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Blood Pressure Monitor Accuracy

by Evie / September 15, 2004 3:33 AM PDT

The cuff on our BP monitor sprung a leak Sad

So we are considering the following options:
1. Replacement cuff ($30 with shipping)
2. New monitor
3. Wrist monitor -- seem to run about $75 but most we have looked at have memory functions our current monitor doesn't have. Also like the better portability.

I've heard that wrist monitors aren't as accurate. Is this true? Does anyone know how they compare to similarly priced or quality arm cuff monitors available for home use?

TIA!

Evie Happy

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Re: Blood Pressure Monitor Accuracy
by James Denison / September 15, 2004 4:04 AM PDT

My arm is thick enough that I have to use the regular cuff on my lower arm instead of the upper part. I seem to get accurate pressure and heart rate readings from it. I tested it that way on several family members and got similar readings on both lower and upper arms. I turn it backwards however so the pulse sensor will be as high as I can get to the inside elbow on the lower arm. My upper arm is 21-22" round depending on how tight I pull this cloth measurement tape.

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Re: Blood Pressure Monitor Accuracy
by Edward ODaniel / September 15, 2004 6:23 AM PDT

Take a look here Evie.
http://www.portablenebs.com/bpmonitors.htm

http://www.fpnotebook.com/CV92.htm
Types of home monitors:
Automatic arm monitors -- Most accurate
Manual arm monitors -- Less consistent, but less accurate
Wrist monitors -- Most convenient but least accurate

assuming normal circulation finger monitors are just as accurate as the wrist monitors.

Tests have shown that both wrist and finger monitors are sensitive to position and temperature.

How do I choose...
http://www.drugstore.com/qxa1838_333181_sespider-how_do_i_choose_a_blood_pressure_monitor.htm

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Re: Blood Pressure Monitor Accuracy
by Dragon / September 15, 2004 6:23 AM PDT

Ive read that theres a certain way to get a BP measurement, and that there are certain things that shouldnt be done.

The nurses at clinics and at the Dentist office, often dont follow procedure, so I often (silently) question their measurements.

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From a strict scientific perspective, don't do wrist ...
by Bill Osler / September 15, 2004 10:07 AM PDT

Wrist pressures do correlate to some extent with carefully taken arm pressures, but essentially all of the experimental work linking blood pressure elevations to health outcomes has been done using brachial pressure - it, taken at the elbow with a cuff on the upper arm.

To get a reliable reading you should sit quietly for 10 minutes with both feet on the floor prior to taking the pressure. Most folks don't do that part right.

The other wild card is that the pressure is not reliable unless the cuff fits your upper arm correctly. Many adults get erroneous results using a 'standard' adult cuff. In most cases this is an artificially high reading due to using a cuff that is too small for the upper arm.

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Re: From a strict scientific perspective, don't do wrist ...
by Evie / September 15, 2004 10:32 AM PDT

Thanks for your input! I guess I'm less concerned that the monitor give the same readings as an arm cuff one, so long as it was consistent and we could calibrate it somewhat -- as in take it to the docs next time and see how the readings compare.

At just the time the doc wants my hubby to keep a diary of his bp measurements, ours has sprung a leak. His bp is well controlled in general, but he still has the unexplained spikes that can really be freaky!

Do you have any comments on James' method of using the cuff on the upper forearm?

I guess I'm leaning towards getting getting the replacement cuff for our existing monitor. It's not that old and I think the leak is (hopefully) just a fluke.

Evie Happy

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I don't understand the physics well enough to comment ...
by Bill Osler / September 16, 2004 11:25 AM PDT

If the monitor's sensor is placed on the proximal ('upstream') portion of the forearm but the cuff is on the forearm distal ('downstream') to the sensor then I really do not know whether the readings will be different from those obtained with the usual arrangement.

I have to admit that I have never fully understood the physics behind the Korotkoff sounds that we use to identify systolic and diastolic pressures. Also, my suspicion is that electronic cuffs determine the pressures a bit differently from the way the human ear and brain do. I've never studied that. IOW, I'd have to run the experiment in order to have any notion of how James' method compares to other methods. I doubt it would work using a standard cuff and stethoscope, but I'm not sure. Since I do not actually own a blood pressure cuff of any kind I'm not really equipped to do the experiment. I have the standard office type cuffs at work, but no electronic ones to compare to.

James' method is interesting, but that is all I can say with certainty.

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