PP309 Accuracy Of Automated Wrist Blood Pressure Monitors: Systematic Review

2020 ◽  
Vol 36 (S1) ◽  
pp. 27-27
Author(s):  
Nila Albuquerque ◽  
Thelma Araujo ◽  
Samantha Borges ◽  
Liana Queren Silva ◽  
Lais Vitoria da Silva ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Validation Studies ◽  
Measurement Errors ◽  
Research Question ◽  
Blood Pressure Measurement ◽  
Patient Positioning ◽  
Mean Difference ◽  
British Society ◽  
Blood Pressure Monitors

IntroductionThe use of automated blood pressure monitors is recommended by current guidelines; however, the accuracy of the device must be validated according to standardized protocols. Wrist blood pressure monitors have been undergoing technical improvements; nonetheless, their reliability is not unanimously recognized. No systematic review to date has analyzed the accuracy of wrist blood pressure monitors according to standardized protocols. This study aims to summarize the evidence on the accuracy of wrist blood pressure monitors in adults.MethodsThree databases (PubMed, Scopus and SciELO) were searched on 9 September 2019. The PICO (Patient, Intervention, Comparison and Outcome) strategy was used to outline the research question: Do automated wrist blood pressure monitors have accuracy equivalent to mercury sphygmomanometers in adults? Validation studies of wrist blood pressure monitors were included. Two reviewers independently screened abstracts and full texts. Summary data was extracted for each device, including mean difference of systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the monitor and the mercury sphygmomanometer.ResultsThe review identified twenty-nine validation studies. Most of them were developed in China (44.82%), followed by Italy (20.68%). The most commonly used validation protocol was from the British Society of Hypertension. The mean difference between the devices and the mercury sphygmomanometers was 0.47 (±5.75) mmHg for SBP and 0.17 (±4.75) mmHg for DBP. The percentage of wrist blood pressure monitors that passed validation protocols was 93.1.ConclusionsMost automated wrist blood pressure monitors showed accuracy equivalent to the reference standard for blood pressure measurement, with mean differences less than 0.5 mmHg for SBP and 0.2 for DBP. This evidence supports the recommendation to adopt this technology for the measurement of blood pressure in adults. However, wrist blood pressure monitors have patient positioning specificities, which, if not followed, may lead to measurement errors. Therefore, the adoption of these monitors should consider not only their accuracy, but also aspects of patient use and preferences.

scholarly journals The Effect of Smartphone App–Based Interventions for Patients With Hypertension: Systematic Review and Meta-Analysis (Preprint)

2020 ◽  
Author(s):  
Hongxuan Xu ◽  
Huanyu Long
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Medication Adherence ◽  
Meta Analysis ◽  
Blood Pressure Reduction ◽  
Pooled Analysis ◽  
Lifestyle Changes ◽  
Mean Difference ◽  
Smartphone App ◽  
Smartphone Intervention

BACKGROUND Hypertension is a major cause of cardiovascular disease, which is the leading cause of premature death. People with hypertension who do not comply with recommended treatment strategies have a higher risk of heart attacks and strokes, leading to hospitalization and consequently greater health care costs. The smartphone, which is now ubiquitous, offers a convenient tool to aid in the treatment of hypertension through the use of apps targeting lifestyle management, and such app-based interventions have shown promising results. In particular, recent evidence has shown the feasibility, acceptability, and success of digital interventions in changing the behavior of people with chronic conditions. OBJECTIVE The aim of this study was to systematically compile available evidence to determine the overall effect of smartphone apps on blood pressure control, medication adherence, and lifestyle changes for people with hypertension. METHODS This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines. Databases were searched to identify randomized controlled trials related to the influence of an app-based intervention in people with hypertension. Data extracted from the included studies were subjected to a meta-analysis to compare the effects of the smartphone app intervention to a control. RESULTS Eight studies with a total of 1657 participants fulfilled the inclusion criteria. Pooled analysis of 6 studies assessing systolic blood pressure showed a significant overall effect in favor of the smartphone intervention (weighted mean difference –2.28, 95% CI –3.90-0.66). Pooled analysis of studies assessing medication adherence demonstrated a significant effect (<i>P</i>&lt;.001) in favor of the intervention group (standard mean difference 0.38, 95% CI 0.26-0.50) with low heterogeneity (I<sup>2</sup>=0%). No difference between groups was demonstrated with respect to physical activity. CONCLUSIONS A smartphone intervention leads to a reduction in blood pressure and an increase in medication adherence for people with hypertension. Future research should focus on the effect of behavior coaching apps on medication adherence, lifestyle change, and blood pressure reduction.

scholarly journals Uncertainty in Blood Pressure Measurement Estimated Using Ensemble-Based Recursive Methodology

Sensors ◽  
2020 ◽  
Vol 20 (7) ◽  
pp. 2108
Author(s):  
Soojeong Lee ◽  
Hilmi R Dajani ◽  
Sreeraman Rajan ◽  
Gangseong Lee ◽  
Voicu Z Groza
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Measured Quantity ◽  
Home Office ◽  
Medical Centers ◽  
Measure Blood Pressure ◽  
Third Stage ◽  
Blood Pressure Monitors ◽  
A New Technique ◽  
Fine Tune

Automated oscillometric blood pressure monitors are commonly used to measure blood pressure for many patients at home, office, and medical centers, and they have been actively studied recently. These devices usually provide a single blood pressure point and they are not able to indicate the uncertainty of the measured quantity. We propose a new technique using an ensemble-based recursive methodology to measure uncertainty for oscillometric blood pressure measurements. There are three stages we consider: the first stage is pre-learning to initialize good parameters using the bagging technique. In the second stage, we fine-tune the parameters using the ensemble-based recursive methodology that is used to accurately estimate blood pressure and then measure the uncertainty for the systolic blood pressure and diastolic blood pressure in the third stage.

scholarly journals Validation Study to Determine the Accuracy of Central Blood Pressure Measurement Using the Sphygmocor Xcel Cuff Device

Hypertension ◽  
2020 ◽  
Vol 76 (1) ◽  
pp. 244-250 ◽  
Author(s):  
Martin G. Schultz ◽  
Dean S. Picone ◽  
Matthew K. Armstrong ◽  
J. Andrew Black ◽  
Nathan Dwyer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Form Factor ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Validation Study ◽  
Blood Pressure Measurement ◽  
Mean Difference ◽  
Total N ◽  
Acceptable Error ◽  
Calibration Methods

Numerous devices purport to measure central (aortic) blood pressure (BP) as distinct from conventional brachial BP. This validation study aimed to determine the accuracy of the Sphygmocor Xcel cuff device (AtCor Medical, CardieX, Sydney, Australia) for measuring central BP. 296 patients (mean age 61±12 years) undergoing coronary angiography had simultaneous measurement of invasive central BP and noninvasive cuff-derived central BP using the Xcel cuff device (total n=558 individual comparisons). A subsample (n=151) also had invasive brachial BP measured. Methods were undertaken according to the Artery Society recommendations, and several calibration techniques to derive central systolic BP (SBP) were examined. Minimum acceptable error was ≤5±≤8 mm Hg. Central SBP was significantly underestimated, and with wide variability, when using the default calibration of brachial-cuff SBP and diastolic BP (DBP; mean difference±SD, −7.7±11.0 mm Hg). Similar variability was observed using other calibration methods (cuff 33% form-factor mean arterial pressure and DBP, −4.4±11.5 mm Hg; cuff 40% form-factor mean arterial pressure and DBP, 4.7±11.9 mm Hg; cuff oscillometric mean arterial pressure and DBP, −18.2±12.1 mm Hg). Only calibration with invasive central integrated mean arterial pressure and DBP was within minimal acceptable error (3.3±7.5 mm Hg). The difference between brachial-cuff SBP and invasive central SBP was 3.3±10.7 mm Hg. A subsample analysis to determine the accuracy of central-to-brachial SBP amplification showed this to be overestimated by the Xcel cuff device (mean difference 4.3±9.1 mm Hg, P =0.02). Irrespective of cuff calibration technique, the Sphygmocor Xcel cuff device does not meet the Artery Society accuracy criteria for noninvasive measurement of central BP.

scholarly journals Physiological Impact of Vibration and Noise in an Open-Air Magnetic Resonance Imager: Analysis of a PPG Signal of an Examined Person

Proceedings ◽  
2019 ◽  
Vol 42 (1) ◽  
pp. 14
Author(s):  
Jiří Přibil ◽  
Anna Přibilová ◽  
Ivan Frollo
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Magnetic Resonance ◽  
Acoustic Noise ◽  
Blood Pressure Measurement ◽  
Psychological Impact ◽  
Blood Pressure Monitors ◽  
Instantaneous Heart Rate ◽  
Magnetic Resonance Imaging Mri ◽  
Physiological Impact

The paper represents a preliminary analysis of the physiological and psychological impact of vibration and acoustic noise on a person examined by a low-field magnetic resonance imaging (MRI) tomograph. First, a methodology for the measurement of different signals of a tested person was found. The main investigation consists of a parallel heart rate and blood pressure measurement using a photoplethysmographic (PPG) optical sensor and standard portable blood pressure monitors. The recorded PPG signal is filtered and processed to obtain a clean waveform used to determine an instantaneous heart rate. Different types of portable blood pressure monitors are tested and compared to choose the best one for further experiments.

Blood pressure measurement prior to initiating hormonal contraception: a systematic review

Contraception ◽  
2013 ◽  
Vol 87 (5) ◽  
pp. 631-638 ◽  
Author(s):  
Naomi K. Tepper ◽  
Kathryn M. Curtis ◽  
Maria W. Steenland ◽  
Polly A. Marchbanks
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Hormonal Contraception

scholarly journals Prevalence of postural hypotension in primary, community and institutional care: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sinead T. J. McDonagh ◽  
Natasha Mejzner ◽  
Christopher E. Clark
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Primary Care ◽  
Postural Hypotension ◽  
Blood Pressure Measurement ◽  
Institutional Care ◽  
Consensus Definition ◽  
Meta Regression ◽  
Definition Of ◽  
Meta Analyses

Abstract Background Postural hypotension (PH), the reduction in blood pressure when rising from sitting or lying 0to standing, is a risk factor for falls, cognitive decline and mortality. However, it is not often tested for in primary care. PH prevalence varies according to definition, population, care setting and measurement method. The aim of this study was to determine the prevalence of PH across different care settings and disease subgroups. Methods Systematic review, meta-analyses and meta-regression. We searched Medline and Embase to October 2019 for studies based in primary, community or institutional care settings reporting PH prevalence. Data and study level demographics were extracted independently by two reviewers. Pooled estimates for mean PH prevalence were compared between care settings and disease subgroups using random effects meta-analyses. Predictors of PH were explored using meta-regression. Quality assessment was undertaken using an adapted Newcastle-Ottawa Scale. Results One thousand eight hundred sixteen studies were identified; 61 contributed to analyses. Pooled prevalences for PH using the consensus definition were 17% (95% CI, 14–20%; I2 = 99%) for 34 community cohorts, 19% (15–25%; I2 = 98%) for 23 primary care cohorts and 31% (15–50%; I2 = 0%) for 3 residential care or nursing homes cohorts (P = 0.16 between groups). By condition, prevalences were 20% (16–23%; I2 = 98%) with hypertension (20 cohorts), 21% (16–26%; I2 = 92%) with diabetes (4 cohorts), 25% (18–33%; I2 = 88%) with Parkinson’s disease (7 cohorts) and 29% (25–33%, I2 = 0%) with dementia (3 cohorts), compared to 14% (12–17%, I2 = 99%) without these conditions (P < 0.01 between groups). Multivariable meta-regression modelling identified increasing age and diabetes as predictors of PH (P < 0.01, P = 0.13, respectively; R2 = 36%). PH prevalence was not affected by blood pressure measurement device (P = 0.65) or sitting or supine resting position (P = 0.24), however, when the definition of PH did not fulfil the consensus description, but fell within its parameters, prevalence was underestimated (P = 0.01) irrespective of study quality (P = 0.04). Conclusions PH prevalence in populations relevant to primary care is substantial and the definition of PH used is important. Our findings emphasise the importance of considering checking for PH, particularly in vulnerable populations, to enable interventions to manage it. These data should contribute to future guidelines relevant to the detection and treatment of PH. PROSPERO:CRD42017075423.

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