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The use of ambulatory tonometric radial arterial wave capture to measure ambulatory blood pressure: the validation of a novel wrist-bound device in adults

Journal of Human Hypertension volume 22, pages 220–222 (2008)Cite this article

Although ambulatory blood pressure (BP) monitoring provides a better guide to the management of hypertension, 1, 2, 3, 4 these devices are cumbersome and inconvenient, and therefore not widely used. HealthSTATS International (Singapore) developed a wrist-bound BP measurement device (BPro), which measures BP using arterial tonometry. 5 We aimed to validate the accuracy of this device in measuring BP according to the modified European Society of Hypertension (ESH) protocol 6 and Association for the Advancement of Medical Instrumentation (AAMI) standard. 7

The wrist-bound BP measurement system consists of a wrist-bound BP monitor that works by applanation tonometry, with a hemispheric plunger placed on the radial artery. Before use, it is calibrated by an arm-based oscillometric monitor. A proprietary strapping system for the plunger provides constant pressure on the artery without obstructing venous return and compression of surrounding structures, for example, median nerve. The position of the sensor, housed in the watch-head, is stabilized, allowing the forearm and wrist to move reasonably freely. Pulsation of the radial artery is sampled at a rate of 60–200 Hz to generate the arterial waveform. Several indices and coefficients are obtained to generate a template of the individual's waveform. During subsequent samplings, waveforms that match the template are collected and sorted in an array, and the mean BP is computed. Proprietary software using derived coefficients is used to calculate systolic BP (SBP) and diastolic BP (DBP) by detecting BP changes from the calibrated level through changes in the arterial waveform.

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References

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Acknowledgements

KHM was the study director and principal investigator; he directed the entire study, including protocol development, training of staff, conduct of study, review of findings, and obtaining ethics approval. DN, SYT and HWG were the co-investigators. JT recruited subjects and coordinated the validation sessions. SFL supervised nurses during the validation sessions. ZM and GH managed the data and performed the statistical analysis in accordance with the protocol. WLP and NHC provided technical support. DN, SYT and KHM wrote the paper. All the authors reviewed and approved the final version. This study was funded by HealthSTATS, Singapore.

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Authors and Affiliations

  1. Department of Cardiology, National Heart Centre, Singapore, Singapore

    D Nair, S-Y Tan, H-W Gan, S-F Lim, J Tan & K-H Mak

  2. Clinical Trials, Epidemiology and Research Unit, Singapore, Singapore

    M Zhu & H Gao

  3. HealthSTATS, Singapore, Singapore

    N-H Chua & W-L Peh

  4. Gleneagles Medical Centre, Singapore, Singapore

    K-H Mak

Authors
  1. D Nair
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  2. S-Y Tan
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  10. K-H Mak
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Correspondence to K-H Mak.

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Conflict of interest

WLP is employed by HealthSTATS International. NHC is an executive director of the company. All the other authors have no financial or personal relationships with HealthSTATS International.

Supplementary Information accompanies the paper on the Journal of Human Hypertension website (http://www.nature.com/jhh).

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Nair, D., Tan, SY., Gan, HW. et al. The use of ambulatory tonometric radial arterial wave capture to measure ambulatory blood pressure: the validation of a novel wrist-bound device in adults. J Hum Hypertens 22, 220–222 (2008). https://doi.org/10.1038/sj.jhh.1002306

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