Can Validated Wrist Devices With Position Sensors Replace Arm Devices for Self-Home Blood Pressure Monitoring? A Randomized Crossover Trial Using Ambulatory Monitoring as Reference

Stergiou, George S.; Christodoulakis, George R; Nasothimiou, Efthimia; Giovas, Periklis; Kalogeropoulos, Petros

doi:10.1038/ajh.2008.176

Cited by 19 publications

(16 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The full text of 164 papers was reviewed for eligibility (figure 1) and 37 studies were included (32 published in English). One was a randomised trial and one a case–control study;17 18 the remainder were cross-sectional studies. Twenty studies (26 comparisons) had extractable data, all of which were of cross-sectional design.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review

Irving

Holden²,

Stevens

et al. 2016

BMJ Open

View full text Add to dashboard Cite

ObjectiveTo determine the diagnostic accuracy of different methods of blood pressure (BP) measurement compared with reference standards for the diagnosis of hypertension in patients with obesity with a large arm circumference.DesignSystematic review with meta-analysis with hierarchical summary receiver operating characteristic models. Bland-Altman analyses where individual patient data were available. Methodological quality appraised using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS2) criteria.Data sourcesMEDLINE, EMBASE, Cochrane, DARE, Medion and Trip databases were searched.Eligibility criteriaCross-sectional, randomised and cohort studies of diagnostic test accuracy that compared any non-invasive BP tests (upper arm, forearm, wrist, finger) with an appropriate reference standard (invasive BP, correctly fitting upper arm cuff, ambulatory BP monitoring) in primary care were included.Results4037 potentially relevant papers were identified. 20 studies involving 26 different comparisons met the inclusion criteria. Individual patient data were available from 4 studies. No studies satisfied all QUADAS2 criteria. Compared with the reference test of invasive BP, a correctly fitting upper arm BP cuff had a sensitivity of 0.87 (0.79 to 0.93) and a specificity of 0.85 (0.64 to 0.95); insufficient evidence was available for other comparisons to invasive BP. Compared with the reference test of a correctly fitting upper arm cuff, BP measurement at the wrist had a sensitivity of 0.92 (0.64 to 0.99) and a specificity of 0.92 (0.85 to 0.87). Measurement with an incorrectly fitting standard cuff had a sensitivity of 0.73 (0.67 to 0.78) and a specificity of 0.76 (0.69 to 0.82). Measurement at the forearm had a sensitivity of 0.84 (0.71 to 0.92) and a specificity 0.75 of (0.66 to 0.83). Bland-Altman analysis of individual patient data from 3 studies comparing wrist and upper arm BP showed a mean difference of 0.46 mm Hg for systolic BP measurement and 2.2 mm Hg for diastolic BP measurement.ConclusionsBP measurement with a correctly fitting upper arm cuff is sufficiently sensitive and specific to diagnose hypertension in patients with obesity with a large upper arm circumference. If a correctly fitting upper arm cuff cannot be applied, an incorrectly fitting standard size cuff should not be used and BP measurement at the wrist should be considered.

show abstract

Section: Resultsmentioning

confidence: 99%

“…17 21 23 31 Funnel plot and χ 2 tests suggested a low probability of publication bias (p=0.89) or heterogeneity (χ 2 : Q=4.26, df=2.00, p=0.06), and subgroup analyses were not possible.…”

Section: Resultsmentioning

confidence: 99%

Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review

Irving

Holden²,

Stevens

et al. 2016

BMJ Open

View full text Add to dashboard Cite

show abstract

“…The error introduced by the hydrostatic effect of differences in position of the wrist relative to the heart can be avoided with the use of position sensors. Indeed, it has been shown that wrist devices are more accurate if they are provided with optical sensors that guide the arm to an appropriate measuring position [17,18]. Another contrary view against the use of equipment performing measurement at the wrist is that wrist cuffs may insufficiently occlude the wrist arteries and thus yield higher BP readings.…”

Section: Discussionmentioning

confidence: 97%

Validation of the visocor HM40 wrist blood pressure measuring device according to the International Protocol

Dorigatti

Bonso

Saladini

et al. 2009

Blood Pressure Monitoring

View full text Add to dashboard Cite

The objective of this study was to determine the accuracy of the UEBE visocor HM40 device for blood pressure measurement at the wrist, tested according to the requirements of the International Protocol of the European Society of Hypertension (ESH). Device evaluation was performed in 33 patients whose age and blood pressure were within the intervals required by the ESH protocol. Their mean +/- SD age was 53.2 +/- 15.5 years (range 30-85 years), systolic blood pressure (SBP) was 142.8 +/- 21.8 mmHg (range 108-178 mmHg), diastolic blood pressure (DBP) was 87.0 +/- 15.4 mmHg (range 62-112 mmHg), and wrist circumference was 18.7 +/- 2.7 cm (range 15.5-21.5 cm). During the measurements, which were performed in the supine position, the patient's wrist was kept extended at the heart level with a support under the forearm. In total, 45 measurements were available for analysis in the first phase of the validation process, and 99 measurements in the second phase. The visocor HM40 passed all three phases of the ESH protocol for SBP and DBP. Mean blood pressure differences for the visocor HM40 monitor (device-observer) were -2.0 +/- 5.0 mmHg for SBP and -1.7 +/- 5.3 mmHg for DBP, respectively. These data show that the UEBE visocor HM40 wrist monitor met the requirements for validation by the International Protocol and can be recommended for clinical use in the adult population.

show abstract

“…Approximately two‐thirds of the facilities used upper arm BP measurement devices, indicating that use of these devices is sufficiently practical in these settings. Moreover, wrist devices, which have been reported to be inaccurate,11, 12 are not recommended by the guidelines 3. Guggiari and colleagues reported that relative to upper arm devices, validated wrist devices significantly underestimate BP in the elderly 13…”

Section: Discussionmentioning

confidence: 99%

Adherence to blood pressure measurement guidelines in long‐term care facilities: A cross sectional study

Ozone

Takayashiki

Sakamoto

et al. 2018

J of Gen and Family Med

View full text Add to dashboard Cite

ObjectiveTo assess the extent to which long‐term care facilities in Japan adhere to blood pressure (BP) measurement guidelines.DesignCross‐sectional, observational survey.SettingJapan (nationwide).ParticipantsGeriatric health service facilities that responded to a questionnaire among 701 facilities that provide short‐time daycare rehabilitation services in Japan.MethodsA written questionnaire that asked about types of measurement devices, number of measurements used to obtain an average BP, resting time prior to measurement, and measurement methods when patients’ arms were covered with thin (eg, a light shirt) or thick sleeves (eg, a sweater) was administered.Main outcome measureProportion of geriatric health service facilities adherent to BP measurement guidelines.ResultsThe response rate was 63.2% (443/701). Appropriate upper‐arm BP measurement devices were used at 302 facilities (68.2%). The number of measurements was appropriate at 7 facilities (1.6%). Pre‐measurement resting time was appropriate (≥5 minutes) at 205 facilities (46.3%). Of the 302 facilities that used appropriate BP measurement devices, 4 (1.3%) measured BP on a bare arm if it was covered with a thin sleeve, while 266 (88.1%) measured BP over a thin sleeve. When arms were covered with thick sleeves, BP was measured on a bare arm at 127 facilities (42.1%) and over a sleeve at 78 facilities (25.8%).Conclusions BP measurement guidelines were not necessarily followed by long‐term care service facilities in Japan. Modification of guidelines regarding removing thick sweaters and assessing BP on a visit‐to‐visit basis might be needed.

show abstract

Can Validated Wrist Devices With Position Sensors Replace Arm Devices for Self-Home Blood Pressure Monitoring? A Randomized Crossover Trial Using Ambulatory Monitoring as Reference

Cited by 19 publications

References 31 publications

Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review

Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review

Validation of the visocor HM40 wrist blood pressure measuring device according to the International Protocol

Adherence to blood pressure measurement guidelines in long‐term care facilities: A cross sectional study

Contact Info

Product

Resources

About