Most of the conventional wrist BP cuffs aren't validated. Cuffless wrist devices are likely the wave of the future but almost all lack validation of accuracy.
So, with the wrist device, I could take my BP under the most extreme condition: When my wife alters our destination just after we've passed the last turn to get to the new destination. That brachial cuff is so difficult to put on while driving... 😉
Your statement that the BP standards...have been lowered to get more people on statins, makes no sense.
Statins are a medical treatment for hyperlipidemia, not hypertension.
Optimal BP goals were modified about 5 years ago based on a very good NIH sponsored trial called the SPRINT trial which I discuss on my website in detail..
This was my published letter to the editor supporting wrist BP cuffs that I still support-it was responded to negatively by the authors. Take a look, see what u think. " .1751-7176.2008.0033_2.XCorpus ID: 70733750
Re: “Call To Action on Use and Reimbursement for Home Blood Pressure Monitoring: Executive Summary” by H. Robert Silverstein, MD, FACC
Published 1 November 2008
The Journal of Clinical Hypertension
To the Editor: The injunction contained in ‘‘Call To Action on Use and Reimbursement for Home Blood Pressure Monitoring: Executive Summary’’ against wrist BP monitors is arbitrary, prejudicial, lacking in clinical experience, and nonsense. Currently, there are so many people with large arms that, rather than larger cuffs, wrist monitors work uniformly well; moreover, wrist monitors fit just fine, are more convenient, are easily portable, and can be verified as accurate. The method that I use is as follows: apply the blood pressure (BP) cuff and record the BP (arm or wrist). BP is immediately measured again using my (lifetime-certified) upper arm BP cuff. This is repeated twice in quick succession. The patient’s BP cuff and mine are used on the same arm, since there may be an important difference in readings between the two arms. If the two cuffs measure identical readings or provide readings that are minimally different, the patient is informed of what to add or subtract from the systolic and ⁄or diastolic values. Pickering and colleagues merely and inadequately state that the BP cuff is to be verified, with no specific method discussed. This article’s recommended method for BP recording has nothing to do with the realities of life. It is ideal to see what the BP is at any time and under any circumstance, as well in the ‘‘9 times zones’’: before and after each meal, in between meals, and at bedtime. These can be measured over 3 or 4 days, giving the physician a comprehensive picture of daytime and evening BP levels. This is more likely to be accomplished with the smaller and more portable wrist cuff. Sitting calmly in a near-meditative state resembles no part of conscious life I am aware of. If the patient smokes, drinks, or exercises, I want to know what their BP numbers are(!). There is no reason to assume that these wrist monitors become inaccurate over time, and if such occurs, the discrepancy is usually obvious and readily identifiable.—H. Robert Silverstein, MD, Hartford, CT
A Comparison of Two Ambulatory Blood Pressure Monitors Worn at the Same Time
And perhaps the algorithms for such a device are developed in such a way so as accurately to characterize central arterial pressure. For those of us who have developed aneurysmal size to ascending aorta secondary to many, many, many years of endurance training and competing, and who are on the cusp of provoking an aneurysmal event secondary to continuing, though moderated exercise (based upon Respiratory VT1 and VT2 values), I'd be first in line to buy it. FinaPress is just too doggone expensive
Mike,
Marital driving and navigation-possibly the most stressful process in life.
Due to excessive micromanagement the former eternal fiancee' of the skeptical cardiologist now does all the driving (and most of the navigation)
dr. P
So, with the wrist device, I could take my BP under the most extreme condition: When my wife alters our destination just after we've passed the last turn to get to the new destination. That brachial cuff is so difficult to put on while driving... 😉
Gorgo,
Your statement that the BP standards...have been lowered to get more people on statins, makes no sense.
Statins are a medical treatment for hyperlipidemia, not hypertension.
Optimal BP goals were modified about 5 years ago based on a very good NIH sponsored trial called the SPRINT trial which I discuss on my website in detail..
Dr. P
This was my published letter to the editor supporting wrist BP cuffs that I still support-it was responded to negatively by the authors. Take a look, see what u think. " .1751-7176.2008.0033_2.XCorpus ID: 70733750
Re: “Call To Action on Use and Reimbursement for Home Blood Pressure Monitoring: Executive Summary” by H. Robert Silverstein, MD, FACC
Published 1 November 2008
The Journal of Clinical Hypertension
To the Editor: The injunction contained in ‘‘Call To Action on Use and Reimbursement for Home Blood Pressure Monitoring: Executive Summary’’ against wrist BP monitors is arbitrary, prejudicial, lacking in clinical experience, and nonsense. Currently, there are so many people with large arms that, rather than larger cuffs, wrist monitors work uniformly well; moreover, wrist monitors fit just fine, are more convenient, are easily portable, and can be verified as accurate. The method that I use is as follows: apply the blood pressure (BP) cuff and record the BP (arm or wrist). BP is immediately measured again using my (lifetime-certified) upper arm BP cuff. This is repeated twice in quick succession. The patient’s BP cuff and mine are used on the same arm, since there may be an important difference in readings between the two arms. If the two cuffs measure identical readings or provide readings that are minimally different, the patient is informed of what to add or subtract from the systolic and ⁄or diastolic values. Pickering and colleagues merely and inadequately state that the BP cuff is to be verified, with no specific method discussed. This article’s recommended method for BP recording has nothing to do with the realities of life. It is ideal to see what the BP is at any time and under any circumstance, as well in the ‘‘9 times zones’’: before and after each meal, in between meals, and at bedtime. These can be measured over 3 or 4 days, giving the physician a comprehensive picture of daytime and evening BP levels. This is more likely to be accomplished with the smaller and more portable wrist cuff. Sitting calmly in a near-meditative state resembles no part of conscious life I am aware of. If the patient smokes, drinks, or exercises, I want to know what their BP numbers are(!). There is no reason to assume that these wrist monitors become inaccurate over time, and if such occurs, the discrepancy is usually obvious and readily identifiable.—H. Robert Silverstein, MD, Hartford, CT
A Comparison of Two Ambulatory Blood Pressure Monitors Worn at the Same Time
Journal of Clinical Hypertension
Patience. I promise my article will come out within a week.
dr. P
And perhaps the algorithms for such a device are developed in such a way so as accurately to characterize central arterial pressure. For those of us who have developed aneurysmal size to ascending aorta secondary to many, many, many years of endurance training and competing, and who are on the cusp of provoking an aneurysmal event secondary to continuing, though moderated exercise (based upon Respiratory VT1 and VT2 values), I'd be first in line to buy it. FinaPress is just too doggone expensive
The price should be reasonable
Dr P
ETA?
I know it not yet approved in the US, but you’ve got to tell us what the new wrist BP device is, Anthony!
John