Ps-c10-11: comparison of measurement options for nocturnal hypertension. study protocol

Background: Nocturnal hypertension is strongly associated with adverse cardiac events and affects patients prognosis. However, to distinguish between true night hypertension and sleeping disorder might be tricky as patients often misinterpret sleep pattern and the role of standard device inconvenience during the 24 hour ABPM measurement. The effect of sleep disturbance on the validity of the results has not been thoroughly investigated. Aim: The main objective is to examine the validity of currently used conventional methods of ABPM in patients with nocturnal hypertension potentially disturbed by monitoring itself. The secondary objective is to determine whether the new (less obtrusive) methods are more effective in detecting true nocturnal hypertension and whether they are applicable to patients. Methods: The study will enter patient treated for arterial hypertension. They will be recruited consecutively and randomized. The study will have an intrasubject experimental design. Patients will first be measured sleep quality using an actigraph and a proposed questionnaire for this purpose (PSQI + own questionnaire of relation to technologies). We plan to enrol two groups of at 100 probands, with the first group being measured in the following way after baseline actigraphy is detected: 1. Measurement using the Spacelab Healthcare ABPM tonometer. 2. Measurement using a wrist tonometer (Beurer BC54) 3. Measurement using a smart watch tonometer (OMRON HeartGuide). In all of these cases, the actigraphy, or other variables indicating quality and sleep progression (HRV), will be measured simultaneously. For the second group, the order will be reversed, moving from the least obtrusive methods to the more obtrusive ones to eliminate bias sequencing. For the testing of the tonometer obtrusivity during the nigh time BP monitoring BP tonometers were improved by additional Blueetooth receivers, so they can be externally triggered by the command send from the tablet equipped with the specifically designed application. The application can trigger the measurement, consequently collect the measured data and securely send them to the hospital server. Measured sound level is used as one of the correlates of the tonometers obtrusivity along with the actigraphy and subjective perception of the obtrusiveness and sleep disturbance that is also evaluated by the developed questionnaire. Results: Number of true verus pseudonocturnal hypertension will be provided according to whether the root problem is poor sleep quality, which causes changes in blood pressure, or pathological changes in blood pressure itself, which causes a deterioration in sleep quality. Supported by MH CZ DRO (FNOl, 0098892), Mex reg. n.: 8787