The QardioArm Blood Pressure App for Self-Measurement in an Obese Population: Validation Study Using the European Society of Hypertension International Protocol Revision 2010

Abstract

BackgroundObesity and high blood pressure (HBP) pose high cardiovascular risks, and they are frequent causes of cardiovascular disease.ObjectiveThe aim of this study was to validate the mobile app QardioArm for high blood pressure monitoring in obese subjects (body mass index ≥30 kg/m2) according to guidelines in the European Society of Hypertension-International Protocol 2 (ESH-IP2).MethodsWe recruited 33 obese subjects and measured their blood pressure using QardioArm (test device) and Omron M3 Intellisense (Omron Healthcare, Kyoto, Japan; standard device). We compared systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) according to the ESH-IP2.ResultsA total of 95 of 99 differences for SBP and 91 of 99 for DBP displayed absolute differences within 10 mm Hg. A total of 98 of 99 differences for SBP and 98 of 99 for DBP exhibited absolute differences within 15 mm Hg. This result satisfied requirements for part 1 of the ESH-IP2. A total of 27 out of 33 individuals for SBP and 30 out of 33 individuals for DBP had a minimum of 2 of 3 comparisons within 5 mm Hg difference. None of the subjects had 3 differences outside 5 mm Hg for SBP and DBP, satisfying part 2 of the ESH-IP2. For HR measurements, a total of 90 of 99 differences had absolute differences within 3 beats per minute (bpm), and a total of 94 or 99 differences had absolute differences within 5 bpm. A total of 98 of 99 differences had absolute differences within 8 bpm. Therefore, the test device satisfied part 1 of ESH-IP2 criteria for HR. For part 2 of ESH-IP2, 31 of 33 individuals had a minimum of 2 of 3 comparisons within 3 bpm difference for HR. Only 1 of 33 subjects had 3 differences outside 3 bpm.ConclusionsTo the best of our knowledge, this was the first study to show that an app that measures blood pressure and HR meets the requirements of the ESH-IP2 in an obese population. We believe the ESH-IP2 should publish explicit criteria for validation of blood pressure devices in specific populations.

QardioArm Upper Arm Blood Pressure Monitor Against Omron M3 Upper Arm Blood Pressure Monitor in Patients With Chronic Kidney Disease: A Validation Study According to the European Society of Hypertension International Protocol Revision 2010

“…QardioArm in the general population achieved better results in both phases of the protocol for systolic and diastolic BP, especially in part 1 (higher differences in the 3 categories) [28]. Within phase 1, the differences obtained in the systolic BP of renal patients in this study were very similar to those of the general population [28], whereas the differences obtained in the diastolic BP were more similar to the obese population [30]. Phase 2 of this study was almost identical to the 3 previous validations [28-30], with minor differences (1 or 2 individuals).…”

“…QardioArm has been previously validated for the general population in the first place by our team [28] and later by other authors [29]. In addition, our team validated QardioArm in obese patients [30].…”

“…According to the results of our prior works, the number of differences included in each category according to the ESH-IP2 (5, 10, and 15 mm Hg) for systolic BP and diastolic BP was similar in the 3 validations [28-30], as parts 1 and 2 of the protocol were passed. QardioArm in the general population achieved better results in both phases of the protocol for systolic and diastolic BP, especially in part 1 (higher differences in the 3 categories) [28].…”

QardioArm Blood Pressure Monitoring in a Population With Type 2 Diabetes: Validation Study

“…QardioArm was validated in 2017 [ 36 , 37 ] in the general population. Furthermore, QardioArm has also been validated in a population of obese individuals in 2018 [ 38 ], and recently, in a population of individuals with chronic kidney disease [ 39 ].…”

The Effect of Electrolytes on Blood Pressure: A Brief Summary of Meta-Analyses

“…Obviously, randomized (controlled) trials are necessary to study this assumption. Also, future clinical trials could determine the effect of different electrolytes on blood pressure by patients’ self-assessment of blood pressure with new validated mHealth devices, like a previous study in obese individuals has shown [69].…”