Comparison of nighttime measurement schedules using a wrist‐type nocturnal home blood pressure monitoring device

Abstract

We investigated the optimal nighttime home blood pressure (BP) measurement schedule for wrist BP monitoring. Fifty hypertensive patients (mean age 68.9 ± 11.3 years) self-measured their nighttime BP hourly using a wrist-type nocturnal home BP monitoring device at home on two consecutive nights. Using the average 7.2 ± 1.5 measurements per night, we compared the clock-based index (average of three measurements at 2:00, 3:00, and 4:00 a.m.) and the bedtime-based index (average of three measurements at 2, 3, and 4 h after bedtime). The clock-based average was significantly higher than the bedtime-based average for both systolic BP (2.7 ± 8.2 mmHg, P = .002) and diastolic BP (1.9 ± 5.1 mmHg, P < .001). Compared to the average of all measurements throughout a night (the same definition of ambulatory BP monitoring, ie, from the time point of going to bed to awakening), the clock-based average was comparable (systolic/diastolic BP: −0.5 ± 5.5/−0.2 ± 3.7), whereas the bedtime-based average was significantly lower (−3.3 ± 5.0/−2.1 ± 3.6). Thus, the repeated measurement of wristmeasured nighttime BP at three clock-based time points per night provided reliable values. Further prospective studies of larger populations are required to confirm the optimal nighttime BP measurement schedule for wrist BP monitoring for the prediction of cardiovascular events.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Reproducibility of nighttime home blood pressure measured by a wrist‐type nocturnal home blood pressure monitoring device

“…As previously reported, the self‐monitored nighttime home systolic BP (SBP) values measured by the wrist HBPM device equipped with a supine‐position algorithm were comparable to those measured by the upper arm HBPM device 9,13 . In a previous paper, we reasoned that the significantly lower diastolic BP (DBP) measured with a wrist device compared to that measured with an upper arm‐device could be due to the different BP algorithms used in the two devices 9 .…”

“…As previously reported, the self‐monitored nighttime home systolic BP (SBP) values measured by the wrist HBPM device equipped with a supine‐position algorithm were comparable to those measured by the upper arm HBPM device. 9 , 13 In a previous paper, we reasoned that the significantly lower diastolic BP (DBP) measured with a wrist device compared to that measured with an upper arm‐device could be due to the different BP algorithms used in the two devices. 9 Among all the 50 participants, the ICCs for the agreement of each reading simultaneously taken by the wrist and upper arm HBPM device in SBP, DBP, and heart rate were 0.802, 0.686, and 0.877, respectively ( Supplementary Table ).…”

Sleep and nocturnal hypertension: Genes, environment, and individual profiles

“… 18 Wearable wrist‐type oscillometric home BP monitoring is validated, and its accuracy is comparable to the upper‐arm deviuce. 19 , 20 In addition, it is much less likely to disturb sleep, compared with upper‐arm device. 19 , 20 Sleep quality and quantity seem to be the key factors determining nocturnal hypertension.…”

“… 19 , 20 In addition, it is much less likely to disturb sleep, compared with upper‐arm device. 19 , 20 Sleep quality and quantity seem to be the key factors determining nocturnal hypertension. 21 The detection of nocturnal hypertension by ABPM or home BP and the improvement of sleep hygiene by digital therapeutics 22 may achieve more effective prevention of cardiovascular disease.…”

“…Wearable cuff‐less BP monitoring is ideal to minimize sleep disturbance, but it is not recommended in clinical practice 18 . Wearable wrist‐type oscillometric home BP monitoring is validated, and its accuracy is comparable to the upper‐arm deviuce 19,20 . In addition, it is much less likely to disturb sleep, compared with upper‐arm device 19,20 .…”