\u3010\u6587\u732e\u540d\u3011
\n\u8457\u8005\u540d\uff1aClark CE.et al.\u00a0
\n\u6587\u732e\u30bf\u30a4\u30c8\u30eb\uff1aAssociation of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis.
\n\u96d1\u8a8c\u540d\u30fb\u66f8\u7c4d\u540d\uff1aLancet.\u00a0
\n\u767a\u884c\u5e74\uff1a2012 Mar 10;379(9819):905-14.<\/p>\n
\u3010\u8981\u7d04\u3011
\n\uff1c\u80cc\u666f\uff1e
\n\u4e21\u8155\u306e\u53ce\u7e2e\u671f\u8840\u5727\u306e\u5dee\u304c10mmHg\u3082\u3057\u304f\u306f15mmHg\u4ee5\u4e0a\u3042\u308b\u3053\u3068\u306f\u672b\u68a2\u8840\u7ba1\u969c\u5bb3\u3068\u9396\u9aa8\u4e0b\u52d5\u8108\u72ed\u7a84\u3068\u95a2\u9023\u304c\u3042\u308b\u3002\u672c\u7814\u7a76\u306f\u3053\u306e\u8840\u5727\u306e\u5dee\u3068\u4e2d\u67a2\u6027\u3082\u3057\u304f\u306f\u672b\u68a2\u6027\u8840\u7ba1\u969c\u5bb3\u3001\u306a\u3089\u3073\u306b\u6b7b\u4ea1\u7387\u3068\u306e\u9593\u306e\u95a2\u9023\u6027\u306b\u3064\u3044\u3066\u8abf\u67fb\u3057\u305f\u3082\u306e\u3067\u3042\u308b\u3002
\nEuropean Society of hypertension\u3001European Society of Cardiology\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\u4e0a\u8155\u8840\u5727\u306e\u5de6\u53f3\u5dee\u306f\u672b\u68a2\u8840\u7ba1\u969c\u5bb3\u306b\u8d77\u56e0\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u3092\u3044\u3063\u3066\u304a\u308a\u3001\u307e\u305a\u306f\u3058\u3081\u306b\u78ba\u8a8d\u3059\u308b\u3088\u3046\u306b\u3068\u3044\u3046\u63a8\u5968\u304c\u3042\u308b\u304c\u3001\u305d\u308c\u3089\u3092\u6b63\u5f53\u5316\u3059\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u306b\u6b20\u3051\u3066\u3044\u305f\u3002\uff08\u3053\u306e\u70b9\u304cnovel\u3067\u3042\u308a\u3001\u304b\u3064relevant\u306a\u70b9\u3060\u3068\u601d\u308f\u308c\u307e\u3059\u3002\uff09<\/p>\n
\uff1c\u65b9\u6cd5\uff1e
\n2011\u5e747\u6708\u4ee5\u524d\u306b\u51fa\u7248\u3055\u308c\u305fMedline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane, and Medline In Process databases\u304b\u3089\u3001\u5de6\u53f3\u4e0a\u8155\u306e\u53ce\u7e2e\u671f\u8840\u5727\u306e\u5dee\u306b\u3064\u3044\u3066\u8a18\u3055\u308c\u305f\u3082\u306e\u3067\u3001\u304b\u3064\u9396\u9aa8\u4e0b\u52d5\u8108\u72ed\u7a84\u3001\u672b\u68a2\u8840\u7ba1\u969c\u5bb3\u3001\u8133\u8840\u7ba1\u969c\u5bb3\u3001\u5fc3\u8840\u7ba1\u969c\u5bb3\u3001\u3082\u3057\u304f\u306f\u751f\u5b58\u7387\u306b\u3064\u3044\u3066\u30c7\u30fc\u30bf\u304c\u3042\u308b\u3082\u306e\u3092\u691c\u7d22\u3057\u305f\u3002\u5de6\u53f3\u306e\u4e0a\u8155\u9593\u306e\u53ce\u7e2e\u671f\u8840\u5727\u3068\u305d\u308c\u305e\u308c\u306e\u7d50\u679c\u306e\u9593\u306b\u3042\u308b\u95a2\u9023\u6027\u3092\u7d71\u5408\u3059\u308b\u305f\u3081\u306b\u5909\u91cf\u52b9\u679c\u30e2\u30c7\u30eb\u203b(random-effect model)\u3092\u7528\u3044\u305f\u3002<\/p>\n
\u203b\u500b\u3005\u306e\u7814\u7a76\u306b\u304a\u3051\u308b\u554f\u984c\u8a2d\u5b9a\u306f\u7570\u306a\u3063\u3066\u3044\u308b\u3082\u306e\u306e\u3001\u985e\u4f3c\u3057\u305f\u554f\u984c\u8a2d\u5b9a\u3092\u3082\u3064\u7814\u7a76\u304c\u5bc6\u63a5\u306b\u95a2\u9023\u3059\u308b\u4e00\u7fa4\u3092\u306a\u3059\u3068\u60f3\u5b9a\u3002\u5404\u3005\u306e\u7814\u7a76\u306f\u3001\u3042\u308b\u554f\u984c\u306b\u95a2\u3059\u308b\u5168\u3066\u306e\u7814\u7a76\u306e\u30e9\u30f3\u30c0\u30e0\u62bd\u51fa\u3055\u308c\u305f\u30b5\u30f3\u30d7\u30eb\u3068\u3057\u3066\u53d6\u308a\u6271\u3046\u3002<\/p>\n
\uff1c\u7d50\u679c\uff1e
\n28\u306e\u7814\u7a76\u304c\u540c\u5b9a\u3055\u308c\u3001\u3046\u306120\u306b\u5bfe\u3057\u3066\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3092\u5b9f\u65bd\u3057\u305f\u3002
\n\u4fb5\u8972\u7684\u306a\u7814\u7a76\u3067\u306f
\n\u25cb\u8840\u7ba1\u9020\u5f71\u3092\u7528\u3044\u3001\u9396\u9aa8\u4e0b\u52d5\u8108\u72ed\u7a84\uff0850\uff05\u4ee5\u4e0a\u306e\u72ed\u7a84\uff09\u3092\u8a3c\u660e\u3059\u308b\u305f\u3081\u306b\u306f\u3001\u5de6\u53f3\u306e\u53ce\u7e2e\u671f\u8840\u5727\u306e\u5dee\u306e\u5e73\u5747\u304c36?9 mm Hg (95% CI 35?4-38?4)\u3067\u3042\u3063\u305f\u3002
\n\u25cb\u5de6\u53f3\u5dee\u304c10mmHg\u4ee5\u4e0a\u3067\u306f\u9396\u9aa8\u4e0b\u52d5\u8108\u72ed\u7a84\uff0850\uff05\u4ee5\u4e0a\u306e\u72ed\u7a84\uff09\u3068\u5f37\u3044\u95a2\u9023\u6027\u304c\u3042\u3063\u305f\u3002(risk ratio [RR] 8?8, 95% CI 3?6-21?2\u3001P<0.0001)\u3002\n\u25cb\u51a0\u52d5\u8108\u9020\u5f71\u7d50\u679c\u3068\u8840\u5727\u5de6\u53f3\u5dee\u306b\u306f\u6709\u610f\u306a\u76f8\u95a2\u306f\u306a\u304b\u3063\u305f\u3002\uff08RR1.1, 95% CI 0.8-1.6\u3001P=0.64\uff09\n\n\u975e\u4fb5\u8972\u7684\u306a\u7814\u7a76\u306b\u304a\u3044\u3066\u3001\n\u25cb\u51a0\u52d5\u8108\u75be\u60a3\u306e\u65e2\u5f80\u3068\u8840\u5727\u5de6\u53f3\u5dee\u306e\u76f8\u95a2\u306f\u306a\u3044\uff08figure2\uff09\n\u25cb15mmHg\u4ee5\u4e0a\u306e\u5de6\u53f3\u5dee\u3068\u5404\u75be\u60a3\u3068\u306e\u95a2\u9023\u306f\u4ee5\u4e0b\u306e\u901a\u308a\u3067\u3042\u3063\u305f\u3002\n\u672b\u68a2\u8840\u7ba1\u969c\u5bb3(9cohorts; RR2?5,95% CI 1?6-3?8; sensitivity 15%,9-23;specificity96%, 94-98) (figure4.A)\n\u3000\u3000\u8133\u8840\u7ba1\u969c\u5bb3\u306e\u65e2\u5f80 (5 cohorts; RR 1?6, 1?1-2?4; sensitivity 8%, 2-26; specificity 93%, 86-97)\u3000\uff08figure3\uff09\n\u3000\u3000\u3000\u3000\u305f\u3060\u3057\u300110mmHg\u4ee5\u4e0a\u3060\u3068\u6709\u610f\u306a\u76f8\u95a2\u306a\u3057\u3001\n15mmHg\u4ee5\u4e0a\u3067\u3082\u540c\u6642\u6e2c\u5b9a\u6cd5\u3060\u3068\u6709\u610f\u5dee\u306a\u3057\uff0f\u540c\u6642\u3067\u306f\u306a\u3044\u6e2c\u5b9a\u6cd5\u3060\u3068\u6709\u610f\u5dee\u3042\u308a\uff08\u4e0a\u8a18\uff09\n\u3000\u3000\u5fc3\u8840\u7ba1\u75be\u60a3\u306b\u3088\u308b\u6b7b\u4ea1\u7387 (4 cohorts; hazard ratio [HR] 1?7, 95% CI 1?1-2?5) (figure5)\n\u3000\u3000\u7dcf\u6b7b\u4ea1\u7387\u3000(4 cohorts; HR 1?6, 95%CI 1?1-2?3) (figure5)\n\u25cb10mmHg\u4ee5\u4e0a\u306e\u5de6\u53f3\u5dee\u3068\u5404\u75be\u60a3\u3068\u306e\u95a2\u9023\u306f\u4ee5\u4e0b\u306e\u901a\u308a\u3067\u3042\u3063\u305f\u3002\n\u3000\u3000\u672b\u68a2\u8840\u7ba1\u969c\u5bb3\u3000(5 studies; RR 2?4, 1?5-3?9; sensitivity 32%, 23-41; specificity 91%, 86-94)\uff08figure4.A\uff09\n\n\uff1c\u89e3\u91c8\uff1e\n\u4e0a\u8155\u306e\u53ce\u7e2e\u671f\u8840\u5727\u5de6\u53f3\u5dee\u304c10mmHg\u4ee5\u4e0a\u3001\u3082\u3057\u304f\u306f15mmHg\u4ee5\u4e0a\u306b\u3088\u308a\u3001\u3055\u3089\u306a\u308b\u8840\u7ba1\u8a55\u4fa1\u304c\u5fc5\u8981\u306a\u60a3\u8005\u306e\u540c\u5b9a\u306b\u5f79\u7acb\u3064\u300215mmHg\u4ee5\u4e0a\u306e\u5de6\u53f3\u5dee\u306f\u8840\u7ba1\u75be\u60a3\u3084\u6b7b\u4ea1\u306e\u30ea\u30b9\u30af\u306e\u6709\u7528\u306a\u6307\u6a19\u306b\u306a\u308a\u3046\u308b\u3002\n\n\n\u3010\u958b\u50ac\u65e5\u3011\n2012\u5e747\u67084\u65e5\n<\/p>\n","protected":false},"excerpt":{"rendered":"
\u3010\u6587\u732e\u540d\u3011 \u8457\u8005\u540d\uff1aClark CE.et al.\u00a0 \u6587\u732e\u30bf\u30a4\u30c8\u30eb\uff1aAssociation of a difference in systolic blood pressure between arms with vas … \u7d9a\u304d\u3092\u8aad\u3080 \u8840\u5727\u306f\u5de6\u53f3\u3067\u6e2c\u308b\u3079\u304d\u304b\uff1f<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-403","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/403","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=403"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/403\/revisions"}],"predecessor-version":[{"id":404,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/403\/revisions\/404"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=403"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=403"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=403"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}