Sex and Age Differences in Ambulatory Blood Pressure Monitoring Tolerability

Abstract

Background Clinical Practice Guidelines endorse using ambulatory blood pressure monitoring (ABPM) for the diagnosis and management of hypertension (HTN). However, ABPM is not always tolerated by patients, and differences between individuals according to age and sex remain unexplored. Methods This is a post-hoc analysis of a prospective, single-arm clinical trial (NCT03920956) that evaluated the feasibility of an ABPM service provided at two community pharmacies. Tolerability was assessed using a previously published survey, which included seven yes/no questions and eight answered on a scale of 0-10. Descriptive statistics and Chi-square analyses were used to summarize the data for the patient surveys and to describe sex and age differences in device tolerability. Results Of the 52 subjects enrolled, 50 (96%) completed the survey; half were female with a mean (SD) age of 57.5 years (15.8). Chi-square analyses showed that compared to their male counterparts, females were more likely to find the monitor cumbersome to wear (76.2% vs. 40%, p = 0.014). Subjects under 55 years of age were more likely to be disturbed by the noise of the monitor during driving (38.1% vs. 4.2%, p = 0.005) and at other times (35.0% vs. 8.3%, p = 0.029), and to find the monitor embarrassing to wear (33.3% vs. 7.1%, p = 0.019). Conclusions Although ABPM was generally well-tolerated overall, we did identify age and sex differences in tolerability. These factors should be considered to ensure patient acceptance and tolerability of ABPM.

Feasibility of 24-h blood pressure telemonitoring in community pharmacies: the TEMPLAR project

“…In a multivariate model taking into account the interaction of the various factors, the significant residual predictors of good-quality ABPM were age, area of the country, and season. In contrast to our finding, a recent study originating from the same setting and evaluating ABPM tolerability through a survey found significantly lower tolerability in women and younger patients (<55 years of age) [20]. However, in two other studies performed in a hospital setting, older patients complained more often about discomfort during the recording [7,23].…”

“…Our study evaluated in a broad group of patients visiting community pharmacies the quality level of ABPMs and its association with patients' demographic and clinical characteristics. To our knowledge, only two studies evaluated the feasibility of ABPM in community pharmacies [9,20]. In contrast with these studies, our study is based on a larger sample of patients and included individuals homogeneously representing different geographical areas within the same country.…”

“…In contrast with these studies, our study is based on a larger sample of patients and included individuals homogeneously representing different geographical areas within the same country. Besides, compared with previous studies carried out in a pharmacy, primary care, or research setting, in our study, the evaluation of the test feasibility was not based on self-reported information but rather on an objective evaluation of the quality of ABPM recordings [5][6][7]20,21].…”

Cost-accuracy and patient experience assessment of blood pressure monitoring methods to diagnose hypertension: A comparative effectiveness study

“…Therefore, 1 h-AOBP and HBPM may be the best methods for physicians based on the patient experience. Studies of patient experiences in the diagnosis of hypertension show that HBPM is better accepted than OBPM, mainly because of patient confidence in the accuracy of BP measurement ( 32 ). However, a nationwide physician survey in Canada—where AOBP is most established, since the Canadian Hypertension guidelines included it as a valid method—showed that the preferred method of hypertension screening remains OBPM carried out with mercury devices (54.2%) compared with AOBP (38.8%) ( 33 ).…”

Association between Cardio-Ankle Vascular Index and Masked Uncontrolled Hypertension in Hypertensive Patients: A Cross-Sectional Study

“…ABPM measurement is more closely associated with hypertension-mediated target organ damage and the risk of cardiovascular events, is more reproducible than office BP measurement, and can help identify MUCH in treated hypertensive subjects [ 7 ]. However, ABPM measurement is limited often due to time restraints and intolerances when wearing [ 8 ]. Most hypertension screening and BP control assessments use office BP measurement, which is usually normal in patients with MH or MUCH.…”