Otis Singleton
Monitoring blood pressure at home can be tricky, but it is a basic part of good health. The American Heart Association (AHA) recommends an automatic, cuff-style, upper-arm monitor. Wrist and finger monitors are not recommended as they give less reliable readings. The correct cuff size is important for accurate blood pressure readings. A cuff that is too loose or too tight will produce a falsely elevated or lowered reading. A digital blood pressure monitor uses an air pump to inflate a cuff surrounding an upper arm or wrist with enough pressure to stop blood flow in the main artery. This pressure is then slowly released until blood begins to flow through the artery again. The systolic pressure is determined by the pressure sensor at this point. The diastolic pressure is the measurement taken when blood flow is no longer restricted.
| Characteristics | Values |
|---|---|
| Name of device | Blood pressure monitoring device, sphygmomanometer |
| Type of device | Digital BP monitor |
| Parts | Inflatable air-bladder cuff, battery-powered air pump, pressure sensor, LCD display |
| Function | Measures systolic and diastolic pressure, and pulse rate |
| Usage | Upper arm, wrist |
| Accuracy | Depends on cuff size and fit, avoid caffeine, smoking, exercise, and distractions before use |
| Validation | FDA clearance, AMA website validatebp.org, stridebp.org |
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What You'll Learn
The importance of cuff size and fit
Cuff size is especially important in communities with a high prevalence of obesity since larger cuff sizes may provide more accurate blood pressure readings. Therefore, it is important to measure your mid-arm circumference and choose a monitor that comes with the correct cuff size. A "'universal' cuff will work for most people, but if you have a very slender or large arm, you will need an alternate.
To ensure an accurate reading, it is also important to prepare properly before taking your blood pressure. For instance, you should avoid caffeine, smoking, and exercising within 30 minutes before taking your blood pressure. You should also empty your bladder, sit quietly without any distractions for five minutes, and sit with your back straight and supported, with your feet flat on the floor.
It is also important to note that wrist and finger monitors are not recommended as they give less reliable readings. Upper arm cuff devices are preferred, and you should follow the instructions for accurate blood pressure monitoring at home.
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How to prepare for an accurate reading
To prepare for an accurate blood pressure reading, there are a few important steps to follow. Firstly, ensure that you have chosen a validated device that fits your arm correctly. Upper arm cuff devices are generally preferred over wrist devices as they provide more reliable results. Make sure the cuff is placed on bare skin, covering at least 80% of your upper arm. It is also crucial to avoid smoking, consuming caffeine, or exercising within 30 minutes before the reading. Go to the bathroom, and wait for at least 30 minutes after a meal. Find a quiet space, sit down in a chair with your back straight and supported, feet flat on the floor, and avoid crossing your legs. Keep your arm supported at heart level with your palm up and muscles relaxed. It is recommended to take multiple readings at the same time each day and record the results.
- Discuss the usage of your home blood pressure monitor with your healthcare professional to ensure accuracy and correct cuff size and fit.
- Measure your blood pressure twice, with a brief break in between. If the readings differ by 5 points or more, take a third measurement.
- Blood pressure can vary throughout the day, so it is advised to check your blood pressure at the same time each day for a week, and then consult your doctor about the results.
- Your blood pressure should be measured in both arms at least once, as the reading in one arm, usually the right, may be slightly higher than the other.
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The auscultatory method
The cuff is inflated to a point where it exerts high pressure on the underlying arm, stopping blood flow underneath. As the cuff pressure is deflated, the pressure transmitted to the walls of the underlying arteries reduces to the point where blood flow resumes, and sounds begin to be heard. These sounds vary in intensity and usually stop at the lowest pressure within the arteries before the next pulse. The initial sound corresponds to the peak (systolic) pressure, and the final sound corresponds to the relaxation (diastolic) pressure in the artery.
Listening to and interpreting these sounds requires training and can be challenging, especially in cases of impaired hearing or significant environmental noise. The auscultatory method provides a reference standard for validating non-invasive blood pressure devices, and the accuracy of observer measurements is crucial to the validation process.
To improve the accuracy of auscultatory blood pressure measurements, electronic and computer technology, such as the Visual Auscultation Method, can be employed. This method utilizes a computerized data acquisition and analysis system to provide observers with more objective information, leading to potentially more accurate and objective measurements.
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Digital blood pressure monitors
To use a digital blood pressure monitor, the cuff is placed around the upper arm or wrist and inflated with an air pump to a pressure that is sufficient to prevent blood flow in the local main artery. The cuff is then gradually deflated until blood begins to flow through the artery again. The vibrations that occur when blood has to push the arterial wall open in order to flow through the artery are transferred from the arterial wall, through the air inside the cuff, into a transducer in the monitor that converts the measurements into electrical signals. The systolic pressure is determined by the pressure at which blood begins to flow through the artery again. The diastolic pressure is determined by the pressure at which blood flow is no longer restricted. The pulse rate is also sensed at this time.
The signal from the pressure sensor is conditioned with an instrumentation amplifier before data conversion by an analog-to-digital converter (ADC). The systolic pressure, diastolic pressure, and pulse rate are then calculated in the digital domain using an algorithm appropriate for the type of monitor and sensor utilised. The monitor is typically powered by batteries and turned on and off with a physical push button.
It is important to ensure that the cuff is the correct size and is placed correctly on a bare arm. The bottom edge of the cuff should be about one inch above the bend in the elbow, with the middle of the cuff placed at heart level. The arm should be still and supported on a flat surface, with the back straight and supported. It is also important to allow at least five minutes of quiet rest before taking a measurement.
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The systolic and diastolic pressure readings
The diastolic pressure, the bottom number, refers to the amount of pressure in the arteries when the heart is at rest between beats. This is the lowest pressure point. Diastolic blood pressure is considered dangerously low when it is 60 mmHg or lower and alarmingly high when it is 120 mmHg or over. If you receive multiple readings with these numbers, you should call your healthcare provider. Low diastolic pressure may be seen with dehydration or severe bleeding, or if the arteries relax and widen. There are also multiple stages of high diastolic blood pressure, with Stage 2 hypertension drastically increasing the risk of stroke or heart attack.
It is important to monitor your blood pressure, especially if you have been diagnosed with high blood pressure. The American Heart Association recommends home monitoring for people with high blood pressure to help their healthcare providers know if treatments are working. However, home monitoring does not replace regular doctor visits. It is also important to ensure that your blood pressure monitor is accurate and that you are using it correctly.
To get the most accurate reading, it is recommended to rest quietly for at least five minutes in a calm, warm space before taking a measurement. You should also make sure that your arm is bare, supported, and at heart level, with your palm facing up and your arm muscles relaxed. Other factors that can affect your blood pressure include activity level, stress, and fluid intake, so it is best to avoid caffeine, nicotine, and exercise for 30 minutes before taking a reading.
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Frequently asked questions
The American Heart Association (AHA) recommends an automatic, cuff-style, upper-arm (bicep) monitor. Wrist and finger monitors are not recommended as they give less reliable readings. You should also ensure that the cuff fits your arm correctly.
A digital blood pressure monitor uses an air pump to inflate a cuff, applying pressure to an upper arm or wrist to prevent blood flow in the main artery. This pressure is then gradually released until blood begins to flow through the artery. A pressure sensor measures the systolic pressure, and the pulse rate is also sensed. The systolic pressure, diastolic pressure, and pulse rate are then calculated using an algorithm and displayed on a screen.
Before taking a reading, avoid caffeine, smoking, and exercising for 30 minutes beforehand. Go to the bathroom and wait 30 minutes after a meal. Sit quietly for five minutes, without distractions, with your feet flat on the ground and your arm at heart level.
