2023 Update Guidelines on Arterial Hypertension af European Society of Hypertension (ESH)

Vigtige budskaber

• The ESH has recently updated their guidelines for the management of arterial hypertension, with greater emphasis on the use of clinically validated devices¹

• Home BP monitoring with validated devices leads to better blood pressure control, whereas the use of non-validated devices with inaccurate measurements can lead to misdiagnosis⁷

Hvad har ændret sig for blodtryksmålinger i de opdaterede ESH-retningslinjer fra 2023?¹

Voksne

• Opportunistic screening for all adults

• Regular measurements for those >40 years or at high risk

Børn

• Screening of all children <3 years old

• Screening of children >3 years old with risk factors for high blood pressure (BP) including congenital heart disease, chronic kidney disease, solid organ transplantation, treatment with BP increasing drugs, or history of preterm birth

Enheder

• Only properly validated devices should be used to ensure measurements are accurate

• Automatic electronic, upper-arm cuff devices are recommended for both office and out-of-office use

• Devices with automated storage and connectivity are preferred

• Support for telehealth technologies and nocturnal BP measurements are encouraged

Blodtryksmåling i hjemmet anbefales til:

• Providing better reproducibility and prognostic value

• Support the identification of white-coat or masked hypertension

• Improving BP control through long-term follow-up of treated hypertension

• Novel home devices could provide an alternative to ambulatory blood pressure measurement (ABPM) to measure blood pressure values during sleep to detect elevated or non-dipping blood pressure
  

Hvorfor er klinisk validering af udstyr afgørende?

Selvom klinisk validering af nøjagtighed anbefales i retningslinjerne, er det ikke obligatorisk, før en blodtryksmåler (BPM) kommer på markedet^3,4

På verdensplan er mindre end en fjerdedel af overarmsenhederne valideret eller svarer til en valideret enhed⁵

Ikke-valideret udstyr kan give unøjagtige målinger, hvilket fører til fejldiagnosticering og fejlbehandling^⁷

ESH anbefaler, at sundhedspersonale, patienter og offentligheden tjekker STRIDE BP for at finde en liste over korrekt udstyr¹

Lister over udstyr, der er valideret til brug i hjemmet, på kontoret/hospitalet eller i ambulatoriet, samt udstyr, der er valideret til brug hos børn eller gravide, findes på www.stridebp.org

STRIDE BP godkender i øjeblikket 390 af de &gt;4000 enheder på markedet²

Hvordan valideres blodtryksmålere?

• New devices are validated by comparing their measurements to those of reference devices using protocols set out by professional societies

• A universal protocol has been developed by the US Association for the Advancement of Medical Instrumentation (AAMI), ESH, and the International Organization for Standardization (ISO)¹²

• STRIDE BP will list a device if the results of such a validation study are published as a full paper^10,11

Alle OMRON-enheder er klinisk validerede og listet af STRIDE BP^13,14

• OMRON ensures that every model of their BPMs meets the highest standards of precision and reliability¹³

• OMRON has 91 validated upper-arm devices listed on STRIDE BP²