Objective: To compare the impact of manual right arm blood pressure measurement with computer-controlled blood pressure meter (CCBPM) on the detection rate of hypertension among elderly individuals. Method: This was a cross-sectional study. Elderly residents undergoing routine health check-up in a village in Jiangxi Province from April to June 2024 were enrolled. Manual blood pressure measurements were performed on the right arm using an electronic sphygmomanometer, while standardized dual-arm synchronized blood pressure assessments were conducted using the CCBPM. Blood pressure data were recorded from three sources: manual measurement on the right arm; the first CCBPM measurement on the arm with higher systolic blood pressure (CCBPM single); and the mean blood pressure of the arm with higher systolic blood pressure from two (if the difference between the first two measurements was less than 5 mmHg, 1 mmHg=0.133 kPa) or three (if the difference exceeded 5 mmHg) CCBPM measurements (CCBPM mean). Hypertension detection rates from these three datasets were compared. Subgroup analysis was performed according to age (60-74 years old as the elderly group,≥75 years old as the senior group) and gender. Intra-group correlation coefficient (ICC) was analyzed to evaluate the consistency of blood pressure data of different blood pressure measurement methods, and Kappa value was analyzed to evaluate the consistency of hypertension classification determined by different blood pressure measurement methods. Results: A total of 1 498 participants were enrolled, aged (71.30±6.83) years old, including 678 males (45.26%). The blood pressure and heart rate measured by the artificial right arm blood pressure measurement were higher than those measured by CCBPM single (blood pressure: (140.09±17.19)/(82.40±10.93) mmHg vs. (135.31±18.98)/(81.23±10.51) mmHg; heart rate: (75.76±11.72) beats/min vs.(72.94±11.21) beats/min) and CCBPM mean (blood pressure: (140.09±17.19)/(82.40±10.93) mmHg vs. (134.64±18.39)/(80.28±9.78) mmHg; heart rate: (75.76±11.72) beats/min vs. (72.87±10.70) beats/min, all P<0.05). The detection rate of hypertension determined by CCBPM mean was significantly lower than that of artificial right arm (40.25% (603/1 498) vs.54.34% (814/1 498)) and CCBPM single (40.25% (603/1 498) vs. 44.79% (671/1 498), all P<0.05). Subgroup analysis showed that that the detection rate of hypertension determined by CCBPM mean was lower than that measured by artificial right arm regardless of gender and age (all P<0.05). The consistency of blood pressure data between artificial right arm and the CCBPM mean was moderate (systolic blood pressure: ICC=0.70; diastolic blood pressure: ICC=0.62), with less consistent classification (Kappa=0.37). The consistency of blood pressure data between CCBPM single and CCBPM mean is extremely high (systolic blood pressure: ICC=0.94; diastolic blood pressure: ICC=0.91), with highly consistent classification (Kappa=0.74). Conclusions: Artificial right arm blood pressure measurement in physical examinations may overestimate the hypertension detection rate, and the standardized dual-arm synchronized blood pressure measurement using CCBPM can reduce irregular blood pressure measurement.
目的： 比较人工右臂血压测量和计算机程序控制血压测量（CCBPM）两种血压测量方式对高血压检出率的影响。 方法： 本研究为横断面研究。选取2024年4—6月在江西省某村镇例行健康检查的老年居民为调查对象，用电子血压计进行人工右臂血压测量，同时采用CCBPM进行规范化双臂同步血压测量。记录电子血压计测得的人工右臂血压数据、CCBPM第1次测量收缩压更高一侧参考臂的血压数据（CCBPM单次）以及CCBPM 2次（若前2次测量差值≤5 mmHg，1 mmHg=0.133 kPa）或3次（若前2次测量差值>5 mmHg则需进行第3次测量）测量的血压均值中收缩压更高一侧参考臂的血压数据平均值（CCBPM均值），比较3组数据之间高血压检出率的差异。并依据年龄（60~74岁为老年组，≥75岁为高龄组）、性别进行亚组分析。通过分析组内相关系数（ICC）评价不同血压测量方式血压数据的一致性，分析Kappa值评价不同血压测量方式高血压分级的一致性。 结果： 最终入选1 498人，年龄（71.30±6.83）岁，其中男性678人（45.26%）。人工右臂测得的血压及心率高于CCBPM单次［血压：（140.09±17.19）/（82.40±10.93）mmHg比（135.31±18.98）/（81.23±10.51）mmHg；心率：（75.76±11.72）次/min比（72.94±11.21）次/min］和CCBPM均值测量方法［血压：（140.09±17.19）/（82.40±10.93）mmHg比（134.64±18.39）/（80.28±9.78）mmHg；心率：（75.76±11.72）次/min比（72.87±10.70）次/min，P均<0.05］。依据CCBPM均值方法确定的高血压检出率明显低于人工右臂［40.25%（603/1 498）比54.34%（814/1 498）］和CCBPM单次测量方法［40.25%（603/1 498）比44.79%（671/1 498），P均<0.05］。亚组分析显示，无论性别和年龄差异，依据CCBPM均值确定的高血压检出率均低于人工右臂测量方法（P均<0.05）。人工右臂和CCBPM均值血压测量方法的血压数据的一致性中等（收缩压：ICC=0.70；舒张压：ICC=0.62），高血压分级的一致性较低（Kappa=0.37）。CCBPM单次和CCBPM均值血压测量方法的血压数据的一致性极高（收缩压：ICC=0.94；舒张压：ICC=0.91），高血压分级的一致性也较高（Kappa=0.74）。 结论： 在健康体查中，人工右臂血压测量可能会高估高血压检出率，使用CCBPM方法进行规范化双臂同步血压测量可以减少血压测量不规范的现象。.