Objective: Blood pressure measurements are the basis of diagnosis, treatment and research of arterial hypertension and its sequelae. All decisions hinge on the validity of the measurement method. Here, the ABPM is considered best practice. Evaluation of ABPM, notwithstanding known issues like availability and economy, regarding its validity, accuracy and applicability to clinical practice was investigated. Design and method: We retrospectively consider 450 ABPMs executed using validated devices from Nephrology Center Göttingen (ESH-Excellence-Center). This work evaluates the measurements’ adherence to diagnostic guidelines (ESH) with respect to sources of error, count of valid measurements and cancellation by patient. Criteria for validity are: - Minimum 24 h recording duration.- At least 20 valid day and 7 valid night measurements- Minimum of 70 percent valid measurements in total Cancellation by the patient is assumed if: - Recording duration is below 22h without indication of technical fault or measurement is stopped prior to 7 30 a.m. Results: 23 % (n = 106) of 450 ABPM considered to meet all guideline criteria. Remaining 77 % of measurements failed at least one criterion. In 27 % (n = 120), measurement duration was below 24 h and for 22 % (n = 98) it was below 22 h. In 2.6 % (n = 12) minimum amount of daytime (n = 3) and night-time (n = 9) data points was not met. Requirement for at least 70 % of valid data points was failed by 23.5 % (n = 105). Here the source of error were motion artefacts in about 50 % of cases, pressurisation issues during the day in 17 % (n = 15) and 27 % (n = 11) at night and kinks in tubing in 14 % (n = 12) during daytime. About 20.6 % (n = 93) of ABPM were preliminary cancelled by the patient which amounts to approximately a quarter (25.4 %) of all measurements failing the guideline criteria. Conclusions: Value of ABPM hinges on guideline conforming execution of measurements and should therefore be explicitly discussed with the patient. Quality of data obtained by an ABPM needs to be examined for every case to ensure its validity to justify a course of action.
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