Measurement of SBP at home by parents using hand-held Doppler device and aneroid sphygmomanometer: a single-centre experience

Abstract

Objective: We taught parents to use at home a hand-held Doppler device and aneroid sphygmomanometer for SBP measurement (HDBPM).Methods: Retrospective study including all children referred to evaluate hypertension over a 6-year period. Each child underwent HDBPM measurements performed by parents while awake over 2 weeks with three measurements performed twice daily.Results: Of n ¼ 155 children, 145 (93.5%) were successful and aged median (interquartile range) 2.48 (1.01, 5.12) years, including 85 boys. Overall, there were 25, 19, 30 and 26% aged less than 1, 1 to less than 2, 2 to less than 5 and at least 5 years old, respectively. Seventy-eight (54%) had been referred for confirming diagnosis and 67 (46%) for ongoing monitoring of treated hypertension. Following HDBPM, 70 of 78 (90%) patients in the 'Diagnosis subgroup' were observed to have normal blood pressure (BP). In the monitoring subgroup, treated hypertension that required no medication changes was recorded in 35 of 67 (52%) and medication changed in 32 of 67 (48%), [increased, decreased or changed] in 22, 6 and 5%, respectively. In 10 of 67 (15%) medication was weaned and stopped completely following HDBPM. None of the children required admission to hospital to evaluate their BP level or manage hypertension. Conclusion:Out-of-office BP monitoring using HDBPM is acceptable to children and families of young children when parents are taught to measure BP and supported by health professionals. We report evidence of the feasibility and clinical utility of HDBPM in a challenging population of children who are either too young or unable to tolerate 24-h ambulatory BP monitoring for both the diagnosis and ongoing management of clinically relevant hypertension.

Reliability of systolic blood pressure measured by parents in young children at home using a hand held doppler device and aneroid sphygmomanometer

“…We have previously shown systolic BP measured using doppler device to be similar to that measured using auscultation with <1 mmHg difference between the two methods [16]. Using HDBPM, in this study, we observed an average difference of ∼3 mmHg, with home systolic BP values lower than those measured in office using the same technique.…”

“…Currently, normative data for blood pressure at home is only available for children age 6–18 years using automated oscillometric BP instrument [8], with no normative out-of-office data for children less than 5 years and none using HDBPM. Despite this, as systolic BP measured using HDBPM is similar to auscultatory systolic BP it is relevant and shown to be clinically helpful [16]. Despite the low study numbers, we would contend that our finding of lower than initially estimated difference between Office-SBP Doppler and Home-SBP Doppler , provides further useful data to inform design for a prospective study evaluating agreement between home and office BP for young children.…”

“…Blood pressure evaluation in young children <5 years old remains challenging with sparse data regarding HBP. We have previously reported BP monitoring performed by parents at home using a hand-held doppler device and aneroid sphygmomanometer for SBP measurements (HDBPM) [15,16].…”

“…We have previously reported data highlighting comparability of auscultatory office SBP measurement with office SBP measured using a doppler device and the same cuff and aneroid sphygmomanometer [16]. In this report, our objectives in children aged <5, were to compare health professional measured office systolic BP by doppler device (Office-SBP Doppler ) vs. parent measured systolic BP using same doppler device at home (Home-SBP Doppler ); to evaluate the reliability of parent measured systolic BP measurements using doppler device at home (Home-SBP Doppler ); and to evaluate the optimal number of days for monitoring with HDBPM.…”

Reliability of systolic blood pressure measured by parents in young children at home using a hand held Doppler device and aneroid sphygmomanometer: methodological issue to avoid misinterpretation

“…Reliability of systolic blood pressure measured by parents in young children at home using a hand held Doppler device and aneroid sphygmomanometer: methodological issue to avoid misinterpretation Siamak Sabour a,b I read with great interest the study by Newton et al that published in the J Hypertens 2024 Feb. [1] The purpose of the study was to compare health professional measured office systolic BP by Doppler device (Office-SBP Doppler) with parent measured home systolic BP using the same Doppler device (Home-SBP Doppler). They also report data evaluating reliability.…”