Sex and Age Differences in Ambulatory Blood Pressure Monitoring Tolerability

Abstract

Background: Clinical practice guidelines endorse using ambulatory blood pressure monitoring (ABPM) for the diagnosis and management of hypertension. However, ABPM is not always tolerated by patients, and differences between individuals according to age and sex remain unexplored.

Methods: This is a post hoc analysis of a prospective, single-arm clinical trial (NCT03920956) that evaluated the feasibility of an ABPM service provided at 2 community pharmacies. Tolerability was assessed using a previously published survey, which included 7 yes/no questions and 8 answered on a scale of 0-10. Descriptive statistics and Chi-square analyses were used to summarize the data for the patient surveys and to describe sex and age differences in device tolerability.

Results: Of the 52 subjects enrolled, 50 (96%) completed the survey; half were female with a mean (SD) age of 57.5 years (15.8). Chi-square analyses showed that compared with their male counterparts, females were more likely to find the monitor cumbersome to wear (76.2% vs. 40%, P = 0.014). Subjects under 55 years of age were more likely to be disturbed by the noise of the monitor during driving (38.1% vs. 4.2%, P = 0.005) and at other times (35.0% vs. 8.3%, P = 0.029), and to find the monitor embarrassing to wear (33.3% vs. 7.1%, P = 0.019).

Conclusions: Although ABPM was generally well-tolerated overall, we did identify age and sex differences in tolerability. These factors should be considered to ensure patient acceptance and tolerability of ABPM.

Keywords: ambulatory blood pressure monitoring; blood pressure; hypertension; sex.