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

Abstract

The authors investigated the reproducibility of nighttime home blood pressure (BP) measured by a wrist‐type BP monitoring device. Forty‐six hypertensive patients (mean 69.0±11.6 years, 56.5% male) self‐measured their nighttime BP hourly using simultaneously worn wrist‐type and upper arm‐type nocturnal home BP monitoring devices at home on two consecutive nights. Using the average 7.4±1.3 measurements on the first night and the average 7.0 ± 1.8 measurements on the second night, the authors assessed the reliability and the reproducibility of nighttime BP measured on the two nights. The difference between nights in systolic BP (SBP) measured by the wrist‐device was not significant (1.6±7.0 mmHg, p = .124), while the difference in diastolic BP (DBP) was marginally significant (1.4±4.9 mmHg, p = .050). The intraclass correlation coefficients (ICCs) for agreement between nights were high both in SBP and DBP average (SBP: 0.835, DBP: 0.804). Averaging only three points of SBP resulted in lower ICC values, but still indicated good correlations (ICC > 0.6). On the other hand, the correlations of the standard deviation and average real variability of SBP between nights were low, with ICCs of 0.220 and 0.436, respectively. In conclusion, the average SBP values measured on the first night were reliable even when averaging only three readings. The reproducibility of nighttime BP variability seemed inferior to that of BP average; it might be better to measure nighttime BP over multiple nights to assess BP variability. However, this hypothesis needs verification in other study population. In addition, our study population had well‐controlled BP, which limits the generalizability of this findings to all hypertensive patients.

Nighttime home blood pressure lowering effect of esaxerenone in patients with uncontrolled nocturnal hypertension: the EARLY-NH study

“…However, the “change in BP” had similar BP values and SDs for the brachial and the wrist devices (SBP/DBP at EOT, −12.9 ± 10.3/−5.4 ± 5.6 for the brachial, and −11.7 ± 10.9/−5.4 ± 6.0 for the wrist). As previously reported [ 4 – 7 ], these results suggest that the wrist device can be used to monitor nighttime BP changes as well as the brachial type recommended in the guidelines. Advances in the development of HBPM devices reduce patients’ burdens, and enable them to monitor nighttime BP, which has been previously only measurable by ABPM.…”

“…Identifying patients with nocturnal hypertension is difficult because of the high patient burden of measuring nighttime blood pressure (BP) with ambulatory BP monitoring (ABPM). However, recent development of brachial and wrist type nocturnal home BP monitoring (HBPM) devices makes taking nighttime BP measurements easier [ 2 , 4 – 7 ].…”

Antihypertensive effect of esaxerenone and correlation between brachial and wrist home monitoring devices in patients with nocturnal hypertension: A post hoc analysis of the EARLY‐NH study

“…Regarding the correlation between the two HBPM devices, previous reports have shown that nighttime home BP measurements obtained with the wrist device are reproducible and were consistent with measurements obtained with the brachial device 28–30 . However, their correlation before and after administration of antihypertensive drugs had not been investigated previously.…”

“…Correlation between brachial and wrist HBPM devices for measuring nighttime home SBP at baseline (A), week 12 (B), and change from baseline to week 12 (C). HBPM, home blood pressure monitoring; SBP, systolic blood pressure.Regarding the correlation between the two HBPM devices, previous reports have shown that nighttime home BP measurements obtained with the wrist device are reproducible and were consistent with measurements obtained with the brachial device [28][29][30]. However, their correlation before and after administration of antihypertensive drugs had not been investigated previously.…”

Prevalence and Characteristics of Isolated Nocturnal Hypertension and Masked Nocturnal Hypertension in a Tertiary Hospital in the City of Buenos Aires

“…Office BP does not allow the detection of any of these conditions, as they can only be diagnosed by ABPM or HBPM and especially the former since home BP monitors that can be programmed to perform measurements during sleep exist but are not very widely used [ 12 , 13 , 14 ].…”