Blood pressure self-measurement in upper arm and in wrist for treatment control of arterial hypertension compared to ABPM.

Automatic 24 h Ambulatory Blood Pressure Monitoring (ABPM) has become an established method in the diagnosis and treatment control of arterial hypertension. Fully automatic blood pressure devices for blood pressure self-measurement (BPSM) in the upper arm and in the wrist using the oscillometric measuring technique have been available in Germany for several years. After evaluating the blood pressure devices boso Oscillomat (upper arm) and Omron HEM-601 (wrist) by means of simultaneous invasive measurements, we studied the suitability of this new method for the control of treated hypertension. Using the device Space Labs 90207, we had ABPM carried out in 100 men (aged 58 +/- 8 years) with mild to moderate hypertension. They recorded hourly blood pressure measurements in the wrist between 6 a.m. and 6 p.m., in the same arm as the blood pressure monitoring using the device Omron HEM-601, or in the other arm using the device boso Oscillomat. The values of systolic and diastolic blood pressure were measured using both methods. Since the random samples probably consisted of non-standard distribution differences, we applied the Wilcoxon matched pairs signed rank test for statistical analysis. No significant differences were recorded between the daily mean systolic (p < .07) and diastolic (p < .97) blood pressure values determined by ABPM and by frequent blood pressure self-measurement. Multiple blood pressure readings obtained using blood pressure self-measurement in the upper arm as well as in the wrist are an alternative to the established, automatic 24-h, ambulatory blood pressure measurement for the treatment control of arterial hypertension, that nightly blood pressure measurement can be omitted. It has advantage of unrestricted and desired frequent use under standardized conditions.