Abstract P010: Performance Of Home Blood Pressure Monitors In The Clinical Setting

Background: Self-measured blood pressure (SMBP) monitoring is increasingly used for remote management of hypertension, but the real-world performance of home BP devices remains unsettled. Objectives: To determine the performance of home BP devices among patients with hypertension using the American Medical Association’s (AMA) Self-Measured Blood Pressure Device Accuracy Test protocol. Methods: Patients at a single hypertension clinic underwent up to five seated, same-arm BP readings using home monitors and an automated BP machine (Omron HEM-907XL). Following the AMA’s 3-step protocol, we used the home device for the first, second, and fourth measures and the office device for the third and fifth (if needed) measures. Device failure was defined as an absolute difference in systolic BP >10 mm Hg between the home and office monitors in either Step 2 or Step 3. Patient factors associated with failure were examined via logistic regression models adjusted for age, sex, and race. Results: We evaluated 152 patients (mean age 60 ± 15 years, 58% women, 31% Black) seen between October 2020 and November 2021. Device failure occurred in 21.7% (95% CI: 15.8, 29.0) of devices tested, including 18.1% among Omron devices and 27.6% among non-Omron devices ( P = 0.08) ( Table ). Higher BMI was associated with higher odds of device failure (OR: 1.09; 95% CI: 1.01, 1.17) though age, sex, and race were not associated with device failure. Conclusions: Over one-fifth of home devices failed accuracy testing using the AMA SMBP protocol. Higher BMI was associated with device failure. These findings confirm the importance of office-based monitor verification to ensure the accuracy of home BP monitoring.