Reliability of home blood pressure monitoring: in the context of validation and accuracy

Home blood pressure (BP) monitoring offers clinically relevant information enriched with more abundant data. However, there are few studies addressing the reliability of home BP devices and the quality of its data. This study aimed to evaluate the current status of home BP devices in terms of validation and accuracy.

Hypertensive patients with automated upper arm-type BP devices were consecutively enrolled. First, the validation status of each device was assessed through the website. Next, the accuracy of the individual device was evaluated by comparing the mean BP values between the automated device and a mercury sphygmomanometer. Accuracy of the device was defined as having less than a 5 mmHg difference in the mean BP values.

A total of 212 individuals were analyzed; 38.7% (82 of 212) of the participants used validated devices and 85.4% (181 of 212) were accurate. Inaccuracy was more common with nonvalidated devices than validated devices [19.2% (n=25) vs. 7.3% (n=6), P=0.017]. The range of inaccuracy of the validated devices was 6-26 mmHg for the systolic BP and 6-11 mmHg for the diastolic BP.

The present study showed that nonvalidated devices are used widely in clinical practice and a substantial portion is inaccurate. Therefore, recommendation of validated devices should be the first step. Furthermore, all devices need to be examined for accuracy before use irrespective of their validation status.