Analyzing 24-Hour Blood Pressure Measurements with a Novel Cuffless Pulse Transit Time Device in Clinical Practice—Does the Software for Heartbeat Detection Matter?

Abstract

Background: The Somnotouch-Non-Invasive-Blood-Pressure (NIBP) device delivers raw data consisting of electrocardiography and photoplethysmography for estimating blood pressure (BP) over 24 h using pulse-transit-time. The study’s aim was to analyze the impact on 24-hour BP results when processing raw data by two different software solutions delivered with the device. Methods: We used data from 234 participants. The Somnotouch-NIBP measurements were analyzed using the Domino-light and Schiller software and compared. BP values differing >5 mmHg were regarded as relevant and explored for their impact on BP classification (normotension vs. hypertension). Results: Mean (±standard deviation) absolute systolic/diastolic differences for 24-hour mean BP were 1.5 (±1.7)/1.1 (±1.3) mm Hg. Besides awake systolic BP (p = 0.022), there were no statistically significant differences in systolic/diastolic 24-hour mean, awake, and asleep BP. Twenty four-hour mean BP agreement (number (%)) between the software solutions within 5, 10, and 15 mmHg were 222 (94.8%), 231 (98.7%), 234 (100%) for systolic and 228 (97.4%), 232 (99.1%), 233 (99.5%) for diastolic measurements, respectively. A BP difference of >5 mmHg was present in 24 (10.3%) participants leading to discordant classification in 4–17%. Conclusion: By comparing the two software solutions, differences in BP are negligible at the population level. However, at the individual level there are, in a minority of cases, differences that lead to different BP classifications, which can influence the therapeutic decision.

Keywords

• somnotouch
• 24-hour blood pressure measurement
• pulse transit time
• cuffless blood pressure
• arterial hypertension