臂部位置和血压读数:ARMS交叉随机临床试验
Hairong Liu1,2, Di Zhao1,2, Ahmed Sabit3
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
JAMA internal medicine
|October 7, 2024
概括
在测血压 (BP) 时,手臂的位置不当,例如将手臂放在膝盖上或在侧面没有支,大大高估计了读数. 这可能导致错误诊断和不准确的高血压管理.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 高血压管理 高血压管理
背景情况:
- 标准指南建议在心脏水平上支手臂,以准确测量血压 (BP).
- 非标准的手臂姿势,如膝盖或不支持的侧面姿势,在临床实践中经常使用.
- 这些非标准位置对BP读数的影响需要调查.
研究的目的:
- 为了确定不同手臂位置对血压 (BP) 读数的影响.
- 为了比较用手臂支在桌子上的血压测量与无支位置 (膝盖或侧面) 的血压.
主要方法:
- 一个交叉随机临床试验,涉及133名成年参与者.
- 参与者接受了三次血压测量,手臂处于三个位置:靠在桌子上 (参考),手靠在膝盖上,手臂在侧面没有支.
- 第四组测量,用手臂支在桌子上,用于计算血压变化.
主要成果:
- 与参考桌子位置相比,腰部和侧臂位置都导致缩血压 (SBP) 和腹缩血压 (DBP) 的统计学上显著高估.
- 侧面位置显示出比膝上位置 (SBP Δ 3.9 mm Hg,DBP Δ 4.0 mm Hg) 的高估值 (SBP Δ 6.5 mm Hg,DBP Δ 4.4 mm Hg).
- 这些发现在各个子组中是一致的,包括患有高血压和没有高血压的人.
结论:
- 通常使用的非标准手臂位置 (膝盖或侧面) 会导致血压读数的高估.
- 这种过度估计可能导致高血压的错误诊断和不适当的治疗决定.
- 坚持推的手臂位置对于准确的血压评估至关重要.
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