The assessment of agreement between non-invasive, near continuous radial blood pressure measurement and conventional ambulatory blood pressure monitoring during night time sleep (original) (raw)
Related papers
Reproducibility of Nocturnal Blood Pressure Assessed by Self-Measurement of Blood Pressure at Home
Hypertension Research, 2007
To assess the reproducibility of nocturnal blood pressure (BP) during sleep as measured using a self-measurement device at home, we obtained repeated nocturnal home BP at 0200 h and quality of sleep assessment from a diary in 556 subjects (71% women, 62.4 ± 11.1 years) in the general population. We used an Omron device (HEM-747IC-N, Omron Healthcare Co., Ltd., Kyoto, Japan), with which the time and frequency of monitoring can be preset and the readings stored. The mean ± SD of the difference between test-retest BP measurements was 0.7 ± 15.1 mmHg systolic and 0.2 ± 9.7 mmHg diastolic with a mean interval of 5.9 days. The absolute differences were greater than 10 mmHg in 261 (46.9%) subjects for systolic and 145 (26.0%) subjects for diastolic. There was no evidence of regression to the mean in nocturnal measurements over at least three nights (n =390, p >0.22). The differences (the first minus the second measurement) were large in subjects who experienced sleep disturbance only in the first (n =64, 2.3 ± 13.6 mmHg and 1.6 ± 9.6 mmHg for systolic and diastolic, respectively) or second sessions (n =56, -4.1 ± 16.4 mmHg and -2.5 ± 11.4 mmHg) compared with the subjects without sleep disturbance (n =66, 1.5 ± 17.8 mmHg and 0.8 ± 10.3 mmHg) and those with sleep disturbance (n =370, 0.9 ± 14.5 mmHg and 0.2 ± 9.3 mmHg) in both sessions. In conclusion, the reproducibility of single nocturnal BP as assessed using a self-measurement device at home was not good, especially for subjects who experienced different quality of sleep in each session. To evaluate nocturnal BP using a self-measurement device, estimation of quality of sleep is indispensable. (Hypertens
Classification of blood pressure during sleep impacts designation of nocturnal nondipping
PLOS digital health, 2023
The identification of nocturnal nondipping blood pressure (< 10% drop in mean systolic blood pressure from awake to sleep periods), as captured by ambulatory blood pressure monitoring, is a valuable element of risk prediction for cardiovascular disease, independent of daytime or clinic blood pressure measurements. However, capturing measurements, including determination of wake/sleep periods, is challenging. Accordingly, we sought to evaluate the impact of different definitions and algorithms for defining sleep onset on the classification of nocturnal nondipping. Using approaches based upon participant self-reports, applied definition of a common sleep period (12 am-6 am), manual actigraphy, and automated actigraphy we identified changes to the classification of nocturnal nondipping, and conducted a secondary analysis on the potential impact of an ambulatory blood pressure monitor on sleep. Among 61 participants in the Eastern Caribbean Health Outcomes Research Network hypertension study with complete ambulatory blood pressure monitor and sleep data, the concordance for nocturnal nondipping across methods was 0.54 by Fleiss' Kappa (depending on the method, 36 to 51 participants classified as having nocturnal nondipping). Sleep quality for participants with dipping versus nondipping was significantly different for total sleep length when wearing the ambulatory blood pressure monitor (shorter sleep duration) versus not (longer sleep duration), although there were no differences in sleep efficiency or disturbances. These findings indicate that consideration of sleep time measurements is critical for interpreting ambulatory blood pressure. As technology advances to detect blood pressure and sleep patterns, further investigation is needed to determine which method should be used for diagnosis, treatment, and future cardiovascular risk.
Pakistan Heart Journal
Hypertension, a disease of epidemic proportion, is assessed by measuring blood pressure (BP). Various methods are employed, the most common being “clinic blood pressure measurement (CBPM).” However, environment and technical errors can confound it. Other methods include home blood pressure measurement (HBPM), which shows readings of awake time only, and 24-hour ambulatory blood pressure monitoring (ABPM). A recent technique that causes less sleep disturbance is “timed HBPM.” Blood pressure is a 24-hour phenomenon, and prognostically night time blood pressure, being more important, must be assessed properly. Besides providing the precise mean of 24-hour blood pressure, it extends knowledge regarding many other parameters of clinical importance like dipping pattern and morning surge etc. For nocturnal BP assessment, 24-hour ABPM and time-triggered HBPM are utilized. The importance of nocturnal blood pressure assessment for diagnostic and prognostic evaluation of various cardiovascular...
Arquivos Brasileiros de Cardiologia, 2002
Objective-To assess the influence of the quality of sleep on the nocturnal physiological drop in blood pressure during ambulatory blood pressure monitoring. Methods-We consecutively assessed ambulatory blood pressure monitoring, the degree of tolerance for the examination, and the quality of sleep in 168 patients with hypertension or with the suspected "white-coat" effect. Blood pressure fall during sleep associated with a specific questionnaire and an analogical visual scale of tolerance for ambulatory blood pressure monitoring were used to assess usual sleep and sleep on the day of examination. Two specialists in sleep disturbances classified the patients into 2 groups: those with normal sleep and those with abnormal sleep. Results-Fifty-nine (35 %) patients comprised the abnormal sleep group. Findings regarding the quality of sleep on the day of ambulatory blood pressure monitoring as compared with those regarding the quality of sleep on a usual day were different and were as follows, respectively: total duration of sleep (-12.4±4.7 versus-42.2±14.9 minutes, P=0.02), latency of sleep (0.4±2.7 versus 17±5.1 minutes, P<0.001), number of awakenings (0.1±0.1 versus 1.35±0.3 times, P<0.001), and tolerance for ambulatory blood pressure monitoring (8±0.2 versus 6.7±0.35, P=0.035). An abnormal drop in blood pressure during sleep occurred in 20 (18%) patients in the normal sleep group and in 14 (24%) patients in the abnormal sleep group, P=0.53. Conclusion-Ambulatory blood pressure monitoring causes sleep disturbances in some patients, and a positive association between quality of sleep and tolerance for the examination was observed.
Portable continuous non-invasive blood pressure recording for sleep studies
Proceedings of the 15th Annual International Conference of the IEEE Engineering in Medicine and Biology Societ, 1993
A parallel continuous non-invasive blood pressure recorder, based on finger-photoplethvsmography was validated in a sleep laboratory setting. The non-invasive pressure signal was compared with invasive blood pressure in 12 polysomnographic studies of sleep apnea patients. The svstem is a delinite improvement compared to the earlier Finapres mainly due to two linger cuffs and a hydrostatic compensation lead. Some details need further improvements.
Reproducibility of ambulatory blood pressure monitoring in children
Journal of Hypertension, 1993
OBJECTIVE: We tested the reproducibility of changes in the ambulatory blood pressure (BP) from the initial values, an indicator of BP reactivity and cardiovascular health outcomes, in young, healthy adults. METHOD: The subjects wore an ambulatory BP monitor attached by the same investigator at the same time of day until the next morning on two different days (day 1 and day 2) separated by a week. We compared the ambulatory BP change from the initial values at hourly intervals over 24 waking and sleeping hours on days 1 and 2 using linear regression and repeated measures analysis of covariance. RESULTS: The subjects comprised 88 men and 57 women (mean age¡SE 22.4¡0.3 years) with normal BP (118.3¡0.9/69.7¡0.6 mmHg). For the total sample, the correlation between the ambulatory BP change on day 1 vs. day 2 over 24, waking, and sleeping hours ranged from 0.37-0.61; among women, the correlation was 0.38-0.71, and among men, it was 0.24-0.52. Among women, the ambulatory systolic/diastolic BP change was greater by 3.1¡1.0/2.4¡0.8 mmHg over 24 hours and by 3.0¡1.1/2.4¡0.8 mmHg over waking hours on day 1 than on day 2. The diastolic ambulatory BP change during sleeping hours was greater by 2.2¡0.9 mmHg on day 1 than on day 2, but the systolic ambulatory BP change during sleeping hours on days 1 and 2 did not differ. Among men, the ambulatory BP change on days 1 and 2 did not differ. CONCLUSION: Our primary findings were that the ambulatory BP change from the initial values was moderately reproducible; however, it was more reproducible in men than in women. These results suggest that women, but not men, may experience an alerting reaction to initially wearing the ambulatory BP monitor.
The Journal of Clinical Hypertension
Nocturnal blood pressure (BP) measured by ambulatory BP monitoring (ABPM) is a better predictor of future cardiovascular events than daytime BP in hypertensive patients. 1-3 In recent years, nocturnal BP measured by home BP monitoring (HBPM) has become available for clinical practice, and a recent meta-analysis showed that the clinical significance of nocturnal BP measured by HBPM is comparable to that of nocturnal BP measured by ABPM. 4 Owing to its simplicity, convenience, and tolerability, HBPM has been rapidly adopted by many clinics and is now recommended by numerous hypertension guidelines. 5-10 The potential advantages of nocturnal HBPM as a substitute for nocturnal ABPM are that it permits the collection of nocturnal home BP values over multiple nights, in the manner of conventional home BP measurement, which can be measured in the morning and evening. On the other hand, participants are likely to measure nocturnal BP levels depending on their own lifestyle. Recently developed HBPM devices permit participants to set specific lengths of time after their chosen bedtime for the measurement of nocturnal
The Role of Nocturnal Blood Pressure and Sleep Quality in Hypertension Management
European Cardiology Review, 2020
The accurate measurement, prediction and treatment of high blood pressure (BP) are essential to the management of hypertension and the prevention of its associated cardiovascular (CV) risks. However, even if BP is optimally controlled during the day, nocturnal high blood pressure may still increase the risk of CV events. The pattern of circadian rhythm of BP can be evaluated by ambulatory BP monitoring (ABPM). Night-time ABPM is more closely associated with fatal and nonfatal CV events than daytime ambulatory BP. However, the use of ABPM is limited by low availability and the fact that it can cause sleep disturbance, therefore may not provide realistic nocturnal measurements. Home blood pressure monitoring (HBPM) offers an inexpensive alternative to ABPM, is preferred by patients and provides a more realistic assessment of BP during an individual’s daily life. However, until recently, HBPM did not offer the possibility to measure nocturnal (sleep time) BP. The development and valida...