Reproducibility of nighttime home blood pressure measured by a wrist-type nocturnal home blood pressure monitoring device

The authors investigated the reproducibility of nighttime home blood pressure (BP) measured by a wrist-type BP monitoring device. Forty-six hypertensive patients (mean 69.0 +/- 11.6 years, 56.5% male) self-measured their nighttime BP hourly using simultaneously worn wrist-type and upper arm-type nocturnal home BP monitoring devices at home on two consecutive nights. Using the average 7.4 +/- 1.3 measurements on the first night and the average 7.0 +/- 1.8 measurements on the second night, the authors assessed the reliability and the reproducibility of nighttime BP measured on the two nights. The difference between nights in systolic BP (SBP) measured by the wrist-device was not significant (1.6 +/- 7.0 mmHg, p = .124), while the difference in diastolic BP (DBP) was marginally significant (1.4 +/- 4.9 mmHg, p = .050). The intraclass correlation coefficients (ICCs) for agreement between nights were high both in SBP and DBP average (SBP: 0.835, DBP: 0.804). Averaging only three points of SBP resulted in lower ICC values, but still indicated good correlations (ICC > 0.6). On the other hand, the correlations of the standard deviation and average real variability of SBP between nights were low, with ICCs of 0.220 and 0.436, respectively. In conclusion, the average SBP values measured on the first night were reliable even when averaging only three readings. The reproducibility of nighttime BP variability seemed inferior to that of BP average; it might be better to measure nighttime BP over multiple nights to assess BP variability. However, this hypothesis needs verification in other study population. In addition, our study population had well-controlled BP, which limits the generalizability of this findings to all hypertensive patients.

Automated summary

The study demonstrated high reliability and reproducibility of nighttime blood pressure measured by a wrist-type BP monitoring device over two consecutive nights. Multiple nights of measurement may be more beneficial in assessing blood pressure variability, which showed inferior reproducibility compared to blood pressure averages.