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Ambulatory blood pressure monitoring
W R Nicholson1, J N Matthews, J J O'Sullivan
1Regional Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne.
Insights
Ambulatory blood pressure monitoring (ABPM) is accurate and acceptable for children. This study validates ABPM
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Ambulatory blood pressure monitoring (ABPM) is established for adult cardiovascular assessment.
- Pediatric applications of ABPM require validation for accuracy and patient tolerance.
Purpose of the Study:
- To assess the accuracy of ABPM in children within a specific blood pressure range.
- To evaluate the acceptability and comfort of ABPM devices in pediatric patients.
Main Methods:
- Thirty-one children (ages 6-18) underwent ABPM using an auscultatory device.
- Comparative blood pressure measurements were taken using mercury sphygmomanometer and oscillometric devices.
- Device wear duration averaged 16 hours with approximately 52 recordings per child.
Main Results:
- ABPM demonstrated close agreement with sphygmomanometer readings (systolic bias <1.0 mm Hg, diastolic bias <1.0 mm Hg).
- Limits of agreement were 11.6 mm Hg (systolic) and 13.6 mm Hg (diastolic).
- Most children tolerated the device well, with minimal sleep disruption.
Conclusions:
- ABPM is an accurate and reliable method for measuring blood pressure in children within the tested range.
- The validated ABPM device is well-accepted by pediatric patients, facilitating its use in clinical settings.
Abstract:
Ambulatory blood pressure monitoring (ABPM) in adults is proving to be useful. The aim of this study was to determine if ABPM is accurate in the lower blood pressure range encountered in children and, equally important, whether it is acceptable to children. Thirty one children, between the ages of 6 and 18 years, were assessed using an ambulatory blood pressure monitor that uses an auscultatory method. Blood pressure was measured in the contralateral arm with a mercury sphygmomanometer and an oscillometric device at the beginning and end of the study for comparison. Over a blood pressure range of 90-130 mm Hg systolic and 40-80 mm Hg diastolic, a close agreement was found with the sphygmomanometer; the limits of agreement (+/- 2 SD) were 11.6 mm Hg for systolic blood pressure and 13.6 mm Hg for diastolic blood pressure. The bias was less than 1.0 mm Hg. The ambulatory device was worn by all patients for at least 16 hours with an average of 52 recordings per patient. The majority found the device comfortable to wear and were not woken from sleep.
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