Comparison of a tonometric with an oscillometric blood pressure monitoring device over 24 hours of ambulatory use.

Abstract

Multiple devices capable of measuring ambulatory blood pressure without cuffs have been recently developed and it is required that they offer high-accuracy measurements. The purpose of this prospective study was to compare the performance of a tonometric blood pressure monitor with that of an oscillometric cuff-based device used as a reference in healthy and hypertensive subjects over 24 hours of ambulatory use. Conventional oscillometric cuff-based device (Oscar 2; Sun Tech Medical) was placed in the left arm of 33 subjects, and a watch-type device based on the tonometric method (Bpro; HealthSTATS International, Singapore) was positioned in the right wrist. Both devices were synchronized to measure simultaneously over 24 hours. The difference between the means over 24 hours of the oscillometric and the tonometric devices was -0.9 mmHg for SBP and -4.5 mmHg for DBP; the standard deviations were 14.7 and 12.2 mmHg, respectively. Greater differences in bias and dispersion were observed overnight than during the daytime. The accuracy of the tonometric device for diagnosing hypertension was 75% and for detecting the non-dipper profile, 48%. The test device presented a high disagreement (especially during the night) compared to the oscillometric cuff-based device against which it was initially calibrated. This disagreement resulted in limited accuracy for diagnosing patients with suspected arterial hypertension and detecting non-dipper profiles.