Abstract
Introduction
Self-monitoring home blood pressure (BP) devices are currently recommended for long-term follow-up of hypertension and its management. Some of these devices are integrated with algorithms aimed at detecting atrial fibrillation (AF), which is common essential hypertension. This study was designed to compare the diagnostic accuracy of two widely diffused home BP monitoring devices in detecting AF in an unselected population of outpatients referred to a hypertension clinic because of high BP.
Methods
In 503 consecutive patients the authors simultaneously compared the accuracy of the Microlife® BP A200 Plus (Microlife) and the OMRON® M6 (OMRON) home BP devices, in detecting AF.
Results
Systolic and diastolic BP as well as heart rate (HR) values detected by the two devices were not significantly different. Pulse irregularity was detected in 124 and 112 patients with the OMRON M6 and Microlife BP A200 Plus devices, respectively. Simultaneous electrocardiogram (ECG) recording revealed that pulse irregularity was due to AF in 101 patients. Pulse irregularity detected by the OMRON M6 device corresponded to AF in 101, to supraventricular premature beats in 18, and to frequent premature ventricular beat in five patients, respectively. Pulse irregularity detected by the Microlife BP A200 Plus device corresponded to AF in 93, to supraventricular premature beats in 14, and to ventricular premature beats in five patients. The sensitivity for detecting AF was 100%, the specificity was 92%, and diagnostic accuracy 95% for the OMRON M6 and 100%, 92%, and 95 for the Microlife BP A200 Plus, respectively. AF was newly diagnosed by ECG recordings in 47 patients, and was detected in all patients by the OMRON device, and in 42 patients by the Microlife device.
Conclusion
These results indicate that OMRON M6 is more accurate than Microlife BP A200 Plus in detecting AF in patients with essential hypertension. Widespread use of these devices in hypertensive patients could be of clinical benefit for the early diagnosis and treatment of this arrhythmia and related consequences.
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References
Fuster V, Rydén LE, Cannom DS, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines; European Society ofCardiology Committee for Practice Guidelines; European Heart Rhythm Association; Heart Rhythm Society. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation. Circulation. 2006;114:e257–e354.
Dewar RI, Lip GY. Guidelines Development Group for the NICE clinical guideline for the management of atrial fibrillation. Identification, diagnosis and assessment of atrial fibrillation. Heart. 2007;93:25–28.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217–223.
Kannel WB. Prevalence, incidence, and hazards of hypertension in the elderly. Am Heart J. 1986;112:1362–1363.
Fitzmaurice DA, Hobbs FD, Jowett S, et al. Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial. BMJ. 2007;335:383–386.
Parati G, Stergiou GS, Asmar R, et al. ESH Working Group on Blood Pressure Monitoring. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens. 2008;26:1505–1526.
Pickering TG, Miller NH, Ogedegbe G, Krakoff LR, Artinian NT, Goff D. American Heart Association; American Society of Hypertension; Preventive Cardiovascular Nurses Association. Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:1–9.
Wiesel J, Wiesel D, Suri R, Messineo FC. The use of a modified sphygmomanometer to detect atrial fibrillation in outpatients. Pacing Clin Electrophysiol. 2004;27:639–643.
Wiesel J, Fitzig L, Yehuda Herschman Y, Messineo FC. Detection of atrial fibrillation using a modified Microlife blood pressure monitor. Am J Hypertens. 2009;22:848–852.
Stergiou GS, Karpettas N, Protogerou A, Nasothimiou EG, Kyriakidis M. Diagnostic accuracy of a home blood pressure monitor to detect atrial fibrillation. J Hum Hypertension. 2009;23:654–658.
Jani B, Bulpitt CJ, Rajkumar C. The accuracy of blood pressure measurement in atrial fibrillation. J Hum Hypertens. 2006;20:543–545.
Belghazi J, El Feghali RN, Moussalem T, Rejdych M, Asmar RG. Validation of four automatic devices for self-measurement of blood pressure according to the International Protocol of the European Society of Hypertension. Vasc Health Risk Manag. 2007;3:389–400.
Lin HJ, Wolf PA, Benjamin EJ, Belanger AJ, D’Agostino RB. Newly diagnosed atrial fibrillation and acute stroke. The Framingham Study. Stroke. 1995;26:1527–1530.
Israel CW, Grönefeld G, Ehrlich JR, Li YG, Hohnloser SH. Long-term risk of recurrent atrial fibrillation as documented by an implantable monitoring device: implications for optimal patient care. J Am Coll Cardiol. 2004;43:47–52.
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An erratum to this article is available at http://dx.doi.org/10.1007/s12325-014-0172-2.
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Marazzi, G., Iellamo, F., Volterrani, M. et al. Comparison of Microlife BP A200 Plus and Omron M6 Blood Pressure Monitors to Detect Atrial Fibrillation in Hypertensive Patients. Adv Therapy 29, 64–70 (2012). https://doi.org/10.1007/s12325-011-0087-0
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DOI: https://doi.org/10.1007/s12325-011-0087-0