The role of wrist monitors to measure blood pressure in older adults.

Abstract

Arterial hypertension is a common condition in older adults with increasing data about blood pressure (BP) targets and antihypertensive treatment in this population. Recent studies have opened new discussions about the different usual and unusual methods of blood pressure monitoring. However, there are no evidence-based recommendations whether BP should be measured at upper arms or at wrist, which seems to be more comfortable in older and frail people. The purpose of this study was to test the quality of wrist BP monitors as diagnostic method in older adults. BP measurements at both upper arms and at both wrists were compared under standardized conditions in 605 patients ≥ 75years. Differences in wrist and upper arm BP were, furthermore, correlated with various diagnoses and parameters including ankle-brachial-index (ABI). In patients of 75-80 years, there were no differences in BP measurements at upper arms compared to wrists whereas in patients > 80 years, BP measurements at wrists were significantly lower than at upper arms. In both age groups BP measured at wrist was significantly lower in patients with ABI < 0.9. BP wrist monitors could be considered as a serious alternative in adults of 75-80years or in older persons with normal ABI values.