居家血壓測量在高血壓管理中的應用

Application of Home Blood Pressure Monitoring in Hypertension Management

高血壓是全球和臺灣常見疾病，有顯著健康風險。根據國民健康署，65歲以上長者的血壓異常比例達八成。高血壓可導致腦血管疾病、腎臟衰竭、心血管疾病等健康問題，是臺灣十大死因之第七位。高血壓診斷標準已下修至130/80 mmHg，規則、連續的血壓測量在高血壓管理中至關重要。研究顯示居家血壓測量具有顯著優勢，能提供準確及長期血壓變化，避免白袍效應，與心血管事件的相關性高。居家血壓測量不僅有助於偵測和管理高血壓，還能提升病人藥物依從性，已被2022年臺灣高血壓指引建議用於高血壓的診斷和長期追蹤。本文旨在探討高血壓診斷標準的演變及居家血壓測量在高血壓管理中的重要性，並強調其在診斷及治療的應用。本文亦介紹居家血壓測量的操作原則，幫助臨床護理人員掌握正確的指導資訊。期待護理同仁在閱讀後能夠了解居家血壓測量在高血壓管理中的優勢，並掌握教導病人執行居家血壓測量的知識，進而透過護理人員促進居家血壓測量的普及與應用，最終提升高血壓病人的健康管理能力。

Hypertension is a common disease both globally and in Taiwan that poses significant health risks. According to Taiwan’s Health Promotion Administration, abnormal blood pressure is prevalent in up to 80% of the adult population aged 65 and above. Hypertension is associated with serious health issues such as cerebrovascular diseases, renal failure, and cardiovascular diseases, and ranks as the seventh leading cause of death in Taiwan. The diagnostic criteria for hypertension have been lowered to 130/80 mmHg. Regular and continuous blood pressure monitoring is crucial in hypertension management. Studies have demonstrated that home blood pressure monitoring (HBPM) offers significant advantages, providing accurate and long-term data on blood pressure variations, avoiding the white-coat effect, and showing a stronger correlation with cardiovascular events. HBPM not only aids in the detection and management of hypertension but also enhances patient medication adherence. Diagnosing and long-term monitoring for hypertension are recommended in 2022 Taiwan Hypertension Treatment Guidelines. The purpose of this paper is to explore the evolution of hypertension diagnostic criteria and the importance of HBPM in hypertension management, emphasizing how HBPM should be applied in diagnosis and treatment. Also, the procedures for HBPM are introduced to help healthcare professionals acquire accurate nursing guidance information. The authors hope these help nursing colleagues better understand the advantages of HBPM in hypertension management and to increase their competence in teaching patients to self-monitor their blood pressure at home to improve the overall health management of hypertensive patients through HBPM.