Home Doppler blood pressure monitoring in infants and children: a pilot study of its feasibility and clinical utility
- Correspondence to Manish D Sinha, Evelina Children's Hospital, Department of Paediatric Nephrology, Room 64, Sky Level, Westminster Bridge Road, London SE1 7EH, UK;
Contributors All authors fulfil criteria for authorship and have contributed to the collection of data, analysis of results and writing of this manuscript. No one who fulfils criteria for authorship has been excluded.
- Received 19 October 2011
- Accepted 16 April 2012
- Published Online First 9 June 2012
Background Out-of-hospital measurements of blood pressure (BP) are important for investigating and managing hypertension, but information is limited regarding the right technique to use in infants, small children and those intolerant of ambulatory BP monitoring. The aim of the study was to determine the feasibility and clinical utility of home Doppler BP monitoring (HDBPM).
Methods This single-centre study included all consecutive patients referred to a tertiary hypertension clinic who underwent HDBPM over a 12-month period. Parents were taught to measure systolic BP using a Doppler instrument.
Results HDBPM was successfully performed in 15 children (median (IQR) age 2.2 (0.9–3.7) years). All six patients referred for confirmation of newly diagnosed hypertension following sustained elevated clinic BP levels were found to be normotensive. Of the nine children referred with ‘treated hypertension’ for monitoring currently elevated clinic BP levels, four had confirmed hypertension and five were normotensive on HDBPM. In all nine ‘treated hypertensive’ patients, medication changes and normotensive BP levels were achieved with on-going home Doppler monitoring. 11/15 (73.3%) subjects successfully performed ≥1 BP measurement on at least 24 days of the 28-day monitoring period. The median (IQR) number of BP measurements performed weekly through week 4 of HDBPM were 22 (13–36), 18 (12–38), 18 (11–36) and 16 (8–32) respectively. No patient was hospitalised for further BP monitoring.
Conclusions HDBPM is acceptable to children and their families, demonstrating its feasibility as an out-of-office measurement technique. The initial results and the reliability of HDBPM need to be explored in larger clinical studies.
Funding MDS acknowledges financial support from the Department of Health via the National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre award to Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.