Systolic blood pressures are not comparable when home blood pressure is measured with a wrist or an arm validated monitor

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

“…Only one published study provided a clinical application comparison of wrist vs. arm home measurements in 265 patients with hypertension. 7 That study was similar to ours, in that routine home measurements were obtained with each device for a few days in a randomized order. Their study showed that wrist-monitored HBP was 8/1 mm Hg (systolic/ diastolic) lower than arm-monitored HBP, which is in line with the findings of our study.…”

“…However, arm-monitored BP remains the fundamental measurement that shows the risks associated with elevated BP and the benefits of antihypertensive treatment, and ABP is regarded as the optimal method for the assessment of the BP load on the heart and vasculature. 3 Three published studies have provided direct comparisons of wrist vs. arm devices 6,7,22 A small study in 15 subjects took hourly readings at home, alternating between a wrist device and an arm device (four readings with each). 22 That study found similar average BP values with the two devices as well as similar s.d.…”

“…Their study showed that wrist-monitored HBP was 8/1 mm Hg (systolic/ diastolic) lower than arm-monitored HBP, which is in line with the findings of our study. 7 The authors attributed this difference to uncertainty in the arm position with the use of wrist devices, and discouraged the use of these devices in order to avoid the uncertainty associated with possible improper use. Additional information is provided by our study, because novel wrist devices fitted with position sensors that ensure the standardization of the measurement were used, ABP measurements were used as reference, and factors that could contribute to the difference between wrist-monitored and -monitored HBP were investigated.…”

“…It is clear that one of the major issues in the application of wrist devices is the difficulty in standardizing the arm position [6][7][8][9] and that the development of a position sensor is expected to overcome this problem. 10 study the s.d.…”

“…5 The main source of inaccuracy of wrist manometers appears to be related to uncertainty regarding the arm position. [6][7][8] Wrist measurements are also influenced by flexion and hyperextension of the wrist. 8,9 Recent technological advances provided wrist devices fitted with position sensors that allow self-measurements to be taken only when the devices are at heart level.…”