<p>Comparison of Ambulatory Tonometric and Oscillometric Blood Pressure Monitoring in Hypertensive Patients</p>

Abstract

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 nondippers (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.

Patient preferences for ambulatory blood pressure monitoring devices: Wrist-type or arm-type?

“…Some studies have compared this device with other conventional arm-cuff ABPM devices including the A&D TM-2430 in complicated hypertensive patients [ 14 ], the A&D TM 2431 in normotensive and prehypertensive volunteers [ 15 ], the A&D TM 2421 in patients with diabetes [ 16 ] and Spacelabs 90207 in hypertensive patients [ 17 ].…”

Validation of the BPro radial pulse waveform acquisition device in pregnancy and gestational hypertensive disorders

“…The sensor detects the maximum radial arterial signal, which is then processed by an algorithm to result in the arterial pressure waveform with a numeric display of BP. However, factors such as increased arterial stiffness or distribution of forearm soft tissue in obese patients have been shown to interfere with this arterial signal and, thus, device accuracy [11,12] These factors may similarly impact upon the accuracy of BPro in pregnancy, particularly in those with preeclampsia as demonstrated in our study. For example, increased arterial stiffness is a common finding both in those at risk of preeclampsia due to underlying comorbidities such as chronic hypertension or due to the disease itself [13].…”

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

“…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 consistency of difference suggests that the tonometric device is not suitable for assessment of nocturnal BP in any population.…”