Blood pressure monitor, sphygmomanometer, sphygmomanometer or even baumanometer. All of these terms define a tool that occupies a “place of honour” in your nearest pharmacy, health centre, or hospital. The blood pressure monitor allows blood pressure to be monitored, an indispensable requirement to avoid high blood pressure dread.
Why is the blood pressure monitor such an important tool?
High blood pressure or hypertension is one of the most prevalent diseases in the world. This condition contributes to the deterioration of our cardiovascular health, increasing the likelihood of suffering other pathologies, such as heart attacks or strokes. If we want to control our blood pressure, it will be essential to measure it properly with a blood pressure monitor (1). When we talk about blood pressure, we are simplified rated the “strength” that blood exerts on our arteries. The blood pressure monitor or sphygmomanometer will be able to detect that pressure safely and virtually painlessly, providing us with two numerical values (120/70, for example) measured in millimetres of mercury (mmHg):
- Systolic blood pressure (“high”): This value measures the “strength” of blood when expelled by the heart at each beat (systole phase). It is the first figure that will indicate the blood pressure monitor and the highest value (120 of 120/70 mmHg), from there that colloquially it is known as “the high”.
- Diastolic blood pressure (“low”)): This figure values blood pressure on the arteries in the “rest” phase of the heart, i.e. between beats or diastole. It will be the lowest value figure indicated by the blood pressure monitor (70 of 120/70 mmHg) and colloquially known as “the low”.
To interpret these values, we will turn to health experts. Each year, medical specialists compare the blood pressure of the population to the risk of getting sick. The results allow them to classify blood pressure as normal, normal-high or hypertension (high risk of damage to the heart, brain, eyes or kidneys) (1).
The likelihood of hypertension increases with age and with factors such as smoking or obesity. However, we can prevent its worst consequences by adopting a healthy lifestyle and good communication with our doctor. In our health checkups, the blood pressure monitor will be essential for detecting changes in blood pressure.
What types of blood pressure monitors are there?
To monitor our blood pressure levels, it is possible to resort to manual or digital blood pressure monitors. The former is much more complicated to use, so their use is usually limited to the field of medicine, nursing or pharmacy (3). Manual blood pressure monitors contain a sleeve or bracelet that fits the arm and can be “inflated” with air (with a manual pump) to generate compression that prevents blood flow. The air pressure value needed to slow blood passage will allow us to obtain blood pressure figures. There are two types of manual sphygmomanometer:
- Mercury blood pressure monitor: In these devices, blood pressure is represented on a device similar to a “mercury thermometer”. Requires the use of a phonendoscope (the device that toilets use to “listen” to the body’s sounds). It is the most accurate blood pressure monitor and the most uncomfortable to use for its large size (4).
- Aneroid Tensiometer: In this case, blood pressure figures are reflected in a pressure gauge, an instrument with a very characteristic shape reminiscent of a needle clock. They will be the most widely used manual sphygmomanometers in the field of health. Like mercury blood pressure monitors, they require the joint use of a phonendoscope.
Digital blood pressure monitors, on the other hand, are a fast, efficient and accessible alternative to blood pressure intake. They are suitable for the health and home environment, not being necessary to be a healthcare professional to use them correctly. Besides, they do not require the use of additional instruments, such as the phonendoscope. There are several types:
- Arm blood pressure monitor: This blood pressure monitor is similar to manual sphygmomanometers. However, the bracelet will be filled with air automatically, and the device itself will value blood pressure. According to the Spanish Heart Foundation, it is less accurate than the aneroid blood pressure monitor but reliable enough to use in our home (5).
- Wrist blood pressure monitor: This device has a smaller sleeve placed around the wrist. It tends to give less reliable readings than the arm blood pressure monitor, so it is not the first option recommended by experts (6).
- Finger Blood pressure monitor: It is not recommended for home use because of its low accuracy. However, we can find it in the hospital field, where it is constantly used to measure admitted patients’ blood pressure. Please do not confuse it with the pulse oximeter, a device that values the blood’s oxygen content (7).
What are the advantages of having a blood pressure monitor at home?
If we’ve been diagnosed with high blood pressure recently, controlling our blood pressure figure from home could better cope with our condition. Pregnant women may also benefit from a home blood pressure monitor, especially if they were hypertensive before pregnancy or if they have been asked to monitor their blood pressure. Also, taking our blood pressure at home will allow us to say “goodbye” to the awkward “white robe hypertension”.
In this uncomfortable phenomenon, the nerves produced by a doctor’s visit “shoot” our blood pressure above our normal values and maybe mislabeled as hypertensive.
The disadvantages of having a blood pressure monitor at home are few, but we must consider them. A good quality device will require an economic investment (more than 40 euros). It shall not replace medical reviews, and it is necessary to consult with a healthcare officer for any “abnormal” results (tensions equal to or greater than 135/85) (8, 9).
Advantages of the domestic blood pressure monitorDisadvantages of the domestic blood pressure monitor
Avoid “white robe hypertension”—moderate or high cost of the appliance.
Allows you to measure the tension throughout the day. Less useful for people with serious illnesses that require expert surveillance.
It is possible to obtain a “pattern” of our voltage (at what times it is highest). It can cause nerves or insecurity in the most “anxious” people.
It helps to assess the effect of antihypertensive medication better. It is necessary to calibrate (adjust) the appliance once a year.
It involves the individual in controlling their blood pressure and health. A suitable intellectual level is needed to use the appliance (cannot be used by children or the elderly with cognitive problems).
Decrease visits to the pharmacy or outpatient. Some low-quality (unvalidated) devices may give erroneous results.
How do I take my blood pressure at home?
Measuring your blood pressure at home is a fairly simple process, although you need to consider certain details to do it correctly. First of all, we advise you to have an automatic (digital) blood pressure monitor. Manual sphygmomanometers require a certain degree of sanitary or third-party experience to deliver reliable results. Once you have a good quality automatic blood pressure monitor in your possession, you will need to follow the following instructions to measure your own blood pressure or that of your family (8, 9):
- It measures blood pressure in a quiet and welcoming environment.
- Do not drink coffee or tobacco at least 15 minutes before your blood pressure measurement. Avoid physical exercise and rest for a minimum of five minutes (sitting and silent) before performing the assessment.
- Take your blood pressure seated, with your back resting on the back of your chair and your arms on the table or seat armrest. Legs can’t be crossed.
- Place the blood pressure monitor bracelet over the “naked” arm. It is not advisable to perform a blood pressure assessment on clothing. If you wear a tight or bulky garment (such as a jacket), it is preferable to remove it rather than raise the sleeves (10).
- If you’re using a wrist blood pressure monitor, keep your device at heart level for a proper reading. Follow the instructions on wrist blood pressure monitors carefully to avoid miscalculations.
- Don’t talk, don’t move and avoid negative thoughts (such as “I’m sure I get a high value”) while taking my blood pressure.
- Measure your blood pressure a minimum of twice. If there is more than a 5 mmHg difference between the two measurements, you should take additional shots (usually two other ratings) and get an average value.
- For two measurements with a value of 135/85 mmHg or very different results, it is recommended to go to a pharmacy or health centre for a professional blood pressure assessment.
Dr Daichi ShimboProfessor of Medicine (Columbia University, USA)
“It is essential that a validated blood pressure monitor is used. This is particularly important because the market is “flooded” by many appliances, many of which are not valid, unfortunately.”
Should I buy a sfingomanometer if I am a health sciences student?
Blood pressure intake is considered a basic skill for most students in the Health Sciences branch (Nursing, Nursing, Pharmacy, or Medicine Assistant) (11). Also, you should not settle for using only the automatic sfingomanometer; you should also be familiar with using the manual. If you notice that you’re “having a hard time” developing your blood pressure measurement skills, getting your own sphygmomanometer will allow you to practice at home. Keep in mind that you will have the blood pressure monitors of your study centre during your internships, but you will not have the time to familiarize yourself with this tool fully.
That’s why, if your academic centre evaluates the use of the manual sphygmomanometer and you want to 100% master your blood pressure intake, we advise you to choose an inexpensive article to practice from home. When you go into healthcare practice, you’ll be able to purchase another, more accurate blood pressure monitor or even use your workplace.
How do I take care of my sphygmomanometer?
Cleaning. Do not immerse the blood pressure monitor in water to wash it. Use a damp cloth with soap, a disinfectant wipe, or hydroalcoholic gel to clean the cuff and other pieces of the sphygmomanometer. Dry it well before storing it. Be sure to remove dust that builds up in valves and inflation pumps from manual blood pressure monitors (12).Storage. Make sure the bracelet is deflated before storing the blood pressure monitor. Avoid subjecting the appliance to extreme temperatures and environments with a humidity of more than 85%. Keep away from sunlight and sharp objects (scissors or scalpels, among others) (12).
Transport. If you are travelling with the blood pressure monitor, it is recommended that you carry it in the bag provided by the manufacturer. To fly, you should carry the sphygmomanometer with you as carry-on baggage. If you’re a Health Sciences student, avoid hitting the device when running down the aisles of your hospital or health centre!
How do I know if my blood pressure monitor has been “miscalibrated”?
Did you know that blood pressure monitor should be calibrated often? (13) Manual devices should be checked approximately every six months, while automatic sphygmomanometers will require calibration at least once a year. Otherwise, you may start receiving erroneous or “impossible” readings. It’s relatively easy to know if your manual (aneroid) blood pressure monitor has been “discoloured”. Normally, these devices’ pressure indicator should indicate the value “0 mmHg” when not in use (with the sleeve completely deflated). Otherwise, we will find ourselves in front of a blood pressure monitor that needs to be calibrated.
It is more difficult to assess whether an automatic blood pressure monitor is working properly. You could compare the values you get on your device with those at your health centre or pharmacy, taking it with you to make both measurements at once. Typically, these devices last about two or three years before needing to be replaced.
If you think your blood pressure monitor needs an adjustment, contact your device seller to try to “leave it as new” again. Some aneroid sphygmomanometers contain a small “key” so that the “more handymen” can calibrate the blood pressure monitor themselves. However, it is preferable to always go to an expert in these tools.
Choosing a blood pressure monitor is no easy task. It doesn’t matter if you want to use it at home or take it to your practices; you’ll need to consider several purchase criteria if you want to enjoy a good quality item. Pay close attention to the following lines if you want to get the perfect sphygmomanometer.
According to the Spanish Heart Foundation, not all blood pressure monitors meet the requirements to measure blood pressure accurately. Before opting for a sphygmomanometer, we should check that official studies and bodies have effectively validated the device after checking its effectiveness.
You can find out if your blood pressure monitor’s make and model have been validated by checking specialized online listings. For example, dabl® Educational Trust (14) is a website managed by health experts that contains a list of validated manual and automatic blood pressure monitors. If you check it, you will see that the most “suitable” blood pressure monitors belong to the marks (14):
- Manual models: A&D, Accoson Greenlight, Heine Gamma, Microlife, Nissei, Pic Solution, PMS Mandaus and Welch-Allyn.
- Automatic models: A&D, Andon, Beurer, Braun, CA-MI Srl CHIESI, Citizen, Erkameter, Foracare, HARTMANN, Health&Life, InBody, Microlife, Nissei, Omron, Pic Solution, Plusmed, Thermor Bios, UEBE and YuWell.
Manual vs. automatic
If you are a person who wants to take care of their health and who does not belong to the medical field, it is recommended that you opt for an automatic arm blood pressure monitor. Wrist blood pressure monitors are less accurate, so they are recommended as a second option (for example, for people with huge arms who do not find a bracelet that fits their body) (5).
Manual aneroid sphygmomanometers will be more appropriate for Health Sciences students. You’ll find very inexpensive options on the online market, including specialized packs, including a blood pressure monitor and a phonendoscope. Everything you need to get started taking your blood pressure from scratch!
If you don’t leave home too much, you can get a bulkier (usually cheaper) blood pressure monitor. However, if you are very travelling, it is convenient that you have a light and easy to carry alternative. In this field, wrist blood pressure monitors will be the winners, lacking a bracelet that takes up space in our trunk or carry-on luggage.
However, arm blood pressure monitors have begun to be designed to be easily stored in a suitcase or even in a wallet. These alternatives are considered “high-end” products and require greater economic investment, although they will delight the “globetrotters”.
Hilary K. WallMaster’s Degree in Public Health and Research (Centers for Disease Control and Prevention, USA)
“There are many systematic reviews and meta-analysis that show that patient blood pressure control, coupled with support and clinical interventions, can lower blood pressure and improve hypertension control.”
Did you know that a very tight or too loose bracelet can result in erroneous readings on the blood pressure monitor? For this reason, you must choose a sphygmomanometer with a sleeve that adapts to the diameter of your arm. The American Heart Association differentiates between the following sleeve sizes ( 15):
- Small size: It will be used in thin people, with arms between 22-26 centimetres in diameter.
- Standard size: This cuff can be used in most people of standard weight and height. Fits arms with a perimeter between 27 and 34 centimetres.
- Large Size: It will be used to measure the blood pressure of people with a larger complexion, with arms between 35 and 44 centimetres in diameter.
- Huge size or XL: This sleeve allows to measure the tension in large people. It will fit arms with a perimeter between 45 and 52 centimetres. Often, you can find this bracelet under the (wrong) denominator of “obese cuff”.
We recommend that you measure the perimeter of your arm before choosing a blood pressure monitor. If you doubt between one measure or another, always choose the largest one. And remember that if you gain or lose weight, you can buy an extra sleeve. In that case, you’ll need to check that the new bracelet is compatible with your blood pressure monitor model.
Manual aneroid and mercury blood pressure monitors obviously do not require batteries or batteries. However, automatic sphygmomanometers will use batteries (usually AAA batteries) or rechargeable lithium batteries. The most modern devices can be charged as if they were a “mobile” and connected to the computer or a USB charger.
Fortunately, products that use disposable batteries can be used for months without requiring new batteries. However, if you’re concerned about the environment, opt for a rechargeable appliance (or get rechargeable batteries)to avoid generating unnecessary waste.
Controlling your blood pressure at home might help your doctor give you more personalized health care.
The price of manual and automatic blood pressure monitors can exceed one hundred euros. However, if you are not prepared to invest in that calibre, we remind you that official bodies validate economic models.
These devices will have high accuracy, and their price will not exceed 30 euros. In return, they won’t have the most “modern” features of the new blood pressure monitors (screen lighting, sending your blood pressure figure to your smartphone or USB charger). Search for them under the denominators“basic” or “simple” in the most popular brands’ catalogues.
Blood pressure monitors are essential tools in your doctor’s office. By measuring blood pressure quickly, accurately and painlessly, these instruments allow health professionals to control and treat blood pressure disturbances with automatic and manual methods.
Remember that hypertension is a “silent” disease. Thus, keeping a blood pressure monitor at home can help you detect any pressure gains and ask for help before complications arise. See your doctor if a home sphygmomanometer is right for you. Hypertension won’t be able to with you!
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