Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
Department of Bioengineering and Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Hypertens. 2022 Aug 1;40(8):1449-1460. doi: 10.1097/HJH.0000000000003224. Epub 2022 Jun 16.
Many cuffless blood pressure (BP) measuring devices are currently on the market claiming that they provide accurate BP measurements. These technologies have considerable potential to improve the awareness, treatment, and management of hypertension. However, recent guidelines by the European Society of Hypertension do not recommend cuffless devices for the diagnosis and management of hypertension.
This statement by the European Society of Hypertension Working Group on BP Monitoring and Cardiovascular Variability presents the types of cuffless BP technologies, issues in their validation, and recommendations for clinical practice.
Cuffless BP monitors constitute a wide and heterogeneous group of novel technologies and devices with different intended uses. Cuffless BP devices have specific accuracy issues, which render the established validation protocols for cuff BP devices inadequate for their validation. In 2014, the Institute of Electrical and Electronics Engineers published a standard for the validation of cuffless BP devices, and the International Organization for Standardization is currently developing another standard. The validation of cuffless devices should address issues related to the need of individual cuff calibration, the stability of measurements post calibration, the ability to track BP changes, and the implementation of machine learning technology. Clinical field investigations may also be considered and issues regarding the clinical implementation of cuffless BP readings should be investigated.
Cuffless BP devices have considerable potential for changing the diagnosis and management of hypertension. However, fundamental questions regarding their accuracy, performance, and implementation need to be carefully addressed before they can be recommended for clinical use.
目前市场上有许多无袖带血压(BP)测量设备,声称可以提供准确的血压测量结果。这些技术在提高高血压的知晓率、治疗和管理方面具有很大的潜力。然而,最近欧洲高血压学会的指南不建议使用无袖带设备来诊断和管理高血压。
这份由欧洲高血压学会血压监测和心血管变异性工作组发布的声明介绍了无袖带 BP 技术的类型、其验证中的问题以及临床实践建议。
无袖带血压监测仪构成了广泛而多样化的新型技术和设备群体,具有不同的预期用途。无袖带 BP 设备存在特定的准确性问题,这使得适用于袖带 BP 设备的既定验证方案不适合用于其验证。2014 年,电气和电子工程师协会发布了无袖带 BP 设备验证标准,国际标准化组织目前正在制定另一个标准。无袖带设备的验证应解决与个体袖带校准需求、校准后测量稳定性、跟踪血压变化的能力以及机器学习技术实施相关的问题。也可以考虑进行临床现场调查,并研究无袖带 BP 读数的临床实施问题。
无袖带 BP 设备在改变高血压的诊断和管理方面具有很大的潜力。然而,在推荐将其用于临床使用之前,需要仔细解决其准确性、性能和实施方面的基本问题。