What exactly is blood pressure?

In the most basic sense, blood pressure is a measure of the force against the walls of your arteries. Arterial blood pressure is constantly changing during the course of the hearts cycle. The highest pressure in the cycle is called the Systolic Blood Pressure; the lowest the Diastolic Blood Pressure. Both pressure readings, the Systolic and Diastolic, are necessary to enable a doctor to evaluate the status of a patients blood pressure. Systolic is the pressure exerted as your heart contracts to send a surge of blood through the vessels. Diastolic is the pressure exerted in the arteries when your heart relaxes between heartbeats. A reading between 135 mm Hg (millimetres of Mercury), Systolic and 85 mm Hg Diastolic is considered normal. According to WHO (World Health Organisation), and ISH (International Society for Hypertension), blood pressure should normally be less than 140 / 90 mm Hg but above 120 / 80 mm Hg for an adult. Blood pressure that stays between 140 -160 / 90 - 95 is considered critical (mild Hypertension), and above this level (160 / 95 mm Hg or higher) is considered high (Hypertension). The values indicated above may differ by region and country. Note - your doctor should evaluate unusually low readings. For additional information please refer to the Instruction Manual for your device.

How does a digital blood pressure monitor measure blood pressure?

Digital monitors measure blood pressure using the Oscillometric method rather than by Auscultation. In Auscultation the method typically used by healthcare professionals, a combination of a stethoscope and an arm cuff is used to take blood pressure reading by listening for the sounds which correspond to Systolic and Diastolic pressures (called Korotkoff sound). To take accurate blood pressure readings using this method requires training and practice. Oscillometric technology measures the vibration of blood travelling through the arteries and converts the movement into digital readings. OMRON Blood Pressure Monitors use the Oscillometric method of blood pressure measurement. An Oscillometric monitor does not require a stethoscope thus creating a simple to use device.

What is the accuracy of OMRON Blood Pressure Monitors?

All OMRON Blood Pressure Monitors must meet stringent specifications for accuracy. Pressure: +/- 3 mm Hg (millimetres of Mercury), Pulse: +/- 5% of display reading. These values meet or exceed the provisions of EC directive 93/42/EEC(Medical Device Directive), and the European Standard EN1060, Non-invasive sphygmomanometers Part 1: General Requirements and Part 3: Supplementary requirements for electromechanical blood pressure measuring systems.

How accurate are personal blood pressure monitors?

Extremely accurate, assuming they have been correctly calibrated and clinically validated. Most OMRON blood pressure monitors are clinically validated by independent doctors according to predetermined protocol. This means you are medically assured of the accuracy of the measurements from a blood pressure monitor with this validation.

Is an upper arm blood pressure Monitor more accurate than a wrist type?
Both of these devices must meet the same stringent specifications for accuracy. Pressure: +/- 3 mm Hg (millimetres of Mercury), Pulse: +/- 5% of display reading. These values meet or exceed the provisions of EC directive 93/42/EEC(Medical Device Directive), and the European Standard EN1060, Non-invasive sphygmanometers Part 1: General Requirements and Part 3: Supplementary requirements for electromechanical blood pressure measuring systems. The choice of device is basically one of convenience. Some people find the compactness of a wrist blood pressure monitor a benefit especially if one is travelling. Others prefer the larger buttons and display on the upper arm blood pressure monitors (easier to use and read).

What size cuff do I need?

It is very important to use the appropriate size cuff for your arm to obtain accurate measurement results when using your blood pressure monitor. In order to determine the appropriate cuff size, you need to measure the circumference of your arm. You should periodically measure your arm size. This is especially true if you have a borderline arm size measurement, or you may have gained or lost weight. It is important to ensure the arm cuff you are using with your monitor is the correct size for you. If the incorrect cuff is used the result may be an inaccurate reading and/or the cuff will be damaged (air bladder). To determine your arm size, use a cloth tape measure and place the tape measure midway between your elbow and your shoulder around the circumference of your upper arm. Wrap

the tape measure evenly around your arm. Do not pull the tape tight. Note the precise measurement in centimetres. Standard Cuff Sizes *: Small Cuff Medium Cuff Large Cuff - arm sizes 17 2 cm - arm sizes 2232 cm - arm sizes 3242 cm

Wide Range Cuff - arm sizes 22-42cm Comfort Cuff Sizes *: The Comfort Cuff will fit arms 22 42 cm* * Please note, not all cuffs can be used with each model of upper arm OMRON Blood Pressure Monitor. Refer to your Instruction Manual for compatibility.

How do I assemble and use the upper arm cuff (small, medium, large or wide range)?
When the cuff is assembled correctly, the Velcro hook material will be on the outside of the cuff loop and the metal ring will not touch your skin. If the cuff is open, pass the end of the cuff furthest from the tubing through the metal ring to form a loop. The smooth cloth should be on the inside of the cuff loop. 1. Remove tight-fitting clothing from your upper arm. 2. Sit in a chair with your feet flat on the floor. 3. Put your left arm through the cuff loop. The bottom of the cuff should be about 1 2 cm above your elbow (thickness of your index or middle finger). Adjust the cuff around your arm so that the tubing runs down the centre of your arm in line with your middle finger (palm open and facing upwards). 4. Secure the cuff around your arm using the cloth closure. Pull the cuff so that the top and bottom edges are tightened evenly around your arm. 5. The cuff should be firmly secured but not too tight just enough so that it is difficult to slide 2 fingers under the cuff. This space is imperative for an accurate reading. OMRON's digital Blood Pressure Monitors use the Oscillometric method of blood pressure measurement that detects your blood's movement through your brachial artery and converts this movement into a digital reading. 6. Relax your arm and place your elbow on the table so that the cuff is at the same level as your heart. Turn the palm of your hand upward. 7. Check there are no kinks in the air tubing. Be careful that you do not rest your elbow on

the air tube when taking a blood pressure reading. 8. Press the O/I START or START button to begin the blood pressure reading. For additional information please refer to the Instruction Manual for your device.

How do I know if the arm cuff is wrapped too tight or too loose?
Small, Medium or Large Cuff: It is recommended that you apply the cuff using the following directions: 1. Remove tight-fitting clothing from your left upper arm. 2. Sit in a chair with your feet flat on the floor. 3. Put your left arm through the cuff loop. The bottom of the cuff should be about 1 2 cm above your elbow (thickness of your index or middle finger). Adjust the cuff around your arm so that the tubing runs down the centre of your arm in line with your middle finger (palm open and facing upwards). 4. Secure the cuff around your arm using the cloth closure. Pull the cuff so that the top and bottom edges are tightened evenly around your arm. 5. The cuff should be firmly secured but not too tight just enough so that it is difficult to slide 2 fingers under the cuff. This space is imperative for an accurate reading. OMRON's digital Blood Pressure Monitors use the Oscillometric method of blood pressure measurement that detects your blood's movement through your brachial artery and converts this movement into a digital reading. 6. Relax your arm and place your elbow on the table so that the cuff is at the same level as your heart. Turn the palm of your hand upward. 7. Check there are no kinks in the air tubing. Be careful that you do not rest your elbow on the air tube when taking a blood pressure reading. 8. Press the O/I START or START button to begin the blood pressure reading. For additional information please refer to the Instruction Manual for your device. Comfort Cuff: 1. Remove tight-fitting clothing from your left upper arm. 2. Sit in a chair with your feet flat on the floor and place your arm on a table so that the cuff will be at the same level as your heart. 3. Clip the cuff over your lower left arm so the cloth flap is hanging down and slide the cuff up to your upper arm. 4. Turn the palm of your hand upward. 5. Align the middle of the green strip (early version of Comfort Cuff), or the blue line (current version) on the cuff with the inside of the arm in line with the middle finger.

6. The cuff tube should run down the centre of the arm even with the middle finger. 7. The bottom of the cuff should be about 1 2 cm above your elbow (thickness of your index or middle finger). 8. Secure the cuff around your arm using the cloth closure. 9. Secure the cuff firmly but not too tight just enough so that it is difficult to slide 2 fingers under the cuff. This space is imperative for an accurate reading because OMRON's digital Blood Pressure Monitors use the Oscillometric method of blood pressure measurement that detects your blood's movement through your brachial artery and converts this movement into a digital reading. 10. Relax your arm and place your elbow on the table so that the cuff is at the same level as your heart. Turn the palm of your hand upward. 11. Check there are no kinks in the air tubing. Be careful that you do not rest your elbow on the air tube when taking a blood pressure reading. 12. Press the O/I START or START button to begin the blood pressure reading. For additional information please refer to the Instruction Manual for your device.

Why can the measurement values differ when measurements are taken on the right and left arm?
Blood pressure measurement values vary from the left arm to the right arm. The average is generally within 10 mm Hg (millimetres of Mercury) for most individuals. The user should consult a doctor before using the right arm to take a measurement. The doctor can assist the user in determining their measurement values for the right arm. The cuff is designed mainly for use on the left arm. All validation testing is done on the left arm for the general population.

Why do my blood pressure readings seem to vary?

There are are several reasons why you may have inconsistent readings. Many factors exist that can cause a variation in blood pressure measurement values, for example, recent activities or even the time of day can alter the reading. Additionally, the user's technique is very important for reliable measurement results. Listed below are some of the common reasons you may see an inconsistent or inaccurate reading: Cuff Size It is very important to use the appropriate size cuff for your arm to obtain accurate measurement results when using your blood pressure monitor. In order to determine the

appropriate cuff size, you need to measure the circumference of your arm. You should periodically measure your arm size. This is especially true if you have a borderline arm size measurement, or you may have gained or lost weight. It is important to ensure the arm cuff you are using with your monitor is the correct size for you. If the incorrect cuff is used the result may be an inaccurate reading and/or the cuff will be damaged (air bladder). To determine your arm size, use a cloth tape measure and place the tape measure midway between your elbow and your shoulder around the circumference of your upper arm. Wrap the tape measure evenly around your arm. Do not pull the tape tight. Note the precise measurement in centimetres. Cuff Application 1. Put your left arm through the cuff loop. The bottom of the cuff should be about 1 2 cm above your elbow (thickness of your index or middle finger). Adjust the cuff around your arm so that the tubing runs down the centre of your arm in line with your middle finger. 2. Secure the cuff around your arm using the cloth closure. Pull the cuff so that the top and bottom edges are tightened evenly around your arm. 3. Secure the cuff firmly but not too tight just enough so that it is difficult to slide 2 fingers under the cuff. This space is imperative for an accurate reading because OMRON's digital Blood Pressure Monitors use the Oscillometric method of blood pressure measurement that detects your blood's movement through your brachial artery and converts this movement into a digital reading. Before Taking a Measurement Avoid eating, drinking alcohol, smoking, exercising, and bathing for 30 minutes and rest for 15 before starting the measurement. Avoid taking a measurement during stressful times. Take the measurement in a quiet place. Body Position Sit in a chair with your feet flat on the floor. Rest your arm on a table with your palm facing upward. The cuff should be level with your heart. Do not talk or move during the measurement. For additional information please refer to the Instruction Manual for your device.

How do I compare the readings on my blood pressure monitor with my doctor's readings?

When using your unit at home your readings may be lower due to a more relaxed environment. If you want to compare home measurement readings to those taken with the device used by your healthcare professional please follow this direction; use the OMRON Blood Pressure Monitor to take the first measurement followed by the unit used in the healthcare professional office. It is necessary to use the digital unit first because of the different methods used in the devices. The OMRON Blood Pressure Monitor measures the movement of blood through your arteries and converts this into a digital reading (Oscillometric method). A doctor typically uses a stethoscope (to listen to the sounds in the artery) and a gauge for the pressure reading (Auscultation method). The artery is constricted during the measurement so it is important to wait a few minutes between measurements to allow the artery to recover. Please bear in mind that blood pressure is constantly fluctuating therefore a small difference can be expected in the readings between the OMRON Blood Pressure Monitor and the doctors unit.

Why is home monitoring of blood pressure so important?

Doctors, physician assistants, nurses and other healthcare professionals recommend home blood pressure monitoring for various reasons, including the ability to: Be constantly aware of a vital indicator about your overall health Provide your doctor with information to better understand and manage your (high) blood pressure See how you are responding to medication

Many types of hypertension can only be detected by monitoring your blood pressure at home, including: White-coat Hypertension: blood pressure reading is high in doctor's office but lower at home Masked Hypertension: blood pressure reading is low in doctor's office but higher at home Additionally, many factors can affect your blood pressure, including physical exertion, emotional fluctuations, medications and stress, so it is important to regularly monitor your blood pressure at home.

Monitoring your blood pressure at home allows you to more easily be in a relaxed state plus the flexibility to take your measurements at various times during the day. By keeping track of your home blood pressure readings, you can provide your healthcare professional with a

log of blood pressure measurements over time, which can help them evaluate the effectiveness of your treatment.

What is Irregular Heartbeat?

This is a condition where the heartbeat rhythm varies by more than 25% from the average heartbeat detected while your unit is measuring the systolic and diastolic pressure.

Many OMRON Blood Pressure Monitors have an irregular heartbeat detector. If such an irregular rhythm is detected more than twice during measurement, the irregular heartbeat symbol appears on the display.

If this happens frequently during blood pressure measurement it is recommended that you discuss this with a healthcare professional.

What is Arrhythmia?
This is a condition where the heartbeat rhythm is abnormal due to flaws in the bioelectrical system that drives the heartbeat. Typical symptoms are skipped heartbeats, premature contraction, an abnormally rapid (Tachycardia), or slow (Bradycardia) pulse. It will be difficult if not impossible for an OMRON Blood Pressure Monitor to obtain an accurate measurement if you have this condition. If your device has an irregular heartbeat detector it is possible this will be indicated when a measurement is performed. For additional information, reference material regarding Arrhythmia is available on the Internet or contact a healthcare professional.

What are the symptoms of high blood pressure?

Unfortunately more often than not there are no symptoms of high blood pressure. The best plan of action is to ask your doctor for a check-up, or use a personal blood pressure monitor.

What are the long term risks of high blood pressure?

Without treatment, high blood pressure can lead to numerous health problems including heart attacks, circulatory problems and kidney failure. It is also one of the most common causes of strokes.

What causes high blood pressure?

Many day to day activities or habits often linked to modern living. Among the most common are obesity, over-indulgence in alcohol, smoking, lack of exercise and the stress of modern life, although high blood pressure can also be hereditary.

What can I do to lower my blood pressure?

Eat a balanced diet with plenty of fruit, fresh vegetables, potatoes and rice. Avoid animal fats and use less salt. Try to drink less alcohol and exercise more. If you smoke, stop. If needed, your doctor will also prescribe suitable medication.

What is Morning Hypertension?

Morning Hypertension is defined as the weekly average for morning blood pressure reading (blood pressure measured within 1 to 2 hours after awakening in the morning) exceeding 135 / 85 mmHg. There are two types of morning hypertension: - Patients either have consistently high blood pressure through the night or experience blood pressure increases while asleep. - Patients experiencing extreme dips in blood pressure at night and extreme surges in the morning. In either case, it is very difficult to detect morning hypertension. By the time a patient sees a doctor, their blood pressure may have already decreased -- making the condition impossible to diagnose. That is why doctors recommend monitoring blood pressure at home. Significant Impact There are important reasons why patients are being encouraged to differentiate between general hypertension and morning hypertension. It is common knowledge that cardiovascular events and stroke are more common in the morning, and both appear to be linked to morning hypertension. Organ damage and diabetic complications also seem to correlate with morning blood pressure surges.

What is the warranty for the cuff on my blood pressure monitor?

For most models, the warranty coverage for the arm or wrist cuff is one (1) year from date of purchase. Cuffs will need to be periodically replaced throughout the life of the monitor. When purchasing a replacement cuff for an arm unit please be certain to measure the circumference of your arm to purchase the correct cuff size.

For additional information please refer to the Guarantee Card included with your device.

How can I clean my Blood Pressure Monitor?

Wipe the casing of the monitor clean using a soft dry cloth. Never use any abrasive type cleaners or submerge the monitor or any of the components in water. The cuff can be cleaned with a soft moistened cloth and a mild soap.

How should I store my Blood Pressure Monitor?

After each use never fold the cuff or the tubing tightly. Store the monitor in a safe, dry location. Do not subject the unit to extreme hot or cold temperatures, humidity or direct sunlight. Be careful not to subject the monitor to any strong shocks such as dropping the unit on the floor. You should remove the batteries if the unit will not be used for an extended period of time. Always operate the unit following the directions provided in the instruction manual. Use only authorised OMRON parts and accessories.

Can I take a measurement during exercise?

OMRON Blood Pressure Monitors are not intended for use during exercise or activity. We recommend you avoid eating, smoking and exercising for at least 30 minutes before taking a measurement.

What is the cause of the E or EE Error Indicator?

Each model of OMRON Blood Pressure Monitor has some basic diagnostics built into the unit. If the device detects a problem, this will be displayed as an E, EE or Er ## (## = a two digit number). Please refer to the Troubleshooting and Maintenance section in your Instruction Manual for a list of the error codes and explanations applicable to your device.

Can I purchase a small cuff for my upper arm Blood Pressure Monitor?
Many but not all OMRON Blood Pressure Monitors are capable of using a small cuff (17 22cm). Before purchasing a small cuff, please double check the table below to ensure your device can support this cuff. The next step would be to measure the upper arm to ensure a small cuff is appropriate. To determine your arm size, use a cloth tape measure and place the tape measure midway between your elbow and your shoulder around the circumference of your upper arm. Wrap the tape measure evenly around your arm. Do not pull the tape tight. Note the precise

measurement in centimetres. For additional information please refer to the Instruction Manual for your device.

Can I extend the length of the tube connecting the cuff to the Blood Pressure Monitor?
The standard tube length is 60 cm. This can be extended to a maximum of 120 cm by ordering the optional tube from your local OMRON retailer. This longer tube is available for all cuffs including the Comfort Cuff.

Can I use rechargeable batteries in my Blood Pressure Monitor?

This is not possible. OMRON Blood Pressure Monitors are designed to operate on either 3 volt (Wrist type), and 6 volt (Upper Arm type). The low battery indicator will trigger around 2.4 volt (Wrist type), and around 4.8 volt (Upper Arm type). A fully charged rechargeable battery will typically have a maximum voltage of 1.2 or 1.3 volt whereas a new alkaline or manganese battery will have 1.5 to 1.6 volt. A fully charged rechargeable battery will only operate for a short period of time before the low battery indicator is triggered.

Does a Blood Pressure Monitor require any Regular Maintenance?

It is generally recommended to have the unit inspected every two (2) years to ensure correct functioning and accuracy. The OMRON distributor for your country will have the specialised test equipment as well as the trained technicians to facilitate this service. Your local OMRON retailer can assist you with arranging this service. Please bear in mind that this service is not provided free of charge and costs will be involved.

Which type of OMRON Blood Pressure Monitor should I purchase?

Before purchasing your home blood pressure monitor ensure your satisfaction by selecting the right monitor for you. The digital manual inflation upper arm monitors are the most affordable among the digital blood pressure monitors. This type of monitor requires the user to squeeze the inflation bulb to fill the cuff with air until you reach your correct inflation level. The cuff deflates automatically and your measurements appear on a clear digital display. If you have arthritis or any weakness in the hands you may find it difficult to inflate the cuff. For greater convenience choose an automatic inflation blood pressure monitor (most upper arm and all wrist models). This type of monitor inflates at the touch of a button. In seconds your blood pressure and pulse are displayed. OMRON automatic inflation blood

pressure monitors have a wide variety of features that include models with printers, memory functions, high-speed measurement, and compact design. IntelliSense Technology offers the advantage of personalised inflation. Wrist Blood Pressure Monitors give you the portability of a wristwatch style blood pressure monitor. Considering what type of monitor meets your needs is an important decision. You may wish to consult with your healthcare professional regarding what type of monitor is best for you. We recommend those persons with severe hypertension or diabetes or arteriosclerosis to consult their healthcare professional prior to measuring blood pressure at the wrist

Where do I find the Model and Serial Number for my Blood Pressure Monitor?
For upper arm type blood pressure monitors this can be found on the label on the underside of the unit next to the battery cover. The Model Number typically begins with an M for example; M3W, where as the Product Code always begins with HEM for example; HEM7202-E(V). The Serial Number always begins with the year followed by the month and then the remaining unique digits for example: 20120700013LF. This indicates July 2012 production. For most wrist type blood pressure monitors the Model Number and Product Code can be found on the label on the cuff. On some models the Model Number, Product Code and Serial Number can be found on the label on the device and not the cuff. The Model Number typically begins with an R for example; R6, where as the Product Code always begins with HEM for example; HEM-6052-E. For those models with the Model Number and Product Code on the cuff, the Serial number can be found on a sticker on the side of the device. The Serial Number always begins with the year followed by the month and then the remaining unique digits for example: 20120700013LF. This indicates July 2012 production. When you are ordering accessories or replacement parts it is important to have the Product Code (HEM number), Model Number (beginning with M or R), and Serial Number to hand. This will ensure you receive the correct item for your device

What does Clinically Validated mean and is it the same as Clinically Tested?
The two terms are not the same. Clinically Validated means a product has been evaluated by an independent organisation and tested against as well as met the stringent

requirements as set out by numerous international organisations such as the British Hypertension Society (BHS), European Society for Hypertension (ESH), and International Protocol (IP), just to mention a few. A device that is clinically tested has not been tested or evaluated against a set of defined criteria it simply means the device has been used by staff in some type of clinic.

Accuracy of automated blood pressure monitors.

Nelson D, Kennedy B, Regnerus C, Schweinle A. Author information Abstract
PURPOSE: The purpose of this study is to determine if automated and aneroid manometers are as accurate a means of determining blood pressure as the mercury manometer. Obtaining vital signs for patients is considered standard of care, yet many dental offices do not routinely perform this health service because of technique inconsistencies and time constraints. The use of automatic blood pressure monitors addresses both concerns. The mercury column manometer, the control in this study, has long been considered the most accurate and preferred instrument for obtaining blood pressure measurements. METHODS: During this study, 94 participants (19 years of age and older) consented to having blood pressure taken by each of 4 different monitors. These included the mercury column manometer and stethoscope, the aneroid manometer and stethoscope, the automatic arm blood pressure monitor, and the automatic wrist blood pressure monitor. Each of 3 investigators was assigned to and calibrated for a specific monitoring device. All measurements were taken from the left arm with 5 minutes allowed between measurements. Identical stethoscopes were used with the manual monitors. Strict adherence to the manufacturers' directions and patient preparation was followed for all monitors. Investigators were not aware of readings obtained by other investigators during testing. Eighty-three subjects completed all tests. RESULTS: Review and analysis of data indicates little difference for pulse readings between the automated and digital methods. Systolic readings by automated wrist manometers were the most unreliable. Automated arm monitors tended to provide higher measures than the mercury standard on average, and demonstrated significantly different diastolic readings in one age group compared to the control. All monitors exhibited low reliability for participants over age 50 compared to the control. CONCLUSION: This study demonstrates there is inaccuracy in the use of automated blood pressure monitors and traditional aneroid manometers when compared to the gold standard mercury column manometer for subjects of all ages and blood pressure ranges.

High blood pressure (hypertension)

Wrist blood pressure monitors: Are they accurate?

How accurate are wrist blood pressure monitors?

Answer
from Sheldon G. Sheps, M.D. Wrist blood pressure monitors can be accurate if used exactly as directed. However, according to the American Heart Association, it's best to use a home blood pressure monitor that measures blood pressure in your upper arm. Devices for the upper arm are also easier to check for accuracy than are wrist monitors.

Wrist blood pressure monitors are extremely sensitive to body position. To get an accurate reading when taking your blood pressure with a wrist monitor, your arm and wrist must be at heart level. Even then, blood pressure measurements taken at the wrist are usually higher and less accurate than those taken at your arm. That's because the wrist arteries are narrower and not as deep under your skin as those of the forearm. Some people can't have their blood pressure measured at the upper arm because they have a very large arm or find blood pressure measurements painful. In these cases, measuring blood pressure at the wrist is acceptable. It's not uncommon for blood pressure readings taken at home on any type of monitor to be different from those taken at your doctor's office. If you have a wrist blood pressure monitor, it's a good idea to take your monitor to a doctor's appointment. Your doctor can then check your blood pressure with both a standard upper arm monitor and a wrist monitor in the correct position in the same arm to check your wrist blood pressure monitor's accuracy. Free blood pressure machines: Are they accurate?

How accurate are the blood pressure machines in grocery stores and drugstores?
Answer
from Sheldon G. Sheps, M.D. Not accurate enough to make health decisions regarding your blood pressure. The blood pressure machines that you can use free of charge in many grocery stores, drugstores and other locations may have been accurate when first installed. But in order to stay accurate, they must be maintained and recalibrated. Generally, no information is available to the user regarding the care of these devices. As a result, the reading you get has limited value because it may be incorrect. In addition, the blood pressure cuffs on these do-it-yourself machines are often too small to get an accurate reading on a number of people with high blood pressure. To ensure accuracy, the inflatable portion of the cuff should cover at least 80 percent of the upper arm. It's best to have your blood pressure checked in a medical facility or in a community screening program with trained staff. Before diagnosing or treating high blood pressure, you'll need to have your blood pressure measured in your doctor's office at several separate visits. If you need to check your blood pressure more frequently, your doctor can instruct you on the best way to monitor your blood pressure from home. Home blood pressure monitoring can be an inexpensive, accurate way to get regular blood pressure readings.

Measurement Results & Accuracy

My doctor says that digital machines are not accurate and that only a doctor or an experienced nurse can take a blood pressure seriously. How accurate is the result of a Microlife digital blood pressure monitor? Microlife's digital blood pressure monitors perform the measurements by applying the so called 'oscillometric method'. This method has been well accepted worldwide for more than 30 years and is applied in hospitals every day, whenever the patient's blood pressure needs intensive and highly accurate control. Thereby, the blood pressure is accurately detected by analysing the pressure oscillations that can be measured during the deflation period of the cuff pressure.

Microlife has many years of experience in analysing these body signals and detecting the blood pressure very accurately. The high accuracy of Microlife`s detection principle is confirmed by comprehensive clinical studies which are performed by independent medical centres on highest international standards. Please note that high accuracy is specifically given by the fact that the electronic device enables you to perform measurements at home under relaxed conditions. In combination with Microlife's accurate blood pressure monitor, this possibility is by far the best condition for an accurate determination of the human blood pressure! Most doctors and nurses of course prefer the stethoscope method because they can listen to the signals and get a deeper impression of the patient's condition. In comparison, the electronic devices cover a lot of uncertainties for doctors where they cannot follow how the result is detected. The doctor's method of obtaining the pressure covers many personal influences and also may not give the person's "real" pressure as the patient is not as relaxed as at home. It is a proven medical fact that a slow deflation rate of 2-3 mmHg per second is essential to obtain accurate results with the doctor's measurement. But often, doctors or nurses use a much higher deflation rate and obtain wrong results. The most convincing fact is that the world's leading experts on blood pressure monitoring prefer frequent home measurements by electronic devices against periodic measurements taken in their office! With electronic monitors people perform many measurements because it is a very easy and attractive to measure ones blood pressure. It is quite normal for the measurement results not to be identical to each other. If a doctor were to measure the pressure three or four times (which is never done!) he would also get different values.

I expect to get the same results every time with the Microlife monitor, but I always get different results. Is the device defective? The human blood pressure is not a constant body parameter. For normal physiological reasons, your blood pressure may fluctuate by up to 30 mmHg within a short time-period. So the blood pressure may change between the measurements. It is actually not easy to have same conditions during sequentially performed measurements. It is not unusual that sequential measurements give different readings based on the unstable physiological conditions and influencing side factors (talking, noise, movements, etc.). Therefore the average of several results, obtained on several days, under comparable living situations, during the same timeframe of the day represents your individual blood pressure. Measure, for example, an hour after you had dinner on three sequential days and you will not find significant differences. The average of these results best represents your blood pressure.

My doctor says that my blood pressure is 150 to 100, but why does the Microlife device give results around 135 to 95? You might be not as relaxed at the doctor's as you are at home. When you are nervous at the doctor's, the blood pressure is higher. A lower systolic pressure by 15 mmHg is normal in a relaxed surrounding. Human blood pressure varies over the day. Changes up to 30 mmHg within a short time period may appear in relation to physical activity (sport, brain, stress, stomach, etc.). We recommend that you measure your blood pressure at the same time frame of day and under comparable conditions, eg. every evening about an hour after you had dinner. Each manufacturer applies his own principles in detecting blood pressure. A difference between device and doctor measurement can be based on different 'skills' and can be compared with, when two doctors measure the same patient with their stethoscopes, but obtain different values.

I understand that blood pressure varies over the day and I get different results accordingly. But how high is my blood pressure really, then? The average of several results, obtained on several days, under comparable living situations and during the same time frame of the day represents your individual blood pressure. Measure, for example, an hour after you had dinner on three sequential days and you will not find significant differences. The average of these results represents your blood pressure.

Before I bought a Microlife blood pressure monitor, I used a device from another company. Why do I get different results with the Microlife device? Most digital monitors work on the so called 'oscillometric method'. Each manufacturer applies his own principles in analysing the measured signals and finding the related systolic and diastolic values. Significant accuracy differences between the monitors are shown by several clinical studies. Microlife has many years of experience in analysing body signals and detecting the blood pressure very accurately. The high accuracy of Microlife`s detection principle is confirmed by comprehensive clinical studies which are performed by independent medical centres of the highest international standards.

Each manufacturer applies his own principles that are also optimised for the 'standard' population. There might be individuals for whom one device is more suitable than another. In the same way, two doctors who have different skills in measuring blood pressure with their stethoscopes can get different results. A reason for different data might be that the blood pressure may change between the measurements. It is actually not easy to have same conditions at sequentially performed measurements. It is not unusual that sequential measurements taken with the same device give different readings based on the unstable physiological conditions and influencing side factors (talking, noise, movements, etc.)! If you want to compare two systems, you have to eliminate as many influencing factors as possible. The measurements have to be performed without any outside disturbance and by following the instructions as given in the manual. Each measurement should be performed under comparable living conditions at the same time frame of the day. Take care to relax between the measurements and wait for at least three minutes. Perform several measurements with each device and compare the average values. Only after following the above instructions accurately will you know how big the differences really are.

How do I know if the device is still accurate after long usage or after being dropped? Monitors still give accurate results, if the device has been dropped, but you cannot detect any malfunction when operating it. The main component that mainly influences the accuracy is stored in the computer program. This software either works or doesn't. Other parts do also affect the accuracy, eg. deflation valve or the pressure sensor are very well protected against modifications by accidents or ageing. In any case and in accordance with international standards we recommend that you ask your authorized Microlife dealer to perform an accuracy check every two years.

Why and when should I send the device in for an accuracy check? Microlife's blood pressure monitors are developed to remain accurate for a long product life. To guarantee this accuracy we recommend - in accordance with international standards - that you ask your authorized Microlife dealer to perform an accuracy check every two years.

Which monitor is most accurate, a wrist or an upper arm model? Both devices have a comparable accuracy. However, as each human has individual blood vessel and tissue constitution, one of the two different positions may have advantages for some individuals. It is possible that the signals of some individuals are very weak at the wrist due to their artery wall constitution. These people may get frequent error messages. Measurements at wrist are more sensitive against movements during measurement, which may result in a higher number of 'error' messages. So please do not move the wrist or hand during measurement! It is very important that the cuff is positioned at heart level during measurement. This is more difficult at the wrist and may lead to wrong results. 10 cm higher than heart means an under estimation by 8 mmHg while 10 cm below heard level means that the results will be 8 mmHg to high! Wrist devices are very simple and faster to use than upper arm, so normally wrist devices lead to more measurements. As the blood pressure has high variations over the day, it is important to obtain as much data as possible. Therefore, wrist devices enable a good control of the blood pressure profile. Arteries at the wrist are positioned very near to the surface, so the body signals are less covered by tissue than at the upper arm, this may lead to better readings at wrist than upper arm. People with obese arms may face problems with upper arm cuffs, but get better results at the wrist.

I have a Microlife upper arm and a Microlife wrist monitor. Why do I get different results? Both devices have a comparable accuracy and follow the same principle. However, as each human has individual blood vessel and tissue constitution, one of the two different positions may have advantages for some individuals. It is very important that the cuff be positioned at heart level during measurement. This is more difficult at the wrist and may lead to wrong results. 10 cm higher than heart means an under estimation by 8 mmHg while 10 cm below heard level means that the reading will be 8 mmHg too high! It is possible that the signals of some individuals are very weak at the wrist due to their artery wall constitution. These people may get frequent error messages. Arteries at the wrist are positioned very near to the surface, so the body signals are less covered by tissue than at the upper arm, this may lead to better readings at wrist than upper arm. People with obese arms may face problems with upper arm cuffs, but get better results at the wrist. Measurements at wrist are more sensitive against movements during measurement, which may result in higher number of 'error' messages. So please do not move the wrist or hand during measurement!

As individual factors affect the reading, we recommend that you compare both devices and choose the one that gives the most constant results. If you get significantly different values, we recommend that you use the upper arm model (upper arm blood pressure measurement is more established at this state).

Is a manual monitor as accurate as an automatic device? Both systems supply the same accuracy. Automatic models have an installed electric pump instead of the hand-pumping ball but this has no influence on the accuracy.

The systolic pressure measured by the Microlife blood pressure monitor is similar to what my doctor measures, but why is the diastolic pressure about 10 mmHg higher with the digital monitor? The diastolic pressure is very difficult to detect with the stethoscope and depends very much on the observer's capabilities. The correlation of the diastolic pressure is more difficult than the systolic.

I measure at home several times sequentially with a Microlife blood pressure monitor. The first results are fine, but why are they becoming very low with approx. the 5th measurement? The reason might be blood congestion, because you are not waiting long enough between measurements or are not releasing the cuff between measurements.

Do Microlife blood pressure monitors also perform reliable measurements during pregnancy? Yes, Microlife monitors are specifically validated for pregnancy and pre-eclampsia. During pregnancy the pressure should very frequently be controlled to prevent a critical phenomenon, which is called preeclampcia. About 20% of women develop high blood pressure during pregnancy. Please contact your doctor immediately, if you recognize a significant increase of your blood pressure readings during pregnancy!

Accuracy of Home Blood Pressure Monitors Questioned

Researchers found that blood pressure readings can be off by as much as 15 mm when using an automatic blood pressure machine.
RODALE NEWS, EMMAUS, PAJust this year, researchers found that taking your blood pressure at homeyields truer results than the ones you'd generate at the doctor's office. (The idea is, you're calmer at home.) However, a new study published in The American Journal of Cardiology found you may not want to completely rely on automatic blood pressure monitors' results. Researchers from the University of Southern California found some startling discrepancies between the newer automatic blood pressure readers and the more traditional mercury manometer/stethoscope combo. The automatic monitors consistently produced lower results, meaning you could have high blood pressure, or pre-hypertension, and think your health is not at risk. And getting an accurate reading is important. "If you control high blood pressure, you reduce risk of heart failure, stroke, heart attack, and kidney disease," says study coauthor Robert Kloner, MD, professor of medicine at the University of Southern California Keck School of Medicine, and director of Research at the Heart Institute of Good Samaritan Hospital in Los Angeles. THE DETAILS: Researchers looked at 337 patients seen in routine cardiology office visits who received blood pressure measurements with both the more old-fashioned mercury manometer technique or the increasingly popular automatic blood pressure monitor. The systolic readings (the top number), on average, were about 2 mm higher when using the mercury manometer method; for the diastolic reading (the lower number), it read about 1.3 mm higher. That might not seem like much, but Dr. Kloner notes that there were great variations, some of which could be the difference between being labeled "healthy" or hypertensive, or worse yet, could be a warning sign for a heart attack or stroke. For instance, when looking at systolic numbers, in 5 percent of patients, the discrepancy spanned five to 10 points; in 7 percent, researchers noted a 10- to 15-point

discrepancy. In 4 percent of participants, the difference between the readings on the two different types of machines was 15 to 20 points! It's important to note that in the group of participants younger than 65, discrepancies occurred 10 percent of the time. However, in the older adults, that number jumped to nearly 30 percent. One theory as to why involves the idea that older people's arteries are stiffer, which could lead to less-accurate blood pressure readings. WHAT IT MEANS: This isn't the first study to find discrepancies in automatic blood pressure monitors. Even though this type of screening tool is used in homes and even in hospitals and doctor's offices, previous research has found the old-fashioned mercury-containing sphygmomanometer and stethoscope setup, known clinically as ausculatory blood pressure measurement, to produce more precise readings because it uses a more direct measurement. The technique relies on listening directly with a stethoscope to the sounds, known as Korotkoff sounds, of blood flowing in the brachial artery in the arm. Automatic machines measure waves of pressure during the buckling of the brachial artery under the cuff, explains Dr. Kloner. "They measure a mean, then they calculate the blood pressure," he says. "It's not direct." And since studies presented at this year's American Society of Hypertension's annual meeting found that many "healthy" people are unknowingly living with "pre-" conditions like diabetes and high blood pressure, it's more important than ever to monitor your health in the most accurate ways possible. Here's how to figure out where your blood pressure reading stands. Make a doctor's appointment for your BP device. Dr. Kloner doesn't expect consumers to run out and buy mercury-containing equipment for more accurate blood pressure readings. But he does suggest you make an appointment with a doctor who does use the ausculatory blood pressure measurement method, and then ask to have your BP taken both with your machine and the more tried-and-true, old-fashioned combo. This can give you some sort of an idea of how far off your machine might be; your goal should be a reading in the normal blood pressure range with both systems. Make sure it's validated. Although it won't completely protect you from discrepancies, if you're in the market for a new blood pressure monitor, make sure you get a validated model that has been vigorously tested for a number of quality measures. Adopt a low-BP diet. Use your food and drink choices as a way to slash your blood pressure by abiding by our Eat and Drink This to Avoid High Blood Pressureguide.