Why the study?
Traditional home blood pressure protocols could overlook diurnal fluctuations that may be linked with adverse cardiovascular outcomes.
Does wearable home blood pressure monitoring reliably detect out-of-office control status compared to 24-h ambulatory blood pressure monitoring in treated hypertensive patients?
Does wearable home blood pressure monitoring reliably detect out-of-office control status compared to 24-h ambulatory blood pressure monitoring in treated hypertensive patients?
Wearable home blood pressure monitoring demonstrates good reliability and reproducibility compared to 24-hour ambulatory monitoring, identifying a significant proportion of patients with masked uncontrolled hypertension.
Answers are grounded in this paper and cite their sources.
Wearable HBP shows promise for out-of-office assessment in treated hypertension; leaves open its integration into practice pending prospective validation.
Ambulatory blood pressure (ABP) and home blood pressure (HBP) monitoring is currently recommended for management of hypertension. Nonetheless, traditional HBP protocols could overlook diurnal fluctuations, which could also be linked with adverse cardiovascular outcomes. In this observational study, we studied among a group of treated hypertensive patients (N = 62, age: 52.4 ± 10.4 years) by using out-of-office ABP and wearable HBP. They received one session of 24-h ABP measurement with an oscillometric upper-arm monitor, and totally three sessions of 7-day/6-time-daily wearable HBP measurement separated in each month with HeartGuide. Controlled hypertension is defined as an average BP <130/80 mmHg for both daytime ABP and HBP. There was substantial reliability (intraclass correlation coefficient, ICC 0.883-0.911) and good reproducibility (Cohen's kappa = 0.600) for wearable HBP measurement, especially before breakfast and after dinner. Among all patients, 27.4% had both uncontrolled HBP and ABP, 30.6% had uncontrolled HBP only, while 6.5% had uncontrolled ABP only. Female gender and increased numbers of anti-hypertensive agents are correlated with controlled hypertension. Patients with uncontrolled hypertension had a significantly higher maximal daytime blood pressure, which was previously signified as an imperial marker for cardiovascular risk. In conclusion, wearable HBP monitoring in accordance with a dedicated daily-living schedule results in good reliability and reproducibility. Patients with an uncontrolled wearable HBP should benefit from repeated HBP or ABP measurement for risk stratification.
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Pan et al. (2024) studied this question.
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