scholarly journals Effectiveness of a new one-hour blood pressure monitoring method to diagnose hypertension: a diagnostic accuracy clinical trial protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e029268
Author(s):  
Luis González-de Paz ◽  
Belchin Kostov ◽  
Maria del Carme Alvira-Balada ◽  
Cristina Colungo ◽  
Noemí García ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sensitivity And Specificity ◽  
Blood Pressure Monitoring ◽  
Random Sequence ◽  
Home Blood Pressure ◽  
Monitoring Methods ◽  
Pressure Monitoring ◽  
Monitoring Method ◽  
Policy Makers ◽  
Patient’S Experience

Introduction24-hour ambulatory blood pressure monitoring (ABPM) is the gold standard diagnostic method for hypertension, but has some shortcomings in clinical practice while clinical settings often lack sufficient devices to accommodate all patients with suspected hypertension. Home blood pressure monitoring (HBPM) and office blood pressure monitoring (OBPM) also have shortcomings, such as the white coat effect or a lack of accuracy. This study aims to study the validity of a new method of diagnosing hypertension consisting of monitoring blood pressure (BP) for 1 hour and comparing it with OBPM and HBPM and examining the sensitivity and specificity of this method compared with 24-hour ABPM. The patient experience will be examined in each method.Methods and analysisA minimum sample of 214 patients requiring a diagnostic test for hypertension from three urban primary healthcare centres will be included. Participants will undergo 24-hour ABPM, 1-hour BP measurement (1-BPM), OBPM for three consecutive weeks and HBPM. Patients will follow a random sequence to first receive 24-hour ABPM or 1-hour ABPM. Daytime 24-hour ABPM records will be compared with the other monitoring methods using the correlation coefficient and Bland Altman plots. The kappa concordance index and the sensitivity and specificity of the methods will be calculated. The patient’s experience will be studied, with selected indicators of efficiency and satisfaction calculated using parametric tests.Ethics and disseminationThe protocol has been authorised by the research ethics committee of the Hospital Clinic of Barcelona (Ref. HCB/2014/0615): protocol details and amendments will be recorded and reported to ClinicalTrials.com. The results will be disseminated in peer-reviewed literature, and to policy makers and healthcare partners.Trial registrationNCT03147573; Pre-results.

scholarly journals Patient Barriers and Facilitators to Ambulatory and Home Blood Pressure Monitoring: A Qualitative Study

2018 ◽  
Vol 31 (8) ◽  
pp. 919-927 ◽  
Author(s):  
Eileen J Carter ◽  
Nathalie Moise ◽  
Carmela Alcántara ◽  
Alexandra M Sullivan ◽  
Ian M Kronish
Keyword(s):  
Blood Pressure ◽  
New York ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Barriers And Facilitators ◽  
White Coat ◽  
White Coat Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Monitoring Method

Abstract BACKGROUND Guidelines recommend that patients with newly elevated office blood pressure undergo ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) to rule-out white coat hypertension before being diagnosed with hypertension. We explored patients’ perspectives of the barriers and facilitators to undergoing ABPM or HBPM. METHODS Focus groups were conducted with twenty English- and Spanish-speaking individuals from underserved communities in New York City. Two researchers analyzed transcripts using a conventional content analysis to identify barriers and facilitators to participation in ABPM and HBPM. RESULTS Participants described favorable attitudes toward testing including readily understanding white coat hypertension, agreeing with the rationale for out-of-office testing, and believing that testing would benefit patients. Regarding ABPM, participants expressed concerns over the representativeness of the day the test was performed and the intrusiveness of the frequent readings. Regarding HBPM, participants expressed concerns over the validity of the monitoring method and the reliability of home blood pressure devices. For both tests, participants noted that out-of-pocket costs may deter patient participation and felt that patients would require detailed information about the test itself before deciding to participate. Participants overwhelmingly believed that out-of-office testing benefits outweighed testing barriers, were confident that they could successfully complete either testing if recommended by their provider, and described the rationale for their testing preference. CONCLUSIONS Participants identified dominant barriers and facilitators to ABPM and HBPM testing, articulated testing preferences, and believed that they could successfully complete out-of-office testing if recommended by their provider.

scholarly journals Continuous Blood Pressure Monitoring Method Based on Multiple Photoplethysmography Features

2021 ◽  
Author(s):  
Yang Xu ◽  
Zhipei Huang ◽  
Jiankang Wu ◽  
Zhongdi Liu
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Blood Pressure Monitoring ◽  
Flow Characteristics ◽  
Test Results ◽  
Monitoring Methods ◽  
Pressure Monitoring ◽  
Monitoring Method ◽  
Instrumentation Error ◽  
Continuous Blood Pressure

Continuous blood pressure monitoring is of great significance for the prevention and early diagnosis of cardiovascular diseases. However, the existing continuous blood pressure monitoring methods, especially the sleeveless blood pressure monitoring methods, are complex and computationally heavy. In this paper, we propose a method, using plethysmography (PPG) signals alone, to estimate continuous blood pressure by extracting multiple PPG features related to intravascular blood flow characteristics. The performance of our method was evaluated using ten minutes synchronized PPG signals and continuous blood pressure from 21 healthy volunteers and 19 patients with hypertension and diabetes. The test results have shown that the absolute mean errors and standard deviation errors between the estimated and referenced blood pressure are 3.22±0.66 mmHg for systolic blood pressure and 2.11±1.11 mmHg for diastolic blood pressure, which meet AAMI (the association for the advancement of medical instrumentation) error acceptance.

Home Blood Pressure Monitoring Devices: Device Performance in an Alaska Native and American Indian Population

2021 ◽  
Vol 33 (7-8_suppl) ◽  
pp. 40S-50S
Author(s):  
Krista R. Schaefer ◽  
Amber L. Fyfe-Johnson ◽  
Carolyn J. Noonan ◽  
Michael R. Todd ◽  
Jason G. Umans ◽  
...  
Keyword(s):  
Blood Pressure ◽  
American Indian ◽  
Alaska Native ◽  
Blood Pressure Monitoring ◽  
Intraclass Correlation ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Calibration Models ◽  
American Indian People

Objectives: Home blood pressure monitoring (HBPM) is an important component of blood pressure (BP) management. We assessed performance of two HBPM devices among Alaska Native and American Indian people (ANAIs). Methods: We measured BP using Omron BP786 arm cuff, Omron BP654 wrist cuff, and Baum aneroid sphygmomanometer in 100 ANAIs. Performance was assessed with intraclass correlation, paired t-tests, and calibration models. Results: Compared to sphygmomanometer, average BP was higher for wrist cuff (systolic = 4.8 mmHg and diastolic = 3.6 mmHg) and varied for arm cuff (systolic = −1.5 mmHg and diastolic = 2.5 mmHg). Calibration increased performance from grade B to A for arm cuff and from D to B for wrist cuff. Calibration increased false negatives and decreased false positives. Discussion: The arm HBPM device is more accurate than the wrist cuff among ANAIs with hypertension. Most patients are willing to use the arm cuff when accuracy is discussed.

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