[1]张硕,刘旭,李昱熙,等.高血压数字化管理初探：FAIR研究中家庭自测血压的设计与实践[J].心血管病学进展,2024,(3):277.[doi:10.16806/j.cnki.issn.1004-3934.2024.03.019]
　ZHANG Shuo,LIU Xu,LI Yuxi,et al.Exploring Digital Management of Hypertension:Design and Practice of Home Blood Pressure Self-Monitoring in the FAIR Study[J].Advances in Cardiovascular Diseases,2024,(3):277.[doi:10.16806/j.cnki.issn.1004-3934.2024.03.019]
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高血压数字化管理初探：FAIR研究中家庭自测血压的设计与实践()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2024年3期
页码:
277
栏目:
论著
出版日期:
2024-03-25

文章信息/Info

Title:
Exploring Digital Management of Hypertension:Design and Practice of Home Blood Pressure Self-Monitoring in the FAIR Study
作者:
张硕; 刘旭; 李昱熙; 范芳芳; 王贝宁; 贾佳; 李建平
(北京大学第一医院心内科,北京 100034)
Author(s):
ZHANG Shuo; LIU Xu; LI Yuxi; FAN Fangfang; WANG Beining; JIA Jia; LI Jianping
(Department of Cardiology,Peking University First Hospital,Beijing 100034,China)
关键词:
家庭自测血压; 血压变异率; 数字化; 信息技术
Keywords:
Home blood pressure; Blood pressure variability; Digital management; Information technology
DOI:
10.16806/j.cnki.issn.1004-3934.2024.03.019
摘要:
目的 探索数字化家庭自测血压管理（HBPM）在 高血压患者中的应用，并对血压变异率等指标进行分析。方法 纳入自2023年2月1日 —2024年1月15日期间参与FAIR-pilot研究并接受数字化家庭自测血压管理的受试者，利用蓝牙血压计与配套微信小程序实现HBPM数据的自动上传，并对HBPM数据、不同时段血压变异率及小程序使用情况进行分析。结果 最终纳入86例符合条件的受试者，其中男性53例（61.6%），平均年龄 （61.70±9.81）岁，共计分析HBPM血压读数23 277人次。总体受试者晨间收缩压的变异率为17.31±67.34，晚间收缩压的变异率为13.75±36.10；晨间舒张压的变异率为5.87±1.81，晚间舒张压的变异率为6.22±3.66。整体受试者在小程序使用行为上的活跃度随着时间的推移呈下降趋势，但整体活跃度在80%以上。结论 基于新 型信息技术的数字化HBPM管理在高血压领域具备可行性，与收缩压相比，HBPM舒张压的变异率可能是作为变异率更稳定的指标。但规范的HBPM流程仍有待进一步的研究与推广。
Abstract:
Objective To explore the application of digital home blood pressure monitoring (HBPM) management in hypertensive patients and analyze indicators such as blood pressure variability. Methods Subjects participating in the FAIR-pilot study and undergoing HBPM between February 1,2023 and January 15,2024 were included. HBPM data were automatically uploaded using Bluetooth blood pressure monitors and integrated with a mini-app. HBPM data, blood pressure variability at different time periods , and usage of the mini-app were analyzed. Results A total of 86 eligible subjects were included , with 53 males (61.6%) and a mean age of (61.70±9.81) years. A total of 23 277 HBPM blood pressure readings were analyzed. The overall variability of morning systolic blood pressure was 17.31±67.34,and evening systolic blood pressure variability was 13.75±36.10. The variability of morning diastolic blood pressure was 5.87±1.81,and evening diastolic blood pressure variability was 6.22±3.66. Overall, subject activity on the mini-app showed a decreasing trend over time but remained above 80% overall activity. Conclusion Digital HBPM management based on novel information technology is feasible in the field of hypertension. Compared to systolic blood pressure , diastolic blood pressure variability in HBPM may serve as a more stable indicator of variability. However , standardized HBPM processes still require further research and promotion.

参考文献/References:

[1] Zhang M,Shi Y,Zhou B,et al. Prevalence,awareness,treatment,and control of hypertension in China,2004-18:findings from six rounds of a national survey[J]. BMJ,2023,380:e071952.

[2] Wang Z,Chen Z,Zhang L,et al. Status of hypertension in China:results from the China Hypertension Survey,2012-2015[J]. Circulation,2018,137(22):2344-2356.

[3] Yin R,Yin L,Li L,et al. Hypertension in China:burdens,guidelines and policy responses:a state-of-the-art review[J]. J Hum Hypertens,2022,36(2):126-134.

[4] Lewington S,Lacey B,Clarke R,et al. The burden of hypertension and associated risk for cardiovascular mortality in China[J]. JAMA Intern Med ,2016,176(4):524-532.

[5] Burnier M. Drug adherence in hypertension[J]. Pharmacol Res,2017,125(Pt B):142-149.

[6] 中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会,等. 中国高血压防治指南(2018年修订版) [J]. 中国心血管杂志,2019,24(1):24-56.

[7] Mancia G,Kreutz R,Brunstr?m M,et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension:Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)[J]. J Hypertens,2023,41(12):1874-2071.

[8] Bo Y,Kwok KO,Chung VCH,et al. Short-term reproducibility of ambulatory blood pressure measurements:a systematic review and meta-analysis of 35 observational studies[J]. J Hypertens,2020,38(11):2095-2109.

[9] Kang YY,Li Y,Huang QF,et al. Accuracy of home versus ambulatory blood pressure monitoring in the diagnosis of white-coat and masked hypertension[J]. J Hypertens,2015,33(8):1580-1587.

[10] Al-Arkee S,Mason J,Lane DA,et al. Mobile apps to improve medication adherence in cardiovascular disease:systematic review and meta-analysis[J]. J Med Internet Res,2021,23(5):e24190.

[11] Mcmanus RJ,Little P,Stuart B,et al. Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension :randomised controlled trial[J]. BMJ,2021,372:m4858.

[12] Lu X,Yang H,Xia X,et al. Interactive mobile health intervention and blood pressure management in adults[J]. Hypertension,2019,74(3):697-704.

[13] Li R,Liang N,Bu F,et al. The effectiveness of self-management of hypertension in adults using mobile health:systematic review and meta-analysis[J]. JMIR Mhealth Uhealth,2020,8(3):e17776.

[14] Mancia G,Kreutz R,Brunstr?m M,et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension:Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)[J]. J Hypertens,2023,41(12):1874-2071.

[15] 王继光. 家庭血压监测中国专家共识[J]. 中国医学前沿杂志(电子版),2012,4(4):43-47.

[16] 陈歆,李燕,刘靖等. 高血压患者高质量血压管理中国专家建议[J/OL]. 中华高血压杂志:1-8[2024-01-14]. http://kns.cnki.net/kcms/detail/11.5540.R.20231212.1333.002.html.

[17] Stevens SL,Wood S,Koshiaris C,et al. Blood pressure variability and cardiovascular disease:systematic review and meta-analysis[J]. BMJ,2016,354:i4098.

[18] Sheikh AB,Sobotka PA,Garg I,et al. Blood pressure variability in clinical practice:past,present and the future[J]. J Am Heart Assoc,2023,12(9):e029297.

[19] Schutte AE,Kollias A,Stergiou GS. Blood pressure and its variability:classic and novel measurement techniques[J]. Nat Rev Cardiol,2022,19(10):643-654.

[20] Buckley LF,Baker WL,van Tassell BW,et al. Systolic blood pressure time in target range and major adverse kidney and cardiovascular events[J]. Hypertension,2023,80(2):305-313.

[21] Huang X,Deng S,Xie W,et al. Time in target range of systolic blood pressure and cognitive outcomes in patients with hypertension[J]. J Am Geriatr Soc,2024,72(2):423-432.

[22] Lin Z,Xiao Z,Chen W,et al. Association of long-term time in target range for systolic blood pressure with cardiovascular risk in the elderly:a Chinese veteran cohort study[J]. Eur J Prev Cardiol,2023,30(10):969-977.

更新日期/Last Update: 2024-04-26