Week of cuffless, continuous BP monitoring may improve hypertension management
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Key takeaways:
- Continuous BP monitoring with a cuffless device may provide sufficient data to accurately evaluate patient time in target range.
- One week of 24-hour data was enough to accurately classify most patients.
With use of a cuffless BP device, 1 week of continuous monitoring was enough to accurately identify the majority of patients’ time in target range, which may improve management of hypertension, researchers reported.
“The successful management of hypertension depends on patients being able to take blood pressure measurements easily and reliably outside of the traditional doctor’s office setting,” Naomi D. L. Fisher, MD, director of the hypertension service and hypertension specialty clinic in the division of endocrinology, diabetes and hypertension at Brigham and Women’s Hospital and associate professor of medicine at Harvard Medical School, said in a press release. “Cuffless devices have the potential to revolutionize hypertension management. They provide many more readings than traditional devices, during both the day and night, which can help confirm the diagnosis of hypertension and guide medication titration.”
To investigate the optimal duration of time in target range assessment as a potential metric to improve BP management, Fisher and colleagues conducted a retrospective study, published in Frontiers in Medicine, of nearly 2.3 million BP readings from 5,189 home users of a cuffless oscillometric BP device (Aktiia SA) in the U.K., Germany and Switzerland (mean age, 55 years; 82% men).
On average, 29 readings per participant per day were collected, and a mean of 434 readings per participant over 15 days were analyzed.
Participants were classified into groups A, B, C or D, based on a 15-day reference time in target range, defined as 24-hour target of 90 mm Hg to 125 mm Hg with six or more daytime systolic BP readings: 0%, 25%, 50% or 75%, respectively.
Overall, 63% of the participants were classified as group A, 10.3% as group B, 8.7% as group C and 18% as group D based on the reference time in target range.
For this analysis, the researchers compared different quantities of daily readings over differing ranges of days on the classification of time in target range BP.
Fisher and colleagues concluded that 1 week of 24-hour BP monitoring with the cuffless device was needed to classify time in target range with 90% sensitivity compared with the 15-day reference.
Moreover, participants with six or more 24-hour readings per day were more accurately classified compared with those with two or four readings per day, with a sensitivity approaching 90% by 1 week.
Continuous monitoring for 1 day inaccurately classified 26% of participants compared with the 15-day reference, whereas daytime monitoring only for 1 week inaccurately classified 45% of participants compared with the 15-day reference, the researchers wrote.
“At least 1 week of 24-hour continual monitoring was needed to identify a subject’s BP risk with time in target range at 90% sensitivity, which can only be achieved in practice with cuffless BP devices,” Fisher and colleagues wrote. “Our results suggest that continual cuffless BP monitoring enables rapid and practical assessment of systolic BP time in target range, an emerging metric of hypertension control.
“Cuffless BP technologies represent a dramatic shift in the paradigm of BP monitoring and hypertension management,” the researchers wrote. “The employment of cuffless BP devices in future studies should allow improved assessments of hypertension control, and their use in clinical practice and research may innovate hypertension management.”
Reference:
- Study finds innovative cuffless blood pressure device streamlines and enhances hypertension management. https://www.eurekalert.org/news-releases/1049307. Published June 26, 2024. Accessed June 27, 2024.
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