USING A NOVEL NON-INVASIVE, CUFF-LESS, WIRELESS DEVICE FOR 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING

Abstract

Objective: Ambulatory blood pressure monitoring (ABPM) using cuff-based devices is used for diagnosis and treatment of hypertension. Technical limitations, low compliance and complex procedure limit their use. The aim of the present study was to compare a new technique of 24H ABPM using a photoplethysmography (PPG)-based, wearable device to the standard cuff-based device. Design and method: In this prospective study, 24H ABPM was performed using a standard cuff-based device and the PPG-based device (Wrist-monitor) in parallel on volunteers aged 18–65 years, while documenting their daily activities. Level of comfort and activity disturbance of both devices were recorded. Linear regression and Bland-Altman were used to evaluate the agreement between the Wrist-monitor and Holter. Receiver Operating Characteristic (ROC) curve analysis was used to assess the ability of the Wrist-monitor to identify abnormal BP values. Results: The study included 28 subjects (18 men) mean age 41.5 ± 16.2 years. Bland-Altman analysis results in 24H bias of -1.1 mmHg for both diastolic blood pressure (DBP) and systolic blood pressure (SBP). Mean daytime bias was -1.9 mmHg for DBP and SBP, while nighttime bias was smaller (0.7 and 0.4 mmHg for DBP and SBP respectively). ROC curve analysis on all BP readings (n = 2381) yielded a mean area under the curve (AUC) for 24 hours of 0.965 for both SBP and DBP. 24H ABPM with the Wrist-monitor caused significantly less inconvenience compared to the Holter (p < 0.001). Conclusions: The cuff-less device provides comparable measurements to those obtained with the currently used ABPM device, with significantly less inconvenience to the subject.