Background:
Recent guidelines endorse the use of ambulatory blood pressure monitoring (ABPM) for out-of-office BP measurement and HTN management. Past literature has described patient perceptions of ABPM tolerability but differences between sex and age have not previously been determined. The objective of this study was to evaluate sex and age differences in such patient perceptions.
Methods:
This was a prospective, single-arm trial (NCT03920956) of a community pharmacy-driven ABPM service that enrolled 52 patients at least 18 years of age who were suspected of having white coat, masked, or sustained HTN, have symptoms of hypotension, or require confirmation of an initial diagnosis of HTN. We evaluated the tolerability of the ABPM device (Oscar 2; SunTech Medical, Morrisville, NC) as a secondary outcome with a previously published 8-question survey using a 0-10 scale (0=not at all, 5=somewhat, 10=extremely). The responses were dichotomized as either favorable (0-4) or unfavorable (5-10) with reverse coding for positively-worded questions. Descriptive statistics and Chi-square analyses were used to describe sex and age differences.
Results:
A total of 50 surveys (96%) were completed and returned. Respondents were 50% female (n=25) with a mean (SD) age of 57.5 (15.8), and 58% (n=29) were at least 55 years of age. Female respondents were more likely to find the monitor cumbersome to wear at times other than at home, work, or driving (16/21, 76.2% vs. 10/25, 40%, p = 0.014). Although nonsignificant, male respondents were more likely to find the monitor embarrassing to wear (7/25, 28.0% vs. 2/24, 8.3%, p = 0.076). In comparisons of tolerability by age, subjects less than 55 years of age were more likely to report being disturbed by the pump during driving (8/21, 38.1% vs. 1/24, 4.2%, p = 0.005), at other times (7/20, 35.0% vs. 2/24, 8.3%, p = 0.029), and found the monitor embarrassing to wear (7/21, 33.3% vs. 2/28, 7.1%, p = 0.019).
Conclusions:
Previous studies suggest that ABPM is generally well-tolerated by patients but may cause some discomfort or disturbed sleep. Differences in tolerability appear to become more evident across age groups and sex. These data suggest select patients may require additional counseling and education to ensure adherence to ABPM.
Patient perceptions of ambulatory blood pressure monitoring testing, tolerability, accessibility, and expense