Evaluation of noninvasive blood pressure monitoring devices Spacelabs 90202 and 90207 versus resting and ambulatory 24-hour intra-arterial blood pressure (original) (raw)
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24-Hour ambulatory blood pressure monitoring
American Heart Journal, 2006
This paper reviews technical, methodological and clinical aspects of ambulatory blood pressure (aBP) monitoring. It describes deficits in the evaluation of available aBP devices and in the description and interpretation of slow (e.g. seasonal or circadian) and fast blood pressure variations. The ongoing discussion about the mere existence of circadian blood pressure rhythms is reflected, referring to the most recent data. Further methodological questions considered encompass the problem of centrality (how to describe an aBP profile with one numerical measure) and the question of variability (how to describe variance within an aBP profile). Good reasons for the use of MESOR or RMSSD parameters are given. Finally, the evidence behind a broad clinical application of aBP measurements is critically reviewed; except for 'white coat' hypertension, the clinical superiority of aBP values compared with office and home blood pressure readings is not well established on epidemiological grounds.
Ambulatory blood pressure measurement in the diagnosis and management of hypertension
Journal of human hypertension, 1991
Before the diagnostic potential of 24-hour non-invasive BP measurement can be assessed, the accuracy of ambulatory recorders must be established, and normal reference values determined. The accuracy criteria of four ambulatory BP measuring systems (the SpaceLabs 90207, the Novecor DIASYS 200, the Takeda TM-2420 and the Del Mar Avionics Pressurometer IV) have been assessed according to the British Hypertension Society (BHS) protocol, and the Medilog, Suntech Accutracker II and the SpaceLabs 90202 according to the standard of the Association for the Advancement of Medical Instrumentation (AAMI). The SpaceLabs 90202 and 90207, the DIASYS 200 and the Medilog fulfilled the AAMI criteria. The best devices with the BHS grading system are the SpaceLabs 90207 and the DIASYS 200. Normal reference values for daytime, night-time and 24-hour ambulatory BP have been provided by the Allied Irish Bank study of 815 healthy individuals, which showed clear age and sex differences. The mean 24-hour amb...
Ambulatory Blood Pressure Monitoring: How Reproducible Is It
American Journal of Hypertension, 1997
We tested the reproducibility of ambulatory blood pressure monitoring (ABPM) by the use of agreement plots. Thirty-two normotensive volunteers underwent ABPM on four separate days (interval 28 days), on the same typical weekday. Sleeping time was restricted to the ABPM nighttime subperiod from 11:00 PM to 7:00 AM. Twenty-four-hour average values-both systolic and diastolic-daytime average values, and nighttime average values, as well as standard deviation (SD) values, were analyzed for differences (analysis of variance). Adaptation occurred from the first to the fourth ABPM, ie, average 24 h, daytime, and nighttime values were lower (؊1 to ؊3 mm Hg) during the fourth recording than the first (P < .05 to P < .01). The agreement analysis showed a surprisingly high agreement among the four data sets (ie, differences from ؎2.54 to ؎5.92 mm Hg; ؎2 SD of the distribution). We concluded that reproducibility of ABPM seems excellent, but adaptation may occur, even in normotensive volunteers under research conditions. Caution must be paid before labeling a patient as hypertensive, because initial ABPM may yield higher values than later monitorings. Am J Hypertens 1997;10:936 -939
American journal of hypertension, 2020
BACKGROUND The U.S. Preventive Services Task Force recommends the use of 24-hour ambulatory blood pressure monitoring (ABPM) as part of screening and diagnosis of hypertension. The optimal ABPM device for population-based surveys is unknown. OBJECTIVE Among three ABPM devices, we compared the proportion of valid BP readings, mean awake and asleep BP readings, differences between awake ABPM readings and initial standardized BP readings, and sleep experience. RESULTS The proportions of valid blood pressure readings were not different among the three devices ( p > 0.45). Mean awake and asleep systolic BP were significantly higher for STO device (WA vs. STO vs. SL: 126.65 mmHg, 138.09 mmHg, 127.44 mmHg; 114.34 mmHg, 120.34 mmHg, 113.13 mmHg; p <0.0001 for both). The difference between the initial average standardized mercury systolic BP readings and the ABPM mean awake systolic BP was larger for STO device (WA vs. STO. vs. SL: -5.26 mmHg, -16.24 mmHg, -5.36 mmHg; p <0.0001); di...
Variability of office, 24-hour ambulatory, and self-monitored blood pressure measurements
British Journal of General Practice, 2010
Background The diagnosis of hypertension is difficult when faced with several different blood pressure measurements in an individual. Using the average of several office measurements is recommended, although considerable uncertainty remains. Twenty-four-hour ambulatory monitoring is often considered the gold standard, but self-monitoring of blood pressure has been proposed as a superior method. Aim Determination of within-individual variability of blood pressure measured in the office, by ambulatory monitoring, and by a week of self-monitoring. Design of study Retrospective analysis of a clinical trial of 163 subjects. Method Within-patient variability of office and ambulatory blood pressure was determined from measurements at 0 and 6 weeks. Subjects had performed self-monitoring of blood pressure twice each morning and evening, for at least 6 weeks; variability was determined from the means of week 1 and week 6. Results The within-individual coefficients of variation (CVs) for systolic blood pressure were: office, 8.6%; ambulatory, 5.5%; self, 4.2%. Equivalent values for diastolic blood pressure were 8.6%, 4.9%, and 3.9%. CVs tended to be lower with longer self-monitoring duration, and higher with longer intervals between self-monitoring. Conclusion Office blood pressure is impractical for precise assessment, as 10-13 measurements are required to give the accuracy required for rational titration of antihypertensive drugs. Twenty-four-hour ambulatory monitoring is better than a single office measurement, but considerable uncertainty remains around the estimate. A week of self-monitoring appears to be the most accurate method of measuring blood pressure, but remains imperfect. Further research may identify superior self-monitoring schedules. Given the inherent accuracy in blood pressure measurement, the importance of considering overall cardiovascular risk is emphasised.
AMBULATORY BLOOD PRESSURE MONITORING: THE NEED OF 7-DAY RECORD
Scripta medica
The need for systematic around-the-clock self-measurements of blood pressure (BP) and heart rate (HR), or preferably for automatic monitoring as the need arises and can be met by inexpensive tools, is illustrated in two case reports. Miniaturized unobtrusive, as yet unavailable instrumentation for the automatic measurement of BP and HR should be a high priority for both government and industry. Automatic ambulatorily functioning monitors already represent great progress, enabling us to introduce the concept of eventually continuous or, as yet, intermittent home ABPM. On BP and HR records, gliding spectra aligned with global spectra visualize the changing dynamics involved in health and disease, and can be part of an eventually automated system of therapy adjusted to the everpresent variability of BP. In the interim, with tools already available, chronomics on self-or automatic measurements can be considered, with analyses provided by the Halberg Chronobiology Center, as an alternative to "flying blind", as an editor put it. Chronomics assessing variability has to be considered.
Journal of Applied Physiology
The AM-5600 is a new device that simultaneously monitors electrocardiogram (ECG) and noninvasive blood pressure (BP) over a 24-h period. BP readings (Korotkoff sounds and cuff air pressure) are stored into the recorder, allowing the removal of BP artifacts after a visual check. In 12 subjects with essential hypertension, we compared BP values simultaneously provided by the AM-5600 and intra-arterial recordings. At rest, noninvasive systolic BP (SBP) values were lower (5.4 +/- 4.9 mmHg) and diastolic BP (DBP) values were higher (7.3 +/- 7.3 mmHg) than were intra-arterial values. In ambulatory conditions (9 subjects), between-method discrepancies were +0.8 +/- 6.1 and +12.2 +/- 7.4 mmHg for 24-h SBP and DBP, respectively. AM-5600 underestimated 24-h intra-arterial SBP and DBP SD, but it accurately tracked intra-arterial SBP and DBP changes. Editing removed 22.1% of total readings, slightly reducing between-method discrepancies. Thus the AM-5600 provides an accurate average estimate of...
Chronobiologically interpreted ambulatory blood pressure monitoring: past, present, and future
Biological Rhythm Research, 2018
To subscribe, visit www.gahmj.com. *By aligning longitudinal and linked cross-sectional biomedical with (whenever possible also local and global) physical environmental monitoring for transdisciplinary science-while safeguarding anonymity, privacy, and security with lifelong follow-up. **If abnormal, participants are advised to allow data and analyses transfer to care providers for surveillance, diagnosis, optimization of treatment, if and as need be, and for ascertaining continued efficacy.
Continuous vs intermittent blood pressure measurements in estimating 24- hour average blood pressure
Hypertension, 1983
In the past few years noninvasive automatic blood pressure (BP) recorders have been increasingly used to estimate patients' 24-hour BP more accurately than by one or few isolated measurements. However, these recorders only allow BP to be intermittently measured at intervals between 5 to 30 minutes, which means that the number of values collected over 24 hours (10 to 100) remains a tiny fraction of the thousands of values that occur during the same period. To determine whether this represents a limitation to this approach, BP was recorded intraarterially for 24 hours (Oxford method) in 20 ambulant hypertensive patients. A beat-to-beat analysis of the BP recording was provided by a computer, and the average 24-hour systolic, diastolic, and mean BP values were compared with those obtained by analyzing single BP waves of the same recording at intervals of 5, 10, 15, 30, and 60 minutes. In each subject the average 24-hour BP values obtained by the beat-to-beat analysis closely corres...