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自动化诊室血压测量:澳大利亚高血压协会和澳大利亚国家高血压特别工作组立场声明

Automated office blood pressure measurement: a Hypertension Australia and National Hypertension Taskforce of Australia position statement.

作者信息

Sharman James E, Schutte Aletta E, Nelson Mark R, Samarawickrama Ania L, Stocks Nigel, Hespe Charlotte M, Usherwood Tim, Stowasser Michael, Rodgers Anthony, Ward Natalie C, Halcomb Elizabeth, James Sharon, Jennings Garry, Schlaich Markus P

机构信息

Menzies Institute for Medical Research, University of Tasmania, Hobart.

School of Population Health, University of New South Wales.

出版信息

J Hypertens. 2025 Sep 1;43(9):1463-1472. doi: 10.1097/HJH.0000000000004079. Epub 2025 Jun 18.

Abstract

Hypertension is the most common problem managed in Australian general practice, yet most adults with hypertension do not have their blood pressure (BP) treated to target. Hypertension diagnosis and management rely upon accurate BP measurements performed using a standardised protocol. However, health system barriers prevent doctors from following measurement protocols, leading to inaccurate BP assessments. A practical BP measurement protocol that can be widely implemented is urgently warranted. Automated office BP (AOBP) is the recommended measurement standard for the diagnosis and management of hypertension. AOBP involves using a validated automated upper-arm cuff BP device programmed to record multiple BP readings at set intervals starting after a rest period. It is done by a trained operator using a standardised protocol in a quiet setting with the correct patient setup, no distractions, and in the absence of a doctor. The device automatically calculates the average of the AOBP recordings and this is comparable to the 24-h ambulatory BP daytime mean. The hypertension threshold based on AOBP is 135/85 mmHg. AOBP can also be applied in other community settings (e.g. pharmacies), provided all the above criteria are met along with communication of results to the person's usual general practitioner. In Australia, nation-wide systematic implementation of evidence based AOBP measurement is strongly recommended. This standardised approach will support healthcare professionals, especially general practitioners, in obtaining high-quality BP values with increasing confidence in clinical decision-making. Policy and practice changes, to address barriers and provide enabling mechanisms for sustained implementation of AOBP, are required.

摘要

高血压是澳大利亚全科医疗中最常见的治疗问题,但大多数高血压成人患者的血压并未得到达标治疗。高血压的诊断和管理依赖于按照标准化方案进行的准确血压测量。然而,卫生系统的障碍阻碍医生遵循测量方案,导致血压评估不准确。因此,迫切需要一种能够广泛实施的实用血压测量方案。自动诊室血压(AOBP)是高血压诊断和管理的推荐测量标准。AOBP包括使用经过验证的自动上臂袖带血压设备,该设备经过编程,在休息一段时间后开始按设定间隔记录多个血压读数。由经过培训的操作人员在安静环境中按照标准化方案进行操作,患者体位正确,无干扰,且无需医生在场。该设备会自动计算AOBP记录的平均值,这与24小时动态血压日间平均值相当。基于AOBP的高血压阈值为135/85 mmHg。只要满足上述所有标准,并将结果告知患者的常规全科医生,AOBP也可应用于其他社区环境(如药店)。在澳大利亚,强烈建议在全国范围内系统实施基于证据的AOBP测量。这种标准化方法将支持医疗保健专业人员,尤其是全科医生,获得高质量的血压值,并增强临床决策的信心。需要进行政策和实践变革,以消除障碍,并为AOBP的持续实施提供支持机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43ec/12337947/33de189150fc/jhype-43-1463-g002.jpg

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