Twenty-four-hour ambulatory blood pressure monitoring: a review of validation data

As the clinical applications for 24-h ambulatory blood pressure monitoring expand, market demands increase, and there are now at least 13 manufacturers producing elaborate and expensive systems for recording 24-h ambulatory pressures. It is often difficult to assess the accuracy and performance characteristics of these devices and failure to standardize validation makes it difficult to compare one system with another. The standard of the Association for the Advancement of Medical Instrumentation (AAMI) and the recently published protocol of the British Hypertension Society (BHS) provide standardized validation procedures which allow comparisons to be made between ambulatory devices. Thirty-three published reports on 18 ambulatory systems are listed. Five of these systems have been validated according to the AAMI standard; of these, the SpaceLabs 90202 and the Medilog have satisfied the standard, and the Pressurometer IV, the Accutracker II and the Takeda TM-2420 did not satisfy the AAMI standard. The results of recent validations of the SpaceLabs 90207, the Diasys 200, the Takeda TM-2420 and the Pressurometer IV according to the BHS protocol are awaited and should provide further data that will allow comparisons of the performance and the accuracy of different ambulatory systems.