Accuracy of Cuffless Ambulatory Blood Pressure Monitors Compared to Cuff-based Monitors in an Ambulatory Elderly Population: A Pilot Study

Sligo General Hospital

Status: Not yet enrolling

Conditions: Hypertension

Treatments: Device: Aktiia SA Bracelet

Study type: Interventional

Funder types: Other

Identifiers

NCT06358378

995

Details and patient eligibility

About

Hypertension is extremely common amongst the elderly, typically manifesting as a silent disease with potentially devastating consequences if left undetected and untreated. Such consequences include stroke, myocardial infarction, kidney and eye disease. Opportunistic screening for hypertension is therefore standard in clinical practice. Currently, the standard of care for screening in the western world is with 24-hour ambulatory cuff-based devices which are often intolerable, particularly for elderly patients.

Several novel cuffless wearables have been developed to overcome the limitations of cuff-based monitors. These devices offer significant advantages over cuff-based devices, including improved patient tolerance and user acceptability. Numerous cuffless monitors are now commercially available. However, validation of such devices is challenging as there is no current universal standard for validating such devices.5 This is highlighted by the heterogenous and often inadequate study methods used to demonstrate accuracy of commercially available cuffless devices for blood pressure measurements. Indeed, the uncertainty about their merit is reflected in international guidelines. The 2023 European Society of Hypertension guidelines currently do not recommend routine use of such devices in clinical practice for evaluation of blood pressure.

There are limited clinical trials comparing 24-hour cuff-based devices directly to cuffless devices, and even fewer specifically in an elderly population where they may be particularly advantageous due to design features that improve tolerability. This study thus aims to address this important gap in the literature to better understand if cuffless devices provide reliable blood pressure measurements in the elderly population by directly comparing these devices to the current standard of care in blood pressure evaluation. The Aktiia device will be used as a surrogate for cuffless wearables while a standard 24-hour ambulatory cuff-based device will represent cuff-based devices. The Aktiia device is a cuffless solution worn as a bracelet on the wrist. It contains optical sensors which collect photoplethysmography signals from arteries in the patient's wrist and uses these to estimate blood pressure. This device is commercially available and clinically validated for use in patients up to age 85.

Enrollment: 30 estimated patients

Sex: All

Ages: 65+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adults >65 years old
• Enrolled on Sligo/Leitrim ICPOP programme
• Participants (or carers) must have access to a smart phone compatible with the Aktiia app

Exclusion criteria

• Cognitive impairment or diagnosis of dementia
• Adults unable to provide informed consent
• Life-expectancy less than one year
• Patient's unlikely to comply with trial protocol in opinion of investigator's

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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30 participants in 1 patient group

Single Arm

Experimental group

Description:

Enrolled patients will be asked to wear both the cuff-based ambulatory blood pressure monitor (ABPM) and the Aktiia bracelet at the same time during daytime hours (9am - 9pm) for a 72-hour period after calibration of the bracelet at the site. The ABPM will provide reference blood pressure measures to compare the Aktiia-derived measures against

Treatment:

Device: Aktiia SA Bracelet