AB778         BLOOD PRESSURE MONITORING AT THE WRIST: IS IT RELIABLE IN THE ELDERLY?

Author(s): 
Lee SY, Kim YJ, Cha HS
Department of Family Medicine, College of Medicine, Pusan National University, PUSAN, SOUTH KOREA
Text: 
Background:
Hypertension is a common disorder in the elderly. It is important not only to detect and treat hypertension but also to monitor adequacy of control of treated hypertension. Devices for blood pressure (BP) measurement at the wrist are becoming more widely used in clinical practice because of their compactness and ease of use. However, systematic comparisons with standard auscultatory BP measurement at the brachial artery are scarce in Korea.
Aim: We aimed to compare an automated wrist BP meter (EW278, National, Japan) with upper arm auscultatory mercury sphygmomanometer.
Methods: The subjects were 75 older patients over ages 60 years who has been treated for hypertension in long period at Un-Bong welfare centre in Pusan, Korea. Trained nurses measured BPs of subjects in the arm using a mercury sphygmomanometer as the standard method and in the wrist using the EW278. Pearson correlation coefficient, paired t-test, and Altman-Bland plot were performed for statistic analysis. Results: The EW278 was correlated with mercury sphygmomanometer, but systolic BP was significantly different. The Altman-Bland plot demonstrated that there was no linear relationship between the mean of the systolic BPs by the two methods and the difference between the two systolic BPs. The EW278 was inadequate according to the validation protocols of British Hypertension Society and American Association for the Advancement of Medical Instrumentation.
Conclusion:
A wrist automated BP meter, EW 278 of National is inaccurate and clinically unavailable in the elderly with hypertension. So, we recommend using the wrist BP meters only when they are validated properly.