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FAQ - Digital blood pressure monitors
IMPORTANT GENERAL INFORMATION REGARDING BLOOD PRESSURE
How does high/low blood pressure occure?
The level of blood pressure is determined in the part of the brain called circulatory centre, and adapted to the respective situation by way of feedback via the nervous system. To adjust the blood pressure, the strength and frequency of the heart (pulse) and the width of circulatory blood vessels is altered. The latter is effected by way of fine muscles in the blood vessel walls. The level of arterial blood pressure changes periodically during the heart's activity: During the "blood ejection" (systole) the value is at its maximum (systolic lood pressure value), at the end of the heart's "rest period" (diastole) at its minimum (diastolic blood pressure value). In order to prevent certain diseases, the blood pressure values must stay within certain normal ranges.
FREQUENTLY ASKED QUESTIONS (FAQ) AND ANSWERS
Questions regarding unsatisfactory measurement results & accuracy
1. My doctor says that all digital machines are of no use whatsoever and that only a doctor or an experienced nurse can take blood pressure correctly. How accurate is the result of a MEDISANA electronic blood pressure monitor?
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2. I expect to get the same results every time with the MEDISANA monitor but I always get different results. Is the device defective?
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3. My doctor says that my blood pressure is 150 to 100 but why does the MEDISANA device give results around 135 to 95?
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4. I understand that blood pressure varies over the day and I get different results accordingly. But how high is my blood pressure really then?
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5. Before I bought a MEDISANA blood pressure monitor, I used a device from another company. Why do I get different results with the MEDISANA device?
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6. How do I know if the device is still accurate alter long usage or after being dropped?
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7. Why and when should I send the device in for an accuracy check?
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8. Which monitor is more accurate, a wrist model or an upper arm model?
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9. Is a manual monitor as accurate as an automatic device?
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10. The systolic pressure measured by the MEDISANA blood pressure monitor is similar to what my doctor measures but why is the diastolic pressure about 10 mmHg higher with the electronic monitor?
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11. I measure at home several times sequentially with a MEDISANA blood pressure monitor. The first results are fine but why do they suddenly become very low after approx. the 5th measurement?
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12. Does the MEDISANA blood pressure monitor also perform reliable measurements during pregnancy?
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Questions regarding: Measurement Performance
13. Under which conditions can I get the best possible measurement results?
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14. How often and when should I measure my blood pressure with the MEDISANA electronic blood pressure monitor?
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15. What is the meaning of the different messages "Err1", "Err3", etc.?
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16. On which side should I generally measure my blood pressure, left or right?
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17. My arm circumference is outside the stated limits. What should I do?
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18. I have a very thin upper arm and the circumference is less than stated on the standard cuff. Can I use a wrist monitor if the cuff fits my upper arm well?
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19. Do I have to place the cuff on my upper arm exclusively or can I place it elsewhere such as the forearm or the leg?
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20. What happens if I do not place the wrist cuff at heart level?
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21. How long should I wait between measurements?
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22. I installed new batteries but after about 50 measurements they were already empty. Is this normal?
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Questions regarding: Products
23. How do MEDISANA's electronic blood pressure monitors detect human blood pressure?
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24. What is "Fuzzy Logic"?
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25. Can I connect any cuff as long as it fits to the connection port?
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26. Can I wash the cuff?
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27. How often can the cuffs be closed and opened by the Velcro system?
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28. I already have an AC/DC adapter at home, can I use it or do I need the MEDISANA adapter?
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29. Can I use rechargeable batteries?
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30. I want to check my level of fitness with a MEDISANA blood pressure monitor but during activity the device always displays an error message. Why can I only measure under quiet conditions?
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31. My doctor says that I have some tendency for arrhythmia and therefore should not control my blood pressure with an electronic blood pressure monitor. Is this correct?
Answer
32. I have to control the pulse rate of my cardiac pacemaker very accurately. Can I use the pulse result from the MEDISANA blood pressure monitor for this?
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33. Can I also use my MEDISANA blood pressure monitor at low pressure levels such as in the high mountains?
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34. Can the MEDISANA blood pressure monitor be used in a driving ambulance, an aeroplane or train?
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35. I heard that some devices measure during inflation but most devices such as the MEDISANA blood pressure monitors measure during deflation. What is more accurate?
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36. What is the total Lifetime of a MEDISANA blood pressure monitor?
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37. Is the MEDISANA blood pressure monitor waterproof?
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Questions regarding: Blood Pressure in general
38. What are normal results and when should I see a doctor?
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39. What is 'White Coat Hypertension'?
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40. Does blood pressure depend on age?
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Medical Questions and Medical Opinions
41. Is it true that blood pressure is generally measured using the "oscillometric" technique? What does this mean?
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42. What should be considered when doing self-measurement?
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43. Is a wrist device to be recommended for self-measurement?
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44. Is it possible for my blood pressure to drop too low due to treatment?
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45. Are side effects to be expected with drug treatment?
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46. Are there unsuitable sports activities if you have high blood pressure?
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QUESTIONS REGARDING UNSATISFACTORY MEASUREMENT RESULTS & ACCURACY
1. My doctor says that all digital machines are of no use whatever and that only a doctor or an experienced nurse can take blood pressure correctly. How accurate is the result of a MEDISANA electronic blood pressure monitor?
MEDISANA's electronic blood pressure monitors perform the measurements by applying the so- called 'oscillometric method'. This method has been well accepted worldwide for more than thirty years and is applied in hospitals every day whenever the patient's blood pressure needs intensive and highly accurate control. It measures blood pressure accurately by analysing the pressure oscillations that can be measured during the deflation period of the cuff pressure.
Please note that high "accuracy" is specifically given by the fact that the electronic device enables measurements to be made at home under relaxed conditions. In combination with MEDISANA's accurate blood pressure monitor, this possibility offers the best conditions by far for accurate determination of human blood pressure!
The doctor's method of obtaining the pressure does not rule out several 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 to 3 mmHg per second is essential to obtain accurate results if the doctor is taking measurements. But often, doctors and nurses use a much higher deflation rate and obtain incorrect results.
Several measurements are performed using electronic monitors people perform because it is very easy and attractive to measure one's own 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 consecutively, (which is never done!) he would also get different values.
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2. I expect to get the same results every time with the MEDISANA monitor but I always get different results.Is the device defective?
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 blood pressure may change between 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 (if measured under the same circumstances) obtained on several days under comparable living situations at similar times of 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.
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3. My doctor says that my blood pressure is 150 to 100 but why does the MEDISANA device give results around 135 to 95?
One reason might be that you are not as relaxed at the doctor's as you are at home. If you are less relaxed at the doctor's, the blood pressure is higher. Systolic pressure 15 mmHg lower is normal in relaxed surroundings.
Another reason can be related to the normal variations of human blood pressure over the day. Changes of up to 30 mmHg within a short time period may appear in relation to physical activity (sport, brainwork, stress, stomach, etc...).
It is therefore recommended that you measure your blood pressure at similar times of day under comparable conditions, for example every evening about an hour after you have dinner.
It is also important to note that each manufacturer applies his own principles in detecting blood pressure. A difference between the device and the doctor can also be based on different 'skills' of both systems and can be compared with the difference that may appear when two doctors measure the same patient with their stethoscopes but obtain different values.
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4. 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 at similar times 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.
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5. Before I bought a MEDISANA blood pressure monitor, I used a device from another company. Why do I get different results with the MEDISANA device?
Most electronic monitors work with the so called 'oscillometric method'. Each manufacturer applies his own principles in analysing the measured signals and finding the related systolic and diastolic values. Therefore there are significant differences in accuracy between the monitors - this was also proven by several clinical studies.
MEDISANA has many years of experience in analysing these body signals and detecting blood pressure very accurately. The high accuracy of MEDISANA's measurement principle has been confirmed by comprehensive clinical studies performed by independent medical centres using the highest international standards.
Each manufacturer applies his own principles which 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 obtain different results.
A further reason for different data might be that the blood pressure may change between measurements. It is actually not easy to have same conditions for sequentially performed measurements. It is not unusual that sequential measurements taken with the same device give different readings based an the unstable physiological conditions and influencing side factors (talking noise, movements, etc.)!
If you want to compare two systems, as many influencing factors as possible must be eliminated. The measurements have to be performed without any outside disturbance and by following the instructions given in the manual. Each measurement should be performed under comparable living conditions at a similar time of 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.
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6. How do I know if the device is still accurate alter long usage or after being dropped?
Generally, the monitor gives accurate results if it is working. If, for example, the device has been dropped and you cannot detect any malfunction when operating it, there is no need to worry about its accuracy. The major component that influences the accuracy is stored in the computer program. This software either works or it doesn't. Other parts that affect the accuracy such as the deflation valve and the pressure sensor are very well protected against alteration by accidents and ageing.
Irrespective of this and in accordance with international standards we recommend that you ask your authorised MEDISANA dealer to perform an accuracy check every two years.
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7. Why and when should I send the device in for an accuracy check?
MEDISANA'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 send in the device to MEDISANA's customer service to perform an accuracy check every two years.
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8. Which monitor is more accurate, a wrist model or an upper arm model?
Basically both systems are comparably accurate. But 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 some individuals emit are very weak at the wrist due to their artery wall constitution. These people may get frequent error messages.
Wrist measurements are more sensitive against movements during measurement and likelier to result in 'error messages'. Therefore please take care not to move the wrist and 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 underestimation by 8 mmHg while 10 cm below heart level means that the results will be 8 mmHg to high!
At the wrist, the arteries are positioned very close to the surface and the body signals are therefore less covered by tissue than at upper arm level. This may lead to better readings at wrist level than from the upper arm for some individuals.
Although both systems show the same accuracy in principle, several single factors may affect the readings. Therefore we recommend comparison of both systems and selection of the system that delivers the most consistent results. If both methods behave similarly and deliver very different values, we recommend the use of the upper arm model because the measurement of blood pressure at the upper arm is developed much better in this state.
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9. Is a manual monitor as accurate as an automatic device?
Both systems provide comparable accuracy. Automatic models have an installed electric pump instead of the hand-pumping ball, but this has no influence on the accuracy.
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10. The systolic pressure measured by the MEDISANA blood pressure monitor is similar to what my doctor measures but why is the diastolic pressure about 10 mmHg higher with the electronic monitor?
The diastolic pressure is very difficult to detect with the stethoscope and depends on the observer's capabilities to a high degree. The correlation of diastolic pressure is therefore typically more difficult than the systolic.
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11. I measure at home several times sequentially with a MEDISANA blood pressure monitor. The first results are fine but why do they suddenly become very low after approx. the 5th measurement?
The reason might be blood congestion because you have not waited long enough between measurements or have not released the cuff between measurements.
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12. Does the MEDISANA blood pressure monitor also perform reliable measurements during pregnancy?
Yes, the pressure detection is no different for a pregnant patient than a non-pregnant patient. During pregnancy the pressure should be controlled frequently to prevent the critical phenomenon called eclampcia. (Roughly 10% of women develop high blood pressure during pregnancy (=preeclampcia). About 10% of these develop eclampcia).
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QUESTIONS REGARDING: MEASUREMENT PERFORMANCE
13. Under which conditions can I get the best possible measurement results?
MEASUREMENT CONDITIONS
1. You should measure your blood pressure under comparable living situations and under relaxed and quiet conditions at similar times of the day, for example every evening about an hour after you had dinner.
2. Perform the measurement while sitting in a quiet atmosphere.
3. Avoid eating, smoking and all forms of exertion directly before measurement.
4. Take several minutes rest before measuring.
MEASUREMENT PREPARATIONS
5. Please confirm that the circumference of your arm or wrist is covered by the range as written on the cuff.
6. Fit the cuff as explained in the manual.
7. Put on the cuff and secure it tightly but not so tight that it is uncomfortable.
8. Take care not to restrict the blood flow by pushing up the sleeve too tightly for upper arm monitors. Thin clothes on the arms do not interfere with the accuracy
9. Connect the cuff with the main unit, switch on the device and inflate the cuff pressure according to the instructions.
10. Ensure that the wrist is at heart level for wrist monitors! A 10 cm difference in the level would result into a measurement error of 8 mmHg!
DURING THE MEASUREMENT
11. Avoid any kind of movement.
12. Do not activate any of the muscles in the measured arm.
13. Breathe normally and do not talk.
14. If you want to perform several measurements sequentially, you should wait at least 1 minute between measurements.
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14. How often and when should I measure my blood pressure with the MEDISANA electronic blood pressure monitor?
The more you measure, the better! But as blood pressure is a highly variable body parameter, be aware of the fact that results are not always the same. To compare your pressure level day by day, you should perform a daily measurement under comparable living situations. Measure, for example, an hour after you have dinner. Make sure that you feel relaxed and are not disturbed by your surroundings.
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15. What is the meaning of the different messages "Err1", "Err3", etc.?
MEDISANA's blood pressure monitors are developed to detect blood pressure accurately and to display the result only if it is clearly free of errors. If an error is detected during measurement, the device distinguishes between different causes of the error and displays the related error number accordingly. The instruction manual explains each error code.
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16. On which side should I generally measure my blood pressure, left or right?
We recommend that you test from which arm you obtain higher blood pressure readings at the beginning when using upper arm devices. We recommend that you monitor your blood pressure using the arm which gave higher values.Wrist devices are designed for measurement performance using the left wrist only.
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17. My arm circumference is outside the stated limits. What should I do?
If you use a MEDISANA upper arm monitor, the standard cuff is suitable for upper arm circumferences between 22 and 32 cm. If your circumference is larger than this, you need the MEDISANA large cuff which is designed for circumferences between 32 and 42 cm.
The wrist cuff is suitable for wrist circumferences between 13.5 and 19.5 cm.
Above dimensions are suitable for most people. If the circumference is lower or higher, the measurements should not be performed with our electronic home monitors. Please discuss the best way to self-monitor your blood pressure with your doctor.
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18. I have a very thin upper arm and the circumference is less than stated on the standard cuff. Can I use a wrist monitor if the cuff fits my upper arm well?
No! Wrist monitors apply a completely different detection procedure that is specifically designed for the physiological condition of the human wrist. This cannot be transferred to the upper arm even if the cuff would fit.
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19. Do I have to place the cuff on my upper arm exclusively or can I place it elsewhere such as the forearm or the leg?
The cuff of upper arm devices can only be placed on the left or right upper arm. Please make sure that the circumference as written on the cuff matches your arm circumference.
Wrist devices are designed for the left wrist only.
Please follow these instructions. Even if the cuff fits at other places, please accept that the devices are exclusively designed for the upper arm or the left wrist and would give wrong results in other positions.
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20. What happens if I do not place the wrist cuff at heart level?
It is very important that the cuff is positioned at heart level during measurement. A position ten centimetres higher than heart level means an underestimation of about eight mmHg while ten centimetres below heart level means about eight mmHg overestimation of the blood pressure.
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21. How long should I wait between measurements?
If you want to perform several measurements sequentially, you should wait at least 1 minute between measurements.
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22. I installed new batteries but after about 50 measurements they were already empty. Is this normal?
MEDISANA branded blood pressure monitors are equipped with high quality long life batteries. The confirmed lifetime of these batteries is above 400 operation cycles (250 cycles for standard batteries).
If the user installs new batteries and gets disappointing results, the following items should be checked:
What type of battery was installed, a standard battery or a long life battery? Please note that even with a new standard battery the lifetime is several hundred operation cycles!
How old is the battery? Batteries reduce capacity if stored for longer periods.
Is it really a new battery or was it used already?
A battery may work with other devices (alarm clocks for example) that have a lower minimum required input voltage but may not work with a blood pressure monitor that has a relatively high minimum level.
A disappointing lifetime may also happen with rechargeable batteries because even fully charged rechargeable batteries have a lower capacity than non-rechargeable ones!
The ambient temperature also has a significant influence. At temperatures below 15°C, the performance of batteries is reduced significantly!
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QUESTIONS REGARDING: PRODUCTS
23. How do MEDISANA's electronic blood pressure monitors detect human blood pressure?
MEDISANA's electronic blood pressure monitors perform the measurements by applying the so- called 'oscillometric method'. This method has been well accepted worldwide for over thirty 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. This technology does not require a microphone or a stethoscope.
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24. What is "Fuzzy-Logic"?
"Fuzzy Logic" is an advanced technology for controlling technical components with a microprocessor.
The benefits for end users are an automatic detection of the approx. systolic value by which the device always inflates to the best level This technology also enables best possible accuracy for reliable measurement results.
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25. Can I connect any cuff as long as it fits to the connection port?
MEDISANA's blood pressure monitors can only give reliable results when the device is connected to a MEDISANA cuff.
If your arm circumference is between 22 and 32 cm, you should use the MEDISANA "M-size" cuff. If it is between 32 and 42 cm, you should use the MEDISANA "L-size" cuff.
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26. Can I wash the cuff?
No, the cuffs of home monitors are generally not designed to be washed. This might change the cuff dimensions and lead to a loss in accuracy. But under normal application it is not necessary to wash the cuff. Spots on the cuff can be removed carefully with a damp cloth and soapsuds.
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27. How often can the cuffs be closed and opened by the Velcro system?
At minimum, the Velcro system can be used 10,000 times. It may be even longer but we stopped the test after 10,000 times as this means more than ten years even if the product is used under abnormal conditions.
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28. I already have an AC/DC adapter at home, can I use it or do I need the MEDISANA adapter?
MEDISANA's blood pressure monitors require a very specific power supply. This can only be guaranteed by the use of batteries or the MEDISANA adapter. The adapter is specifically designed for our products.
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29. Can I use rechargeable batteries?
WE DO NOT RECOMMEND THE USE OF RECHARGEABLE BATTERIES FOR OUR DEVICES.
Electronic blood pressure monitors require a specific level of stable power supply. Even fully charged rechargeable batteries have a lower capacity than non-rechargeable batteries. Rechargeable batteries may reach the lowest required power limit for our products much faster than non-rechargeable batteries. Users of rechargeable batteries therefore have to charge the batteries very often and this does not motivate them to perform home measurements frequently. Please note that the power supply does not have any influence an the accuracy! If the power level is too low, the low battery signal is shown.
As long as the device performs measurements, they are reliable!
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30. I want to check my level of fitness with a MEDISANA blood pressure monitor but during activity the device always displays an error message. Why can I only measure under quiet conditions ?
MEDISANA's blood pressure monitors apply the 'oscillometric method' of detecting the human blood pressure. This method requires quiet conditions. Any movements, vibrations or shaking that appear during body activity interfere significantly with the detection. That is why error messages are always displayed when measuring during activity.
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31. My doctor says that I have some tendency for arrhythmia and therefore should not control my blood pressure with an electronic blood pressure monitor. Is this correct?
The oscillometric method only does not work in cases of severe arrhythmia. Each human being sometimes misses a heart beat and this is not a cause for worries. But if the patient has severe arrhythmia, a normal oscillometric home monitor should not be used.
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32. I have to control the pulse rate of my cardiac pacemaker very accurately. Can I use the pulse result from the MEDISANA blood pressure monitor for this?
All electronic home monitors measure the pulse oscillations over a period of far less than one minute. But accurate pulse controls such as those required to control a cardiac pacemaker require a period of 60 seconds or more. The electronic devices are therefore not suitable for this use.
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33. Can I also use my MEDISANA blood pressure monitor at low pressure levels such as in the high mountains?
Every time a MEDISANA blood pressure monitor is switched on, it calibrates itself to the atmospheric pressure. The internal pressure of the MEDISANA blood pressure monitor is adjusted with the environmental pressure level. Thus you can perform measurements also at low outside pressure levels.
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34. Can the MEDISANA blood pressure monitor be used in a driving ambulance, an aeroplane or train?
MEDISANA's blood pressure monitors apply the 'oscillometric method' of detecting the human blood pressure. This method requires quiet conditions. Any vibrations or shaking which appear in a driving ambulance, an aeroplane or train significantly interfere with the detection. As a result an error message is displayed instead of a reading. So it may be necessary to perform several measurements to obtain a result.
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35. I heard that some devices measure during inflation but most devices such as the MEDISANA blood pressure monitors measure during deflation. What is more accurate?
MEDISANA blood pressure monitors measure the pressure during the deflation period.
It is not known if there are any differences at all and to our knowledge the inflation technology is not under medical investigation. So nobody can say today that there is any advantage or disadvantage.
When blood pressure monitoring is performed, the cuff pressure is first inflated to close the artery and the measurement is performed during the pressure deflation. In the last years, some electronic home monitors applied the measurement during the cuff inflation period. This should theoretically be similar but as there are not yet any clinical studies available as to the accuracy of this method, this technology has several uncertainties about it.
Medical literature does not discuss this technique much.
One medical concern against the inflation method, especially when being applied to the upper arm, is that after the systolic value is detected, the cuff pressure is released suddenly and the blood flows back into the arm very quickly. This increases the risk for the patient to get severe circulation problems.
By summarising the above points to get a clear answer, one can say that there are no facts that favour one of the two different systems. One argument against the inflation method is that there is very little clinical data about this completely new technology. It has not been investigated from a medical view and therefore has many uncertainties.
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36. What is the total Lifetime of a MEDISANA blood pressure monitor?
MEDISANA blood pressure monitors are designed for a long product life.
Components that are important to achieve best accuracy are protected very carefully.
When designing a new product we perform stress tests of key components that dominate the lifetime. In general we test if these parts "survive" a usage of 5 to 10 years under estimated 'normal' home use conditions.
In any case and in accordance with international standards we recommend that you ask your specialist dealer to perform an accuracy check every two years.
By following this rule and watching the handling instructions as given in the manual, your MEDISANA device may last "for ever". Of course, this depends very much on the way the users handle the product and we can never be guarantee that the product lasts ten or twenty years as the product consists of many electronic components that may fail under various conditions.
Please note that the cuff is a 'wearing part' that can develop a leakage if it is highly stressed.
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37. Is the MEDISANA blood pressure monitor waterproof?
No! And please do not store it at above 50°C.
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QUESTIONS REGARDING: BLOOD PRESSURE IN GENERAL
38. What are normal results and when should I see a doctor?
The following table represents the newest update supplied by the World Health Organisation (WHO) in May 1999:
* Target" values are defined as 130 mmHg for systole and 85 mmHg for diastole. Optimal" blood pressure values are 120 mmHg for systole and 80 mmHg for diastole.
** Moderate hypertension values are 160 to 180 mmHg for systole and 100 to 110 mmHg for diastole (Grade 2) Severe Hypertension values are above 180 mmHg for systole and above 110 mmHg for diastole (Grade 3).
|
18 Bar |
Systole (upper value) |
Diastole (lower value) |
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Hypotension (very low values) |
below 100 |
below 60 |
|
Normal* Values |
100 to 140 |
60 to 90 |
|
Mild Hypertension Grade 1 |
140 to 160 |
90 to 100 |
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Hypertension ** |
above 160 |
above 100 |