血压的自我监测应该重复多久? 来自两个随机对照试验的数据的二次分析
Frances Rose1, Richard S Stevens1, Kate S Morton2
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Journal of hypertension
|August 21, 2025
概括
对于血压控制和药物稳定的人来说,每12个月进行一次血压自我监测是足够的. 由于随机波动,频繁的血压测试可能导致不必要的治疗变化.
科学领域:
- 心脏病学
- 高血压管理
- 临床试验
背景情况:
- 没有可靠的证据表明自动监测血压的最佳频率.
- 频繁的血压测试可能会导致基于随机变化的管理变化 ("噪声").
- 这项研究评估了自我监测的血压趋势,以确定最佳的监测频率.
研究的目的:
- 为了确定控制高血压的患者自我监测血压的最佳频率.
- 分析监测频率对BP管理决策的影响.
- 为了区分真正的血压变化与自我监测读数的随机变化.
主要方法:
- 分析了两项试验 (HOMEBP和TASMINH4) 的血压数据,其中包括稳定药物治疗的患者.
- 混合效应建模以评估每月平均血压变化和个体内血压变化.
- 基于不同重复测试间隔的时间,计算血压真正升高的概率.
主要成果:
- 在各个研究中,月度静脉压变化是最小的 (- 0. 1至- 0. 2 mmHg).
- 个体内血压变化 (SD) 每月在4. 7至5. 1mmHg之间.
- 在12个月后,血压升高的概率为26% (≥135 mmHg),而真正升高的概率为65%.
结论:
- 在受控血压和稳定的药物治疗的患者中,尽管个体内读数具有变化,但自我监测的平均血压每月变化很小.
- 每隔12个月对血压进行自我监测可能是指导管理决策的合适方法.
- 这种频率最大限度地降低了对短暂的血压波动的影响.
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