Cuff inflations do not affect night-time blood pressure

Abstract

Discomfort related to cuff inflation may bias 24 h ambulatory blood pressure (BP) measurements, especially during night-time. We accessed the impact of cuff inflations by comparing 24 h BP recorded with a cuff-less tonometric wrist device and an upper-arm oscillometric cuff device. Fifty-three participants with type 2 diabetes were assigned randomly to four 24-h BP recordings with a cuff (TM2430: visit 1 or 2, and 4) and a tonometric device (BPro: visit 1 or 2, 3, and 4). The mean 24 h systolic BP was significantly higher when measured with the cuff versus the tonometric device (141.6±14.6 vs. 128.3±14.6 mmHg, P≤0.01), as was nocturnal BP (6.7±5.3 vs. 10.3±7.6%, P=0.002). In conclusion, nocturnal BP decline was higher when measured with the cuff device, suggesting that cuff inflations did not increase night-time BP. Further evaluation of the tonometric device using the updated European Society of Hypertension International Protocol revision 2010 is recommended before applying it in daily clinical practice.

Screening for hypertension in adults – the use of tonometric blood pressure monitoring

“…Subjects reported less discomfort related to the tonometric device compared to the oscillometric device, and they preferred monitoring with the tonometric device if they had to repeat monitoring. This is in line with finding from Petersen et al [19]. In addition, they also reported that nocturnal BP and BP decline, despite patients reported nocturnal discomfort related to use of an inflatable upper arm monitor, was not influenced by this discomfort.…”

“…Difference in nocturnal SBP decrease or nighttime levels between tonometric and oscillometric measurements have been reported in a study from 2015 on 53 diabetes patients by Petersen et al [ 19 ], in a study by Komori et al . [ 20 ] in young normal- and prehypertensive patients, and in the previous study of hypertensive patients by our group [ 21 ].…”

“…This is in line with finding from Petersen et al . [ 19 ]. In addition, they also reported that nocturnal BP and BP decline, despite patients reported nocturnal discomfort related to use of an inflatable upper arm monitor, was not influenced by this discomfort.…”

Reproducibility of sequential ambulatory blood pressure and pulse wave velocity measurements in normotensive and hypertensive individuals

“…This could be attributable to inconsistency of nocturnal dipping patterns [22] or direct interruption of sleep due to the operation of the ABPM device. Poor sleep quality is associated with increased BPV [23] and with increased BP [24], but it is contentious whether ABPM devices impair sleep quality enough to produce a significant increase in nocturnal pressures [25,26]. We were not able to analyse the effect of sleep quality in this study, but sleep duration did not appear to have a significant effect on night-time variability.…”