Key result
Wrist-worn tonometric monitoring underestimates 24-hour systolic BP by ~7 mmHg vs. oscillometric devices.
Why the study?
Correct measurement of BP is important for optimal diagnosis and treatment of hypertension, but how wrist-worn tonometric monitoring compares to conventional oscillometric monitoring was unclear.
Does a wrist-worn tonometric blood pressure monitoring device accurately measure 24-hour blood pressure compared to a conventional oscillometric device in patients at a renal outpatient clinic?
Cross-Sectional (n=100)
No
Does a wrist-worn tonometric blood pressure monitoring device accurately measure 24-hour blood pressure compared to a conventional oscillometric device in patients at a renal outpatient clinic?
Answers are grounded in this paper and cite their sources.
Wrist-worn tonometric blood pressure monitoring significantly underestimates systolic blood pressure compared to conventional oscillometry, resulting in the misclassification of uncontrolled hypertension and non-dipping status in renal patients.
Aim: Correct measurement of blood pressure (BP) is important for optimal diagnosis and treatment of patients with hypertension. The aim of this study was to compare a wrist-worn device using tonometric measurements of BP to a conventional device using oscillometric measurements of 24 h BP, diagnosing of hypertension, and non-dipping. Methods: One-hundred patients in the Renal Outpatient Clinic had 24 h ambulatory BP monitoring performed with a tonometric device, BPro, and an oscillometric device, A&D, simultaneously. Results: Twenty-four-hour and daytime systolic BP was significantly lower using tonometric monitoring compared to oscillometric (7 and 6 mmHg, respectively, p < 0.001). In the population of patients diagnosed with hypertension, the tonometric device diagnosed 90% of patients with uncontrolled hypertension correctly (positive predictive value), whereas 49% of patients classified as normotensive were uncontrolled hypertensive (negative predictive value). The mean difference between relative nocturnal BP decrease between tonometric and oscillometric was 2± 8% ( p < 0.01), and 33% of patients classified as dippers were non-dippers (negative predictive value). Conclusion: Using the BPro device for tonometric monitoring of BP and classification of hypertension and non-dipping in patients diagnosed with hypertension leads to misclassification of patients. Therefore, the BPro device is not suitable for clinical practice in hypertensive patients from a Renal Outpatient Clinic.
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Hornstrup et al. (2020) conducted a cross-sectional in Hypertension (n=100). Wrist-worn tonometric blood pressure monitoring (BPro) vs. Conventional upper-arm oscillometric blood pressure monitoring (A&D TM-2430) was evaluated on 24-hour systolic blood pressure (Mean difference 7 mmHg, p=<0.0001). Wrist-worn tonometric blood pressure monitoring significantly underestimated 24-hour systolic blood pressure by a mean of 7 mmHg compared to oscillometric monitoring, leading to misclassification of hypertension control.
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