What Does a Perfect Blood Pressure Meter Look Like from a Clinician Point of View?

By Shin-ichi Ando

NOTE: This is an overview of the entire article, which appeared in the June 2014 issue of the IEEE Instrumentation & Measurement Magazine.
Click here to read the entire article.

In busy cardiac clinics and doctor’s offices, patients’ blood pressure is measured hundreds of times each week. Many physicians and clinicians are still using the mercury sphygmomanometer in outpatient and inpatient clinics. Shin-ichi Ando, Research Professor and Director of the Sleep Apnea Center of Kyushu University Hospital in Japan, provides an overview of some problems measuring BP and proposes an ideal BP meter that is as efficient and comfortable for the patient as possible.

Many people throughout the world have high blood pressure. Undiagnosed and untreated, high blood pressure is one of the biggest threats to our health. It greatly increases a person’s risk for heart disease, stroke, kidney failure and blindness. High blood pressure weakens the heart because it makes the heart work harder. It also injures the arteries and increases the tendency for plaques of atherosclerosis to form in them.

Measuring patients’ BP helps the doctor determine whether the patient has either hypertension or hypotension (low blood pressure), and to decide on the best treatment. There are different interests in BP measurements, each related to a different time span ranging from one second to one year. According to Dr. Ando, it is sometimes difficult to attain the correct averaged BP over a long time span without causing pain or restricting the patient because wearing the current BP meter for such a long time would be very uncomfortable.

The article discusses four different BP measurements: Central BP, Home BP, Nocturnal BP, and Continuous BP. Each of these BP measurements has issues with accuracy. For example, hypertension (HT) is subcategorized as simple hypertension for patients who exhibit high BP in both home and office settings, masked hypertension where only the home BP is high, and white coat hypertension where only the office BP is high. Also, evidence has shown that nocturnal (during sleep) hypertension has a greater affect on a patient’s prognosis than daytime hypertension. For that reason, measuring nocturnal BP (usually hidden from daytime clinicians) is becoming more and more important.

Dr. Ando proposes that an ideal BP meter should possess portability and ease of daily use, be non-invasive, and maintain easy data transfer. It should be able to be carried without giving stress to the patient, and contact with skin should be soft and minimal as well as non-irritating to the skin.

To learn Dr. Ando’s final proposal for an ideal BP meter, read the full article.

ABOUT THE AUTHOR

Shin-ichi Ando (shinando@sleep.med.kyushu-u.ac.jp) graduated from Kyushu University Medical School in 1986 and started training of cardiology in Kyushu University hospital. He received Ph.D. degrees in Medicine from Kyushu University, Fukuoka, Japan, in 1994. He is currently a Research Professor and Director of Sleep Apnea Center of Kyushu University Hospital, diagnosing and treating the patients with cardiovascular disease and/or sleep disordered breathing. He is a member of Issuing committee for the Guideline by the Japanese Society of Hypertension.