated whether antihypertensive therapy using a home blood pressure monitor (HBPM) equipped with a graphic display of weekly and monthly averaged blood pressure (BP) can obtain better BP control than the conventional HBPM. Sixty-five hypertensive outpatients who had HBP >135/85 mm Hg were enrolled by 8 doctors in 2 different hospitals. The patients were randomly assigned either a graph-equipped HBPM (graph-equipped HBPM group; n=33) or an HBPM without the graph function (conventional HBPM group; n=32). The patients were treated with antihypertensive medications targeting HBP <135/85 mm Hg. After 2 months, the home systolic BP level was lower in the graph-equipped HBPM group than in the conventional HBPM group (141.3±15.4 vs 147.7±10.8 mm Hg; P<.05); its reduction was significantly larger in the former group (11.9 vs 5.6 mm Hg; P<.05). Using an HBP device with a graphic display could accelerate the achievement of BP control.     

High-sensitivity C-reactive protein in subjects with type 2 diabetes mellitus and/or high blood pressure

Type 2 diabetes mellitus (DM2) and high blood pressure (HBP) may contribute to the development of cardiovascular disease, and inflammation may be an important factor in these diseases. In the present study, plasma levels of high-sensitivity C-reactive protein (hs-CRP) were measured in subjects with DM2 and/or HBP and compared to those of normal subjects. Eighty-nine subjects were analyzed for hs-CRP, including 13 normotensive patients with DM2, 17 patients with HBP, 34 hypertensive patients with DM2 (DM2+HBP) and 25 normal subjects. The plasma hs-CRP levels were significantly lower in the controls than in the HBP+DM2 group (p < 0.05). DM2 associated with HBP was also correlated with increased plasma hs-CRP levels (n = 89, r = 0.25, p = 0.0162). Only hypertensive patients with DM2 had higher levels of hs-CRP, a circulating inflammatory marker, than normal subjects. This finding suggests that patients with two associated diseases have a more active inflammatory state.     

Pharmacists' Awareness and Attitude Toward Blood Pressure Measurement at Home and in the Pharmacy in Japan

The aim of this study is to investigate the status of Japanese pharmacists' awareness and attitude toward blood pressure (BP) measurement at home (HBP) and in the pharmacy. Of the 708 community pharmacists and the 117 hospital pharmacists, more than 90% of pharmacists answered that HBP was equally important to or more important than clinic BP, 71.9% (community) and 48.7% (hospital) recommended HBP measurement to the hypertensive patients, and about 15% correctly recognized the reference values of HBP hypertension. Among community pharmacists, 54.0% answered that BP-measuring devices were available in their pharmacy. More aggressive promotion of HBP measurement among pharmacists is warranted.     

A Comparison of Web Sites Used to Manage and Present Home Blood Pressure Readings

J Clin Hypertens (Greenwich). 2010;12:389–395. ^©2010 Wiley Periodicals, Inc. Home blood pressure (HBP) monitoring is now recommended as a routine component of blood pressure management in patients with known or suspected hypertension. Over the last few years, a large number of Web sites, commonly termed Personal Health Records, have been developed so that patients can manage and present HBP readings. The objective of this report is to describe and compare these Web sites. A list of 33 desirable Web site features, organized into 4 categories, was developed. Between June and August of 2009, a total of 60 Web sites was identified, of which 20 were free or free to try. Each of the 20 Web sites displayed HBP readings in tabular and graphical formats, most offered an option to print results in tabular (70%) and graphical (70%) form, and many (47%) could download HBP data from Microsoft HealthVault. In contrast, none of the Web sites directly linked with common electronic medical records. Overall, Web sites offered between 41% and 77% of the 33 features considered desirable. In conclusion, there is considerable variation in available features on Web sites used to manage HBP data. Information presented in this report should be useful to physicians and patients in selecting a Web site for managing and presenting HBP readings and ultimately improving blood pressure control.     

Strict Blood Pressure Control Achieved Using an ICT‐Based Home Blood Pressure Monitoring System in a Catastrophically Damaged Area After a Disaster

At the time of the Great East Japan earthquake and tsunami (March 2011), the authors developed a web‐based information and communications technology (ICT)–based blood pressure (BP) monitoring system (the Disaster CArdiovascular Prevention [DCAP] Network) and introduced it in an area that was catastrophically damaged (Minamisanriku town) to help control the survivors' BP. Using this system, home BP (HBP) was monitored and the data were automatically transmitted to a central computer database and to the survivors' attending physicians. The study participants, 341 hypertensive patients, continued to use this system for 4 years after the disaster and all of the obtained HBP readings were analyzed. This DCAP HBP‐guided approach helped achieve a decrease in the participants' HBPs (initial average: 151.3±20.0/86.9±10.2 mm Hg to 120.2±12.1/70.8±10.2 mm Hg) over the 4 years. In addition, the amplitude of seasonal BP variation was suppressed and the duration from the summer lowest HBP values to the winter peak HBP values was gradually prolonged. This ICT‐based approach was useful to achieve strict HBP control and minimize the seasonal BP variation even in a catastrophically damaged area during a 4‐year period after the disaster, suggesting that this approach could be a routine way to monitor BP in the community.     

家庭血压监测的临床应用

血压测量是诊断高血压病的基本手段,目前主要有三种方法评价血压：诊所偶测血压、动态血压监测和家庭血压监测。家庭血压监测方便、经济,已有大量数据表明：与诊所偶测血压相比,家庭血压监测是评估心血管疾病风险的一个更好的预测因子。同时它能改善高血压患者的治疗依从性,有利于血压控制,监测降压药物疗效,减少医疗费用。另外对鉴别白大衣高血压和隐性高血压也很有帮助。