A research study looked at a new type of monitor that doesn’t require a cuff and uses optical sensors to continuously and effectively measure blood pressure without causing any disturbances to the patient. The monitor generates numerous readings over a few days, which can help healthcare providers assess the risk of cardiovascular disease and enhance the management of high blood pressure. This is significant because high blood pressure is the main factor that contributes to global mortality and affects one out of every two adults, yet only a quarter of people with hypertension have their blood pressure under control.New research is emphasizing the importance of finding new approaches to manage blood pressure. A recent study conducted by a researcher from Brigham and Women’s Hospital, a key member of the Mass General Brigham healthcare system, examined a monitor that doesn’t require a cuff and instead uses optical sensors to continuously and effectively measure blood pressure with minimal disruption to the patient. The study, which was published in Frontiers in Medicine, suggests that cuffless devices could lead to promising advancements in diagnosing, assessing, and managing hypertension. The ability for patients to easily monitor their blood pressure is crucial for successfully managing hypertension.”Measuring blood pressure outside of the doctor’s office is now easier and more reliable,” said corresponding author Naomi Fisher, MD, of the Division of Endocrinology, Diabetes and Hypertension at Brigham and Women’s Hospital. “Devices without cuffs have the potential to change the way we manage hypertension. They offer more readings than traditional devices, both during the day and at night, which can help confirm a hypertension diagnosis and adjust medication.” Medical guidelines now advise incorporating at-home blood pressure monitoring into hypertension diagnosis and management. This is an important shift in healthcare practice.Inaccurate blood pressure readings can occur when taken at a clinician’s office, as some people experience a rise in blood pressure in medical settings (known as “white coat hypertension”), while others may have normal blood pressure during examination despite actually having high blood pressure at home (“masked hypertension”).
Time-in-target-range (TTR) is a new way to measure how often a patient’s blood pressure is in the normal range, and it is becoming a promising metric for assessing cardiovascular risk. However, TTR requires more frequent blood pressure readings than can be obtained with traditional blood pressure cuffs, which can be inconvenient and burdensome for some patients.The study, led by Fisher and in collaboration with Aktiia SA, a Swiss biotechnology company, analyzed over 2.2 million blood pressure readings from 5,189 subjects in Europe and the U.K. The participants wore a cuffless wrist monitor manufactured by Aktiia, which collected an average of 29 readings per day. This is a significant increase from the typical number of blood pressure readings taken with home devices, as guidelines recommend four readings per day. Over a 15-day period, the researchers obtained an average of 434 readings from each patient, providing a comprehensive dataset for analysis.
The researchers used TTR to group participants based on their readings in the target range over 15 days and compared this to the classifications from traditional 24-hour or week-long monitoring. They found that the traditional methods misclassified 26 and 45 percent of subjects compared to the reference TTR. They concluded that monitoring for seven days is necessary to accurately classify hypertension risk, but this may only be possible with cuffless monitoring.
The cuffless device discussed in this study has not been approved by the U.S. Food and Drug Administration, but it has been validated in multiple studies and is available for purchase over the counter in Europe and the U.K. Efforts are underway to assess and establish standards for such devices in the U.S.
Using a cuffless device, we are now able to gather continuous out-of-office blood pressure readings for the first time and use this data to calculate a new measurement, known as time-in-target-range. This metric shows great potential as a risk predictor,” Fisher explained. “The use of cuffless devices could change the way we monitor blood pressure.”Improving lifestyle and controlling blood pressure.
