What Are The Different Types Of Blood Pressure Monitors
Two types of blood pressure monitors are
Manual blood pressure monitors
Different types of manual blood pressure monitors are
- Mercury: This consists of a cuff that wraps around the arm, a rubber squeeze bulb and a mercury column that measures the blood pressure. A stethoscope is required to listen to the blood pounding through the artery. The blood pressure can be seen on the mercury column as the mercury moves up and down when the pressure in the cuff rises or falls. Mercury blood pressure monitors were a gold standard to monitor blood pressure until recently. However, due to the increased environmental hazard with mercury, doctors are slowly replacing this blood pressure monitor with aneroid or automated ones.
- Aneroid: This consists of a cuff that wraps around the arm, a rubber squeeze bulb and a gauge that measures the blood pressure. A stethoscope is required to listen to the blood pounding through the artery. The blood pressure can be seen on a circular dial of the gauge as the needle moves around and the pressure in the cuff rises or falls.
- Electronic blood pressure machine: This is similar to a mercury instrument. Instead of mercury, it contains an electronic column that rises and falls. It consists of a cuff that wraps around the arm and a rubber squeeze bulb. A stethoscope is required to listen to the blood pounding through the artery.
Automated blood pressure monitors
Table. Advantages and disadvantages of manual and automated blood pressure monitors
What Is The Correct Way To Measure Blood Pressure
Learn the correct way to have your blood pressure taken, whether youre getting it checked at the doctors office or checking it yourself at home. Use this checklist:
- Dont eat or drink anything 30 minutes before you take your blood pressure.
- Empty your bladder before your reading.
- Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
- Put both feet flat on the ground and keep your legs uncrossed.
- Rest your arm with the cuff on a table at chest height.
- Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
- Do not talk while your blood pressure is being measured.
If you are keeping track of your blood pressure at home, use these additional tips.
How To Use An Automated Blood Pressure Machine
The easiest way to take your own blood pressure is to purchase an automated cuff. Automatic blood pressure machines are the easiest to use, and theyre helpful if you have any hearing impairments.
These types of blood pressure cuffs have a digital monitor that will display your blood pressure reading on a screen. You can purchase these online, at most grocery stores, or at a health food store.
The American Heart Association recommends an automatic, upper arm blood pressure monitor for at-home use. To use your digital blood pressure monitor, follow the instructions that come with it. You can also take the monitor to your doctors office, or even your local pharmacy, for a demonstration.
You should also purchase a small notebook to start a blood pressure log. This can be helpful for your doctor. You can a free blood pressure log from the AHA.
Machines can give you a different reading than a manual blood pressure reading. Bring your cuff to your next doctors appointment so you can compare the reading from your cuff to the reading your doctor takes. This can help you calibrate your machine and identify levels you should look for on your own device.
Its also important to purchase a high-quality machine and monitor for errors. Even if you check your blood pressure at home, your doctor will still want to manually check it during appointments.
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How To Interpret The Blood Pressure Reading
American College of Cardiology 2017 Updated Guidelines for High Blood Pressure:
- Normal BP- SBP: < 120 DBP: < 80 mm Hg
- Elevated BP- SBP: 120-129 DBP: < 80 mm Hg
- Hypertension Stage 1- SBP: 130-139 or DBP: 80-89 mm Hg
- Hypertension Stage 2- SBP: 140 or DBP: 90 mm Hg
For a patient to be diagnosed as having hypertension, they need an average reading based on 2 readings or more that are obtained on 2 or more occasions.
References
Manual Blood Pressure Readings
Manual blood pressure gives accurate results when used correctly by a trained person. However, manual blood pressure measurement is not the recommended type of blood pressure monitoring for home use because it requires some training. Some of the common causes include
- Inappropriate cuff size
- Failure to reduce patient anxiety
- Uncalibrated instrument
- Interaction between patient-clinician
A study has shown that automated blood pressure monitors seem to provide inaccurate readings in 5 to 15 percent of people. The study has also stated that the varying blood pressure can be a result of several factors. However, due to its obvious advantages, it is the best choice among many people.
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How To Use A Wrist Blood Pressure Cuff
Blood pressure measurements are important, so avoiding errors are crucial. Using a wrist blood pressure cuff can complicate matters. The differences in technique between a wrist cuff and upper arm cuff can produce false readings if not performed properly. Because of this, a question I get asked from many is, how to use a wrist blood pressure cuff?
How to use a wrist blood pressure cuff:
- Sit upright in a chair with feet flat on the floor and back supported.
- Place the wrist cuff around the bare wrist.
- Position the monitor on the inside of the wrist.
- Adjust the wrist cuff, so its snug with no space between the cuff and wrist.
- The end of the cuff should be approximately 1/2 to 1 inch from the wrist crease at the bottom of the palm.
- The wrist cuff should not cover the wrist bone protrusion on the outside of the wrist.
- Comfortably rest the elbow on a flat surface and raise the wrist to heart level.
- Keep the wrist and hand relaxed.
- Do not bend the wrist backward or forward.
- Begin the measurement.
This blog post will further explain each step and explain why they are necessary. In addition, Ill cover other habits which must be followed when using a wrist cuff. If youre looking to purchase a new wrist monitor, you can check out the one I recommend in my blog post, right here.
How Can I Measure My Blood Pressure At Home
Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure monitoring.
SMBP means you regularly use a personal blood pressure measurement device away from a doctors office or hospitalusually at home. These blood pressure monitors are easy and safe to use. A health care team member can show you how to use one if you need help.
Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their health care team than if they dont use SMBP.3
Use these additional tips for SMBP:4
- Use a blood pressure log pdf icon to record your blood pressure measurements.
- Take your blood pressure at the same time every day.
- Take at least two readings, 1 or 2 minutes apart.
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Wrap Cuff Around Partner’s Arm
- Tuck the end of the cuff through the metal loop and slide onto your partners arm. Using the Velcro on the cuff, secure the cuff roughly one half inch above the bend of the elbow.
- The cuff will have a line or arrow marked on it so that it can be properly placed around the arm.
- Make sure the line or arrow lines up with the brachial artery in the inner elbow. The pulse felt in step one gives the general position of the brachial artery.
- The cuff should fit snugly so that the skin is not pinched.
- It should be possible to fit two fingertips under the cuff, but not the entirety of the fingers.
New Acc/aha Blood Pressure Guidelines: Check
Its been over a year since the new blood pressure guidelines were released and 103 million Americans were recategorized with high blood pressure. Thats nearly 1 in 2 of us. How are YOU doing?
| blood pressure |
|---|
| AND/OR | HIGHER THAN 120 |
Out-of-office BP measurements are recommended to confirm the diagnosis of hypertension and for titration of BP-lowering medication, in conjunction with telehealth counseling or clinical intervention Self monitoring of BP refers to the regular measurement of BP by an individual at home or elsewhere outside the clinic setting .
2013 ESH/ESC Guidelines for the Management of Arterial Hypertension defines high blood pressure readings obtained by self-measurement at home as:Systolic Blood Pressure 135Diastolic Blood Pressure 85
In terms of taking action based on your blood pressure readings, this should always be discussed and decided on between you and your doctor. You should never self-diagnose or adjust your medication if not prescribed by your doctor.
To learn more about blood pressure, click on the following links:
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How Does A Manual Blood Pressure Cuff Work
When you slip the cuff of a manual blood pressure cuff over a persons upper arm and pump up the bladder, the blood flow of the arm is interrupted. The dial gauge or mercury column will register the highest pressure or systolic pressure.
The operator will need a stethoscope so they can listen in on the patients brachial artery for the next step.
Then the pressure valve is released, allowing blood to start flowing again. This is what the stethoscope is used for so the measurer can listen for the whooshing, pounding sound of the heart . When that sound is heard, the measurement is taken that is the systolic measurement.
As the pressure decreases further and the sound can no longer be heard the diastolic measurement is taken. A digital sphygmomanometer is a bit different in that it records both measurements for you.
Wondering if mercury sphygmomanometers are so accurate, then are aneroid sphygmomanometers accurate too? Follow the link for a more in-depth look.
Second Step: Measure Blood Pressure
Now, you can start to measure blood pressure. Place the bell of the cleansed stethoscope over the brachial artery using a light touch and complete seal. Inflate the cuff to the maximum pressure inflation number . Open the valve slightly. Deflate the cuff slowly and evenly at about 2 mm Hg per second. See Film Clip 5.3 which focuses on the speed of the needle when deflating the blood pressure cuff.
Note the points at which you hear the first appearance of Korotkoff sounds and the point at which the Korotkoff sounds go silent . These sounds are called Korotkoff sounds and vary in quality from tapping, swooshing, muffled sounds, and silence. The pressure at which the first Korotkoff sound is noted signifies the systolic pressure, while the pressure at which the Korotkoff sounds are no longer heard marks the diastolic pressure. See Audio Clip 5.1 to listen to Korotkoff sounds and noting systolic and diastolic blood pressure. Alternatively, if viewing textbook as a pdf, use this link: https://www.youtube.com/embed/lPlYNt8cVnI?rel=0
Film clip 5.3: Deflation rate of sphygmomanometer
Alternatively, if viewing textbook as a pdf, use this link: https://www.youtube.com/embed/QbGPzUluT5c?rel=0
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What Steps Should I Take While Checking My Blood Pressure At Home
Before taking your blood pressure
- Find a quiet place.
- Check to be sure you have the correct size cuff. If you are not sure, or if you have questions, talk to your healthcare provider.
- Roll up the sleeve on your left arm or remove any tight-sleeved clothing, if needed.
- Rest in a chair next to a table for 5 to 10 minutes.
- Sit up straight with your back against the chair, legs uncrossed and on the ground.
- Rest your forearm on the table with the palm of your hand facing up.
- You should not talk, read the newspaper, or watch television during this process.
Taking your blood pressure
If you buy a manual or digital blood pressure monitor , follow the instruction booklet carefully.
Record your blood pressure
If you have been asked to record your blood pressure and bring your readings to the office, please write down the date, time of day, systolic and diastolic numbers, heart rate, and which arm you took the reading on. If you are taking part in a program that has remote monitoring, your blood pressure readings are automatically shared with your medical provider. If you are unsure, please ask your provider.
Last reviewed by a Cleveland Clinic medical professional on 10/23/2018.
References
Before You Measure Your Blood Pressure
- Avoid things that can raise your blood pressure in the short term. Dont measure your blood pressure within half an hour of eating, smoking, drinking caffeinated drinks such as coffee, or exercising. These can all raise your blood pressure temporarily. If you need to use the toilet, go before you measure your blood pressure.
- Wear loose-fitting clothes. Wear a short-sleeved t-shirt or something with sleeves you can push up easily, nothing tight. This is so that you can fit the cuff around your arm.
- Rest for five minutes before you take your reading. Sit down somewhere quiet, ideally at a desk or table. Have your back supported with your arm resting on a firm surface and your feet flat on the floor. Stay in this position while you take your blood pressure.
- Make sure your arm is supported and at the same level as your heart. Position yourself so that your arm is resting on a surface and is at the same height as your heart. Keep your arm and hand relaxed, not tensed.
- Make sure you are relaxed and comfortable. If you are anxious or uncomfortable, your blood pressure will rise temporarily.
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What Is The Best Manual Blood Pressure Cuff
I’m sorry if I’ve confused you. My sympathies go out to you! Even yet, it is one of the most important decisions you’ll ever make. If youre still unsure which type of best manual blood pressure cuff is best for you, I recommend comparing the characteristics and functionalities of the best manual blood pressure cuff listed above. Each has advantages and disadvantages.
What Equipment Do I Need To Measure My Blood Pressure At Home
To measure your blood pressure at home, you can use either an aneroid monitor or digital monitor. Choose the type of monitor that best meets your needs. Look at the following features when you select a monitor.
- Size: The right cuff size is very important. The cuff size you need is based on the size of your arm. You can ask the doctor, nurse, orpharmacist to help you. Blood pressure readings can be wrong if your cuff is the wrong size.
- Price: Cost may be a key factor. Home blood pressure units vary in price. You may want to shop around to find the best deal. Keep in mind that pricey units may not be the best or most accurate.
- Display: The numbers on the monitor should be easy for you to read.
- Sound: You must be able to hear your heartbeat through the stethoscope.
Tests show that finger and wrist devices do not always provide correct measurements. These devices are sensitive to placement and body temperature. They also are expensive and can cost more than $100.
Aneroid monitor
The aneroid monitor manually checks your blood pressure. It has a gauge that you read by looking at a pointer on the dial. The cuff goes around your upper arm and you squeeze a rubber bulb to inflate it by hand.
Digital monitor
Inflation of the cuff is either automatic or manual, depending on the model. Deflation is automatic. Digital monitors are good for hearing-impaired patients, since there is no need to listen to your heartbeat through the stethoscope.
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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 year. Cuffs will need to be periodically replaced throughout the life of the monitor. When purchasing a replacement cuff for an upper arm unit, please be certain to measure the circumference of your arm to purchase the correct cuff size. Please check the instruction manual for your specific unit. Electronic versions of the instruction manuals can be found in the Omron Product Support & Solutions Center.
Youve Placed The Cuff Incorrectly
The standard for blood pressure cuff placement is the upper arm using a cuff on bare skin with a stethoscope placed at the elbow fold over the brachial artery.
The patient should be sitting, with the arm supported at mid heart level, legs uncrossed, and not talking. Measurements can be made at other locations such as the wrist, fingers, feet, and calves but will produce varied readings depending on distance from the heart.
The mean pressure, interestingly, varies little between the aorta and peripheral arteries, while the systolic pressure increases and the diastolic decreases in the more distal vessels.
Crossing the legs increases systolic blood pressure by 2 to 8 mm Hg. About 20 percent of the population has differences of more than 10 mmHg pressure between the right and left arms. In cases where significant differences are observed, treatment decisions should be based on the higher of the two pressures.
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How To Line Up A Blood Pressure Cuff
The first step in taking someones blood pressure with a manual blood pressure cuff is attaching the cuff. Proper placement and alignment is critical if you want to get a proper reading. Heres how to line up a blood pressure cuff:
- Make sure the arm is bare, uncovered by a shirt sleeve or clothing you wont get an accurate reading if the cuff is placed over clothing.
- Slide the cuff up over the upper arm, about an inch to 2 inches above the elbow.
- Most manual blood pressure cuffs have a tag with two arrows pointing down. They should be pointing down into the crook of the elbow, on either side of the brachial artery.
You can draw a line up from the pinky finger if you need help aligning the arrow. Thats also where youre going to place the stethoscope diaphragm.
- Cinch the cuff down to where it is snug, but not painfully tight. You should be able to slide a finger between the cuff and arm.
Thats it, now youre ready to go. Heres the full list of the steps on how to take someones blood pressure with a manual blood pressure cuff.