Abstract P334: Comparing A Cuffless Device With Traditional Home Blood Pressure Monitoring In A Remote Hypertension Management Program: Primary Results Of The COOL-BP Study

Background: Innovative BP measurement technology with cuffless devices has the potential to enhance HTN control, especially with remote HTN management. Methods: Patients with uncontrolled BP at Mass General Brigham were managed by navigators and pharmacists in a digital remote HTN management program, based on home BP monitoring (HBPM) with digitally-connected arm cuffs. A subset was enrolled into the 6-month COntinual vs OccasionaL (COOL-BP) study, testing a wrist cuffless device (Aktiia SA, Switzerland). Asynchronous daytime weekly BP averages from both modalities were compared, including all readings from the cuffless device, and guideline-directed twice daily readings from HBPM. Of 38 patients who measured their BP with both devices, 25 collected at least one overlapping week of BPs with each device, with a minimum of 12 valid daytime readings over at least 3 days per week. Results: The scatter plots (Figure, top) showed moderate to strong correlation between 72 weekly average daytime BPs by HBPM and the cuffless device (r=0.57 for SBP; r=0.64 for DBP). The difference plots (Figure, bottom) showed that cuffless SBP was higher than HBPM (4.9±11.3 mmHg, p=0.01), while DBP was lower (-4.2±7.2 mmHg; p=0.003). Importantly, cuffless BPs were non-simultaneous with HBPM, included measurements in different body positions, and were much more numerous, which could help explain the differences between BP averages. Conclusion: Daytime weekly average home BPs with continual monitoring using a cuffless wrist device were comparable to those measured by traditional HBPM. These findings encourage exploring the use of continual cuffless monitoring for the remote management of HTN.