Ambulatory blood pressure monitoring: validation of the accuracy and reliability of the TM-2420 according to the AAMI recommendations

The accuracy of the TM-2420 ambulatory blood pressure monitor (A&D Co, Japan) has been assessed by the indirect method according to the recommendations of the Association for the Advancement of Medical Instrumentation (AAMI). Ninety subjects (43 men and 47 women), aged 19-89 with a range of systolic blood pressures (SBP) of 81-211 mmHg and diastolic blood pressures (DBP) of 32-113 mmHg were studied. The monitor was compared with two observers using the Hawksley random zero sphygomomanometer. The standard deviation of the difference (SDD) between the observers was 3.0 mmHg for SBP and 2.3 mmHg for DBP. The mean differences between observers were -0.31 mmHg for SBP and 0.32 mmHg for DBP (both NS). The average of three readings for each subject recorded by the monitor was compared with the average of the simultaneous readings by the observers. The SDD was 7.2 mmHg for SBP and 5.5 mmHg for DBP (within the recommendations for accuracy). The differences between methods were -0.98 mmHg for SBP and 0.18 mmHg for DBP; these differences were not significant (NS). The monitor was also assessed against direct intra-brachial artery pressure in 12 subjects (36 readings). The mean difference between the monitor and simultaneous individual intra-arterial reading was -9.5 mmHg for SBP (P less than 0.001) and 3.7 mmHg for DBP (P less than 0.001). The SDD's between methods were 12 mmHg for SBP and 5.0 mmHg for DBP. Use of the monitor in general clinical practice in 100 patients was also assessed. The rate of errors was low (6.8%), and the device found to be acceptable.(ABSTRACT TRUNCATED AT 250 WORDS)     

Validation of the OSCAR 2 oscillometric 24-hour ambulatory blood pressure monitor according to the International Protocol for the validation of blood pressure measuring devices

OBJECTIVES: The accuracy of blood pressure measuring devices is of prime importance and should be validated before devices are used clinically. We carried out an independent evaluation of the OSCAR 2 oscillometric ambulatory blood pressure monitor (SunTech Medical model 222) according to the European Society of Hypertension International Protocol. METHODS: Adult subjects were recruited from patients and staff at The James Cook University Hospital, Middlesbrough, UK. Nine sequential same-arm blood pressure measurements were taken alternating between simultaneous readings by two independent, trained observers using mercury sphygmomanometers and the device operated by a third observer. In phase one, 15 subjects participated (five in each of the low, medium and high blood pressure ranges) with 18 subjects participating in phase two. Data from 33 subjects (11 in each of the three blood pressure ranges) were analysed for systolic (19 male, 14 female, mean age 56.0 years) and for diastolic (17 male, 16 female, mean age 51.1 years) blood pressure. RESULTS: The OSCAR 2 passed the first phase of the validation process. In phase 2.1, the OSCAR 2 monitor had 71 readings within 5 mmHg, 86 within 10 mmHg and 94 within 15 mmHg for systolic blood pressure (SBP) and 72 readings within 5 mmHg, 88 within 10 mmHg and 96 within 15 mmHg for diastolic blood pressure (DBP). Mean (+/-SD) differences between observers and device were 0.9+/-2.3 mmHg for SBP and -0.5+/-2.3 mmHg for DBP. In phase 2, 24 subjects had at least two of the differences within 5 mmHg and three subjects had no differences within 5 mmHg for SBP while for DBP 25 subjects had at least two of the differences within 5 mmHg and two subjects had no differences within 5 mmHg. CONCLUSIONS: The OSCAR 2 passes all requirements for validation by the International Protocol and can be recommended for clinical use in an adult population.     

A validation of the Mobil O Graph (version 12) ambulatory blood pressure monitor

OBJECTIVE: To assess the clinical accuracy of the Mobil O Graph (version 12) ambulatory blood pressure monitor in an adult population. METHODS: The accuracy of the device was assessed by predefined criteria (British Hypertension Society, BHS) in 85 subjects recruited from the patients and staff in a teaching hospital. A series of same-arm sequential blood pressure measurements were taken: first two observers taking simultaneous mercury readings, followed by a reading with the Mobil O Graph ambulatory monitor. A total of seven readings were taken from each subject in the sitting position. The data were then analysed according to the BHS protocol and the criteria of the Association for the Advancement of Medical Instrumentation (AAMI). RESULTS: The Mobil O Graph ambulatory monitor fulfilled the criteria of the BHS protocol, achieving a grade B for systolic blood pressure (SBP) and a grade A for diastolic blood pressure (DBP). The mean differences were -2+/-8 mmHg for SBP and -2+/-7 mmHg for DBP. The device therefore also passed the AAMI standard (the mean to be within 5+/-8 mmHg). CONCLUSION: The Mobil O Graph ambulatory monitor performed in a satisfactory manner according to the BHS and the AAMI criteria and can therefore be recommended for clinical use in the general population.     

Validation of the TONOPORT V ambulatory blood pressure monitor according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults

BACKGROUND: It is now accepted that blood pressure measuring devices should be subjected to an independent evaluation of their accuracy before they are marketed for clinical use. The results of validation of the TONOPORT V blood pressure monitor for the measurement of ambulatory blood pressure according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults are presented in this paper. POPULATION: Thirty-three subjects were recruited from among staff and patients at Beaumont Hospital, Dublin, Ireland. METHODS: The TONOPORT V monitor was connected to the Sphygmocorder, an audiovisual system for validation, which records blood pressure on tape and video for later analysis. Nine sequential same-arm measurements between the device and a standard mercury sphygmomanometer were recorded using the Sphygmocorder. RESULTS: In phase 1, the TONOPORT V monitor produced 28 measurements within 5 mmHg, 37 within 10 mmHg and 40 within 15 mmHg for systolic blood pressure (SBP), and 26 within 5 mmHg, 38 within 10 mmHg and 44 within 15 mmHg for diastolic blood pressure (DBP). The mean differences were -2.2 (8.6) [mean (SD)] mmHg for SBP and +0.5 (7.2) mmHg for DBP. The TONOPORT V monitor passed all the criteria for both SBP and DBP. In phase 2.1, the TONOPORT V monitor had 56 measurements within 5 mmHg, 78 within 10 mmHg and 88 within 15 mmHg for SBP, and 60 measurements within 5 mmHg, 83 within 10 mmHg and 97 within 15 mmHg for DBP. The mean differences were -1.4 (8.7) mmHg for SBP and -0.2 (6.8) mmHg for DBP. The TONOPORT V monitor passed the criteria for DBP but failed to meet any of the criteria for SBP. In phase 2.2, 19 subjects had at least two of the differences within 5 mmHg and six subjects had no differences within 5 mmHg for SBP, and 22 subjects had at least two of the differences within 5 mmHg and six subjects no differences within 5 mmHg for DBP. The TONOPORT V monitor failed to meet the criteria for SBP and for DBP. CONCLUSIONS: The TONOPORT V monitor cannot be recommended for clinical use in an adult population because it records SBP inaccurately and because it records DBP inaccurately in an unacceptably high proportion of people.     

Validation of the SpaceLabs 90207 automatic non-invasive blood pressure monitor in elderly subjects

OBJECTIVE: To validate the SpaceLabs 90207 ambulatory blood pressure monitor in the elderly. METHODS: Eighty-five subjects aged 60-90 years were recruited from hospital inpatients. Using the same-arm sequential measurement technique two observers recorded blood pressure with a mercury sphygmomanometer first and then by using the SpaceLabs 90207 ambulatory monitor. This set of blood pressure readings was performed three times with all 85 subjects supine, sitting and standing. Data were analysed according to the British Hypertension Society protocol. RESULTS: Over the blood pressure range tested the SpaceLabs 90207 device recorded diastolic blood pressure (DBP) satisfactorily, achieving grade A in all body postures, but not systolic blood pressure (SBP; supine D, standing C, sitting C). However, at SBP 相似文献   

Reproducibility of nurse-measured, exercise and ambulatory blood pressure and echocardiographic left ventricular mass in borderline hypertension.

OBJECTIVE: To compare the short-term reproducibility of four diagnostic tests: resting blood pressure, exercise blood pressure, non-invasive daytime ambulatory blood pressure and echocardiographic left ventricular mass. DESIGN: Blinded, prospective test-retest (reliability) study. SETTING: Hypertension research units in two teaching hospitals. PARTICIPANTS: Six normal volunteers and 22 patients with untreated borderline to mild hypertension, mean age 44 years. MAIN OUTCOME MEASURES: The intraclass correlation coefficient (RI) and standard deviation of the difference (SDD) between visits. MAIN RESULTS: The mean blood pressures and left ventricular mass did not differ between visits. Concordance between visits reached RI = 0.86 systolic/0.66 diastolic for ambulatory blood pressure and RI = 0.85 systolic/0.64 diastolic for nurse-measured random-zero sphygmomanometer resting blood pressure. The respective variabilities were SDD = 9/8 and 8/8 mmHg. Submaximal exercise systolic blood pressure (SBP) and echo left ventricular mass showed excellent reliability. Echo left ventricular mass and resting SBP or ambulatory SBP were significantly more reproducible than resting diastolic blood pressure (DBP) or ambulatory DBP. CONCLUSIONS: Despite averaging many readings within each day, clinically important between-visit variations in ambulatory blood pressure remained. The between-visit variability of daytime ambulatory blood pressure was similar to that of resting blood pressure when carefully measured by a research nurse. The echo left ventricular mass appears to be more reproducible over the short term than the current diagnostic standard for hypertension, the resting DBP.     

Validation of the SpaceLabs 90207 ambulatory blood pressure device for hemodialysis patients.

BACKGROUND: Background Ambulatory blood pressure monitoring (ABPM) has been used increasingly in assessing dialysis patients. However, devices have not been validated formally for this population. Formal device validation is important in order to guarantee adequate performance for populations with special characteristics, such as patients undergoing hemodialysis. OBJECTIVE: To achieve formal validation of the SpaceLabs 90207 ambulatory blood pressure device (SLD) using a modified British Hypertension Society protocol. METHODS: Eighty-five hemodialysis patients were studied, generating 255 readings. Readings were obtained with patients supine (in a dialysis chair) over 5-10 min during hemodialysis. Simultaneous, same-arm readings were obtained through the use of a T connector to a calibrated mercury manometer. The mean differences between readings obtained by observers and those obtained by the device were calculated. Limits of agreement between observers and SLD were determined and plotted according to the method of Bland and Altman. For grading of performance, we determined the number of readings for which the readings obtained by the device were within 5, 10, and 15mmHg of manometer readings. Final gradings were ascribed according to British Hypertension Society criteria. RESULTS: The mean blood pressure (+/-SD) was 141/76+/-31/15mmHg (observers) and 141/77+/-27/15mmHg (SLD), and the mean (+/-SD) difference between observers and device (observer-device) was -0.5+/-7.5mmHg for systolic blood pressure (SBP) and -0.2+/-5.2mmHg for diastolic blood pressure (DBP). The device was less accurate in extreme ranges of SBP. In fact, there was a positive correlation between average [(observer+device)/2] and difference (observer-device) for SBP (r =0. 54, P <0.0001), showing that underestimation in higher ranges, and overestimation in lower ranges of blood pressure occurred for SBP. For SBP, 53% of readings were within 5mmHg of those obtained by the observers, 85% were within 10mmHg, and 97% within 15mmHg. For DBP, 78% were within 5mmHg, 96% within 10mmHg, and 98% within 15mmHg. These observations conferred on the device grade C for SBP and grade B for DBP. The type of vascular access and the presence of non-functioning arteriovenous grafts and fistulas in the ipsilateral arm did not alter these results significantly. CONCLUSIONS: These data validate the use of this device for hemodialysis patients. However, caution should be exercised in the evaluation of upper and lower ranges of SBP.     

Validation of A&D UA-767 device for the self-measurement of blood pressure

BACKGROUND: The validation of self-measurement devices has been recommended. Automatic monitor A&D UA-767 (A&D Company, Ltd, Tokyo, Japan) is well known and widely used, but not tested according to the Association for Advancement of Medical Instrumentation (AAMI) and British Hypertension Society (BHS) recommendations. OBJECTIVE: To perform a clinical validation for use by adults of the A&D UA-767 device according to the criteria of the AAMI and a modified BHS protocol. METHODS: The test concerned 101 subjects (57 men and 44 women) aged 15-85 years with arm circumferences of 22-39 cm, a systolic blood pressure (SBP) range of 89-206 mmHg, and a diastolic blood pressure (DBP) range of 53-122 mmHg. For each subject, three readings of the UA-767 were compared with simultaneous auscultatory measurements by two trained independent observers who used a mercury manometer and dual stethoscope. The results were graded according to the BHS (1990 and 1993) and AAMI recommendations. RESULTS: Observers showed close agreement, with mean differences of 1.1+/-2.4 mmHg for SBP and -0.7+/-2.0 mmHg for DBP. The proportion of values agreeing to within 5, 10 and 15 mmHg were 93, 100, and 100% for SBP and 97, 100, and 100% for DBP for the two observers. The sphygmomanometer measurements were 132+/-24/79+/-14 mmHg (mean+/-SD). The average difference between the mercury sphygmomanometer and A&D UA-767 readings for SBP and DBP were, respectively, -0.4+/-5.4 and -0.4+/-4. 8 mmHg. The proportion of values agreeing to within 5,10, and 15 mmHg were 82, 94, and 98% for SBP and 80, 95, and 98% for DBP for the observers and device (A/A grade for BHS). CONCLUSIONS: For an adult population, the A&D UA-767 device for the self-measurement of blood pressure satisfied the AAMI criteria, achieved a BHS grade of A/A and can therefore be recommended for monitoring blood pressure in home and clinical conditions by patients with mild-to-moderate arterial hypertension.     

Summer-winter variation in 24 h ambulatory blood pressure

OBJECTIVE: To examine possible seasonal differences in circadian blood pressure patterns and the specific contribution of indoor temperature. METHOD: Twenty-four-hour ambulatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) were monitored once in summer and once in winter in 101 healthy subjects aged 28-63 years. Subjects were interviewed concerning health-related habits, and measurements of environmental and occupational conditions were obtained. RESULTS: After controlling for possible confounders, mean SBP during work was significantly higher in winter than in summer by 3.4 mmHg. Both in winter and in summer, the highest values were recorded during work. The daily SBP circadian amplitude was higher in winter, reflected by higher mean SBP during the day and lower mean SBP at night. All of the daytime DBP measurements were higher in winter than in summer, but at night there were no seasonal differences. The blood pressure showed an independent association with season and with environmental temperature (SBP) beta = 3.98 mmHg and -1.14 mmHg/ degrees C, respectively; DBP beta =4.39 mmHg and -0.58 mmHg/ degrees C, respectively).CONCLUSION: In healthy men, the daily amplitude of ambulatory blood pressure varies physiologically by season with the highest values being obtained during work time in the winter months. If these results can be extrapolated to hypertensives then it might be necessary to tailor drug therapy to these variations. The daily average or clinical measurements may lead to an underestimation of the extent of the seasonal variation in blood pressure. The season of the year must be controlled for in clinical and epidemiological studies comparing blood pressure levels and amplitudes between groups or between baseline and follow-up study.     

海尔BP3BG1-A全自动上臂电子血压计准确性的临床评价

目的:按照《欧洲高血压协会国际质量控制方案2010修正版（ESH-IP 2010）》,评估海尔BP3BG1-A全自动上臂电子血压计临床应用的准确性。方法: 测量者采用水银血压计和受试血压计先后测量33名被试者同一左侧上臂收缩压和舒张压。根据ESH-IP 2010,每位被试者测量3对血压,共收集99例次受试血压计与水银血压计的测值。结果: 受试血压计测得73次（74%）收缩压与水银血压计测值差在5 mmHg以内,98次（99%）在10 mmHg以内,99次（100%）在15 mmHg以内;86次（87%）舒张压与水银血压计测值差5 mmHg以内,98次（99%）差10 mmHg。受试血压计测得收缩压与水银血压计测值差为（3.1±3.7） mmHg;舒张压测值差为（-0.9±3.7） mmHg。采用受试血压计与水银血压计的测值2~3次的差别都在5 mmHg以内的受试者数目分别为26名（79%）和29名（88%）。结论: 受试血压计对临床成人患者血压测量的准确性达到《 ESH-IP 2010》的验证标准。     

Validation of the ROSSMAX blood pressure measuring monitor according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults

BACKGROUND: It is now accepted that blood pressure measuring devices should be subjected to an independent evaluation of their accuracy before they are marketed for clinical use. The results of validation of the ROSSMAX Blood Pressure Measuring Monitor for self-measurement according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults are presented in this paper. POPULATION: Thirty-three subjects were recruited from among staff and patients at Beaumont Hospital, Dublin, Ireland. METHODS: The ROSSMAX monitor was connected to the Sphygmocorder, an audiovisual system for validation, which records blood pressure on tape and video for later analysis. Nine sequential same-arm measurements between the device and a standard mercury sphygmomanometer were recorded using the Sphygmocorder. RESULTS: In phase 1, the ROSSMAX monitor produced 21 measurements within 5 mmHg, 31 within 10 mmHg and 38 within 15 mmHg for systolic blood pressure (SBP), and 36 within 5 mmHg, 43 within 10 mmHg and 45 within 15 mmHg for diastolic blood pressure (DBP). The mean differences were -5.6 (10.2) [mean (SD)] mmHg for SBP and -0.5 (4.5) mmHg for DBP. The ROSSMAX monitor failed to meet any of the criteria for SBP but comfortably passed all of the criteria for DBP. In phase 2.1, the ROSSMAX monitor had 51 measurements within 5 mmHg, 73 within 10 mmHg and 86 within 15 mmHg for SBP, and 71 measurements within 5 mmHg, 93 within 10 mmHg and 98 within 15 mmHg for DBP. The mean differences were -4.5. (9.5) mmHg for SBP and -1.8 (5.0) mmHg for DBP. The ROSSMAX monitor failed to meet any of the criteria for SBP but comfortably passed all of the criteria for DBP. In phase 2.2, 16 subjects had at least two of the differences lying within 5 mmHg and 10 subjects had no differences within 5 mmHg for SBP; 26 subjects had at least two of the differences falling within 5 mmHg and three subjects no differences within 5 mmHg for DBP. The ROSSMAX monitor failed to meet the criteria for SBP but passed the criteria for DBP. CONCLUSIONS: The ROSSMAX monitor cannot be recommended for clinical use in an adult population because it records SBP inaccurately.     

Limited reproducibility of hourly blood pressure values obtained by ambulatory blood pressure monitoring: implications for studies on antihypertensive drugs.

OBJECTIVE: To assess the reproducibility of average hourly blood pressure values obtained by 24-h non-invasive ambulatory monitoring. PATIENTS: Fifteen outpatients with essential hypertension. In all subjects antihypertensive treatment was withdrawn for 4 weeks before and during the 4 weeks of the study. METHODS: The 24-h blood pressure was monitored by a SpaceLabs 5300 device (four readings per hour during the day and three readings per hour during the night) twice, at a 4-week interval. Systolic (SBP) and diastolic blood pressure (DBP) were averaged for each hour and for the whole 24-h period, and hourly and 24-h reproducibility was quantified by the standard deviation of the mean difference (SDD) between the values obtained in the two recordings. RESULTS: The SDD of hourly SBP and DBP was much greater than that of the 24-h values and ranged widely between the hours of recording. The SDD of hourly SBP and DBP were also variably greater than the SDD of the 24-h value in another 14 untreated essential hypertensives in whom 24-h ambulatory blood pressure was monitored intra-arterially twice at a 4-week interval to calculate hourly average blood pressure on thousands rather than on three or four values per hour. CONCLUSION: Reproducibility is less for hourly than for 24-h average blood pressure. This feature (which probably depends on behavioural differences between two recordings) suggests that ambulatory blood pressure measurement partly loses its advantages for reproducibility and reduction in trial size if the results are analysed over hourly periods.     

Reproducibility of intra-arterial ambulatory blood pressure: effects of physical activity and posture

OBJECTIVE: To examine the effects of physical activity, body posture and sleep quality on the reproducibility of continuous ambulatory blood pressure monitoring. METHODS: Measurements were performed in 35 subjects (18 hypertensive, 11 male), mean +/- standard deviation age 49 +/- 13 years. Blood pressure (BP) was measured in the brachial artery, and beat-to-beat values of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure and heart rate (HR) were computed. Physical activity and posture were continuously measured with five accelerometers. Subjective quality of sleep was assessed with a questionnaire. Reproducibility was expressed as an intraclass correlation coefficient and as the standard deviation of the within-subject differences. RESULTS: Posture and activity significantly influenced BP and HR. From lying to sitting, the SBP, DBP and HR increased 6 mmHg, 8 mmHg and 8 beats/min, respectively. From sitting to standing these respective increases were 4 mmHg, 2 mmHg and 13 beats/min. A further rise in activity (from standing to moving generally or walking) increased the SBP by 7 mmHg and the HR by 7 beats/min, and decreased the DBP by 8 mmHg. For daytime SBP, DBP and HR, the intraclass correlation coefficient (standard deviation of the within-subject differences) values were 0.93 (7.2 mmHg), 0.94 (3.8 mmHg) and 0.90 (4.1 beats/min). For night-time these respective values were 0.98 (4.4 mmHg), 0.97 (2.5 mmHg) and 0.96 (2.2 beats/min). Correction for physical activity level and posture hardly improved the reproducibility of daytime BP and HR. Reproducibility of night-time BP and HR was not improved by correction for physical activity, supine position or self-reported sleep quality. CONCLUSIONS: Within-subject differences between ambulatory BP recordings cannot be explained by differences in physical activity and body posture.     

Validation of the AGILIS ambulatory blood pressure monitor according to the European Society of Hypertension International Protocol for validation of blood pressure measuring devices in adults

BACKGROUND: We evaluated the clinical validity of the AGILIS ambulatory blood pressure monitor according to the European Society of Hypertension International Protocol. METHODS: The blood pressure (BP) was measured at the same arm by two certified observers using two mercury columns and a double stethoscope, then by the volunteer with the automatic device, these measurements were done seven times sequentially using 33 volunteers. For the randomization of the patient, one ABPM measure was compared to the mean of three manual measures. Then, we had three ABPM measures and four manual measures. Each ABPM measure, being compared to two manual measures. Blood pressure readings and recordings were blinded. Position of the subjects was standardized. RESULTS: Phase 1: To pass phase 1, the device had to have at least 25 of the 45 measurements within 5 mmHg, 35 within 10 mmHg or 40 within 15 mmHg of the comparative observer measurements. The AGILIS monitor had 35 measurements lying within 5 mmHg, 42 within 10 mmHg and 45 within 15 mmHg for systolic BP (SBP), 35 within 5 mmHg, 44 within 10 mmHg and 45 within 15 mmHg for diastolic BP (DBP). It passed the criteria for SBP and DBP. Phase 2: To pass phase 2.1, a device must have at least 60 of 99 measurements within 5 mmHg, 75 within 10 mmHg and 90 within 15 mmHg of the comparative observer measurements, and in addition must also have either 65 within 5 mmHg and 80 within 10 mmHg, or 65 within 5 mmHg and 95 within 15 mmHg, or 80 within 10 mmHg and 95 within 15 mmHg. The AGILIS monitor had 78 measurements within 5 mmHg, 91 within 10 mmHg and 96 within 15 mmHg for SBP; and 70 measurements within 5 mmHg, 92 within 10 mmHg and 96 within 15 mmHg for DBP. It passed the criteria for SBP and DBP. For phase 2.2 using the AGILIS monitor, 27 subjects had at least two of the differences within 5 mmHg and none had any differences within 5 mmHg for SBP; 27 subjects had at least two of the differences within 5 mmHg and three subjects had no differences within 5 mmHg for DBP. The results are in concordance with the requested criteria for phase 2.2. CONCLUSION: Thus the AGILIS device fulfils the validation criteria of the international protocol.     

Comparison between casual blood pressure and ambulatory blood pressure monitoring parameters in healthy and hypertensive adolescents

Casual blood pressure measurements were compared with mean ambulatory blood pressure values during wakefulness and sleep in 45 normotensive and 30 hypertensive adolescents of both sexes aged 10-18 years. Two sets of auscultatory casual blood pressure were obtained, one in a pediatric office setting (office blood pressure), performed by the physician, and one in the ambulatory blood pressure monitoring (ABPM) unit, performed by a trained nurse, prior to the initiation of ABPM (pre-ABPM blood pressure). In normotensive and hypertensive subjects of both sexes, the mean office systolic blood pressure (SBP) was lower than the mean pre-ABPM SBP, and the mean office diastolic blood pressure (DBP) was lower than the mean pre-ABPM DBP. In normotensive participants, the mean pre-ABPM SBP/DBP was lower than the mean ABPM SBP/DBP while awake, the mean ABPM SBP/DBP during sleep being lower than the mean ABPM SBP/DBP values while awake and the mean pre-ABPM SBP/DBP. No statistical difference was demonstrated between the mean office SBP and the mean ABPM SBP during sleep, the mean ABPM DBP during sleep being lower than the mean office DBP. The hypertensive adolescents presented a blood pressure profile similar to that of the normotensive group, albeit shifted upwards, with no significant difference between the mean pre-ABPM SBP and the mean ABPM SBP while awake but a higher mean pre-ABPM DBP than mean ABPM DBP while awake. This study suggests that, by evaluating the casual blood pressure in different environment/observer situations, the power of casual blood pressure to predict inadequate blood pressure control, manifested as abnormal ABPM parameters, can be enhanced. Our data indicate ABPM to be the method of choice for the early diagnosis and adequate follow-up of adolescent hypertension.     

老年高血压病患者血压昼夜节律与动态的动脉硬化指数的关系

目的 探讨老年高血压病患者血压昼夜节律与动态动脉硬化指数的关系。方法 根据动态血压检测结果将112例老年高血压病患者分为杓形组(n=37)、非杓形组（n=45）和反杓形组（n=30）,并测定及计算动态动脉硬化指数（AASI）。结果 3组年龄,体质量指数,总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖、病程和全天及白天平均收缩压、舒张压和脉压比较均无显著性差异。3组夜间平均收缩压、夜间平均舒张压、AASI比较有显著性差异（P<0.01）。结论 动态血压昼夜节律的改变与动态动脉硬化指数相关。     

Validation of the A&D UA-631 (UA-779 Life Source) device for self-measurement of blood pressure and relationship between its performance and large artery compliance

OBJECTIVES: To determine the accuracy of the UA-631 (UA-779 Life Source for the American market) blood pressure monitor developed by the A&D Company (Toshimi-ku, Tokyo, Japan). DESIGN: Device evaluation was performed using a new protocol proposed by the Working Group on blood pressure monitoring of the European Society of Hypertension (ESH). Monitor performance was assessed in relation to subjects' gender, age, skinfold thickness, arm circumference, BMI, and elasticity index of large (C1) and small (C2) arteries. METHODS: The A&D recorder was assessed according to the various phases of the protocol. Sequential readings were taken for the main validation test. Outcome was classified according to the criteria of ESH recommendations, which are based on four zones of accuracy differing from the mercury standard by 5, 10, 15 mmHg, or more. RESULTS: The main validation test was performed in 66 subjects for a total of 198 device measurements. The A&D monitor passed all three phases both for systolic and diastolic blood pressure (SBP and DBP). Mean blood pressure difference between device and observers was 2 +/- 5 mmHg for SBP and 1 +/- 3 mmHg for DBP. The absolute discrepancy between device and observers (4 +/- 4 mmHg for SBP, and 2 +/- 2 mmHg for DBP) was related to age (negatively) and to C1 (positively), but in a multivariable regression analysis only C1 remained a significant independent predictor of the absolute device-observer discrepancy. CONCLUSIONS: These data show that the A&D UA-631 device satisfies the new recommended ESH accuracy levels for both SBP and DBP. Its performance seems to be better in subjects with stiffer arteries.     

Inverse relationship between upright plasma renin activity and twenty-four hour blood pressure variability in borderline hypertension

Office, i.e. measured by the physician at rest, and 24 h ambulatory systolic (SBP) and diastolic (DBP) blood pressures, heart rate, supine and upright plasma renin activities, supine and upright aldosterone concentrations and plasma and urine sodium and potassium were measured in 61 young male subjects aged 19-25 years, including 40 normotensive subjects (office DBP less than or equal to 90 mmHg and office SBP less than or equal to 140 mmHg) and 21 borderline hypertensive subjects (non-normal blood pressures with office DBP less than or equal to 95 mmHg and office SBP less than or equal to 160 mmHg). No significant differences were found in the plasma or urine K+ or Na+, upright or supine plasma renin activity or aldosterone concentration between normotensives and borderline hypertensive subjects. No correlation was detected between plasma and urine K+ or Na+, upright and supine aldosterone concentration or supine plasma renin activity and blood pressure. In contrast, significant inverse correlations were observed between upright plasma renin activity and blood pressure. The correlations were approaching statistical significance when upright plasma renin activity was related to office SBP and office DBP (r = -0.22, P = 0.097 and r = -0.25, P = 0.049, respectively), and were more significant when plasma renin activity was related to 24 h mean DBP (r = -0.32, P = 0.013) and to SBP and DBP standard deviations (r = -0.37, P = 0.004 and r = -0.26, P = 0.04, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)     

Repeated automated versus daytime ambulatory blood pressure measurement in mild, moderate and severe untreated black hypertensive patients

OBJECTIVE: To examine the extent to which one session of repeated automated (30-45 min) blood pressure measurements in non-treated, hypertensive patients can be used to predict daytime ambulatory blood pressure (ABP). METHODS: Two hundred untreated black hypertensive patients (mean age 50.2+/-11.2) were retrospectively stratified on the basis of the daytime ambulatory diastolic blood pressure (DBP) into mild, moderate and severe hypertensives (90 mmHg 相似文献   

Evaluation of the ambulatory blood pressure monitor SAVE 33 model 2]

This work tests a new ambulatory blood pressure device: Save 33 II. The evaluation is conducted according to the phases II and IV of the British Hypertension Society (BHS) protocol: the phases I and III (before and after use) are not performed as this device has received the European quality label 'CE' that guarantees a +/- 3 mmHg accuracy before and after 10,000 simulated cycles. Two trained observers (hearing test and certification done according to the BHS recommendations) have performed 7 sequential BP measurements with conventional and automatic method, at the same arm, among 85 patients. The ranges of mean blood pressure are 78-203 mmHg, for SBP and 53-130 mmHg for DBP. RESULTS: The Save 33 II monitor satisfies the grade B of BHS evaluation for both systolic and diastolic pressures. This device also satisfies the Association for the Advancement of Medical Instrumentation (AAMI) protocol: mean difference between methods and standard deviation less than 5 +/- 8 mmHg: -2.7 +/- 6.8 mmHg for SBP and -0.86 +/- 6.6 mmHg for DBP. The in-use assessment is conform to BHS criteria for 20 recordings (less than 20% invalid values during day and night); the 5 other recordings have not enough night values, due to batteries failure (2 cases), sleeping discomfort (2 cases) and a cuff withdraw. CONCLUSION: This device, in the tested configuration, agrees the B grade of BHS and can be recommended for ambulatory blood pressure measurement.