Home blood pressure devices are not all equal

Clinicians should advise patients with hypertension that if they are going to use a home blood pressure device, it should be one that has been validated by Hypertension Canada, according to the authors of an Edmonton-based study.Physicians should also advise their patients to avoid online retailers for these devices, they stated.“Accurate and precise measurement of blood pressure is a fundamental principle for the diagnosis and management of hypertension,” wrote the authors in the study published in the Canadian Cardiovascular Society’s publication CJC Open.“Errors of even 5 mm Hg can lead to misclassification of individuals, leading to over- and undertreatment of hypertension.”The study was conducted in July 2022 by medical researchers from the University of Alberta, the University of Sydney and the University of Tasmania. One of the authors, Ross T. Tsuyuki, is also the president of Hypertension Canada, as disclosed in the article. Hypertension Canada is an advocacy group that has put out a list of recommended blood pressure devices that have gone through its validation process and adhere to international standards, according to its website.This list serves as some form of guidance amid an absence of regulation.“It is not widely known that there is no regulatory requirement for blood pressure devices to be tested for accuracy and precision,” the study authors wrote. They said they sought to determine the proportion of Hypertension Canada-recommended devices sold in pharmacies and online.170 devices reviewedTo collect their data, they visited 16 pharmacies in the Edmonton area, seven of which were major chains and nine of which were independent pharmacies. They also reviewed the 50 most popular devices sold online by Amazon, Walmart, Best Buy and Canadian Tire.A total of 170 devices were reviewed. Of those sold in pharmacies, 61 of 68 devices (89.7%) were validated. Of those sold online, only 46 of 102 devices (45.1%) were validated. A full 100% of the devices sold at the independent pharmacies were validated, compared with 85.1% of devices sold in chain pharmacies, the authors noted.Validated devices provide more accurate readings, they stated. However, they are typically more expensive than unvalidated devices. “This would have implications for health equity, as blood pressure devices are not covered by provincial health plans, and patients with lower income levels might then turn to cheaper unvalidated devices found online,” the authors wrote.There are other factors that affect the quality of blood pressure measurements conducted at home, they noted. In ideal conditions, the cuff size is correct, the person is positioned correctly, and the person has prepared properly by resting for at least five minutes prior.These factors could compound the problem of inaccurate home devices, the authors wrote.Hypertension affects 23% of adult Canadians and more than 1.4 billion people worldwide, the study noted. The World Health Organization estimates that only 21% of people with hypertension have their blood pressure under control.

Home blood pressure devices are not all equal

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