PubMed · 8989795
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J J Nobel. 1996. Electronic, automatic sphygmomanometers.. https://doi.org/10.1097/00006565-199612000-00014
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Home blood pressure measurement is a simple, precise and highly reproducible method. Its application is possible in a large majority of patients. The method is valid if performed with devices validated according to international criteria and if an appropriate methodology is applied. It is advantegeously used for diagnostic of high blood pressure, particularly white coat hypertension. It allows for an exact appreciation of treatment efficacy and a long term follow-up of blood pressure control. In a majority of patients it improves their compliance to drug treatment. Its precision allows to decrease the number of patients needed in clinical trials. The main obstacle of larger use of home blood pressure monitoring is the need to give a detailed instructions to patients and generally a laborious evaluation of results. The latter could be simplified by using devices transferring measured results directly to physician's computer. However the cost of such instruments remains high. Finally the lack of financial reimbursement of physicians using home blood pressure measurement limits further its larger use.
Using conventional methods (Riva-Rocci, oscillometric), non-invasive blood pressure measurements allow readings to be obtained only at discrete times, at intervals of at least one or two minutes. During exercise ECG recording, continuous blood pressure monitoring capable of detecting brief blood pressure changes is desirable. Our new approach is based on the known dependency of pulse wave velocity and blood pressure. The pulse transit time is derived from an ECG and a simultaneously recorded photoplethysmogram, and the blood pressure is computed using a linear model. In addition to the conventional ECG device, only a finger or ear sensor is required, so that the application of the method is quite easy. Results indicating dynamic blood pressure variations during an exercise ECG are presented.
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