Advice from the BP Measurement Experts
On top of reducing the risk of cardiovascular disease, aggressive treatment of high blood pressure has shown effectiveness in mitigating risk of mild cognitive impairment. Mild cognitive impairment is viewed as a potential precursor to Alzheimer’s and dementia. A study showed that when treating patients to reduce systolic blood pressure below 120, as opposed to below 140, the past standard target, the risk of mild cognitive impairment was reduced by 19% comparatively.
Anyone who has had a stress test knows that stress tests are not easy and can even be painful! The commonly-used Bruce protocol for treadmill exercise tests includes 7 stages of 3 minutes each. The first stage starts at a 10% grade at a speed of 1.7 miles per hour. Each stage increases by 2% and between 5-9 miles per hour. Even though a stress test can last for over 20 minutes, most people don't last longer than seven minutes on the treadmill. However, it is important to keep going as long as possible to collect lots of data and be sure to reach the target heart rate. Each additional minute of a stress test could yield important information about the heart's condition.
As beloved pets age, it can be difficult to know how their health care needs to change so we will be discussing 3 ways to better care for senior animals. After all, your cat or dog can’t tell you what he or she is feeling. To stay on top their health into old age, it is important to adjust their veterinary care as needed, including going to the vet more often. Here are a few tips for ensuring that your furry friend receives top notch senior health care.
Blood Pressure experts offer new advice based on a recent study conducted by the ACP/AAFP, which shows that the threshold for hypertension in healthy patients may not be as low as what the SPRINT study of 2015 concluded.
A recent study published in the American Journal of Hypertension shows the majority of blood pressure devices sold and used in people’s homes are potentially inaccurate as much as 70% of the time. Since lots of people measure their blood pressure at home to track their cardiovascular health, this study is understandably noteworthy. But what else can we learn from it?
First, let’s talk a little bit about oscillometry. Oscillometry is the general method that most automatic blood pressure devices use to measure blood pressure. This is true for devices in the home, in doctor’s offices, and even in hospitals. As the study pointed out, while the oscillometric method is commonplace, there are differences between devices from different manufacturers because of the mathematical formulas and algorithms used to calculate systolic and diastolic blood pressure values. The math is proprietary, and most private companies that have their own oscillometric technology—including SunTech—guard those calculations very closely.
Why? Well, the simple answer is that the math behind better-performing technologies is based on actual clinical research conducted over long periods of time—in SunTech’s case, decades. This research, and the analysis of the resulting data, is a significant and expensive undertaking that can provide an important commercial advantage when it comes to a device’s clinical accuracy. So if companies had to share their data with the rest of the world, what would be the incentive to conduct all of that research in the first place? So, proprietary data can result in devices with better clinical performance, which is better for physicians and patients. I say ‘can’ because it’s no guarantee, as this study clearly illustrates.
One other fact about this study merits some additional digital copy. The authors discuss several potential reasons for the reported inaccuracy of almost 70% of the home blood pressure devices analyzed. But there is one that the authors mention briefly that could actually explain a lot. And that’s the blood pressure cuff itself. Now, it’s pretty common for folks to call the entire device—digital box, hose, and fabric that wraps around the arm and inflates--a ‘BP cuff’. But what I’m talking about is just the part that goes on the arm. That’s the actual blood pressure cuff.
Blood pressure cuff sizes are incredibly important for any oscillometric blood pressure device. The math behind these devices assumes that the correctly sized cuff will be used on the patient. See, because of the physics around how non-invasive blood pressure is measured, there’s no such thing as a ‘one size fits all’ blood pressure cuff. To be accurate, the cuff must be sized correctly according the circumference of the patient’s upper arm, for a variety of reasons. The researchers in this study reported that the mean arm circumference of study participants was a bit less than 33cm, and that increasing arm circumference was a statistically significant predictor of an inaccurate measurement.
Now, 33cm is on the high side for most standard, adult-sized blood pressure cuffs. Since home blood pressure devices typically include only a single cuff, manufacturers generally pick a very middle-of-the-road size for the cuff, hoping that it will cover the majority of arm sizes. But in the case of this study, the mean arm circumference is already pushing the upper limit of a middle-of-the-road adult cuff. So it should come as no surprise that as arm circumference increases, accuracy suffers. The researchers didn’t publish any data on the sizes of the BP cuffs that were used with the home BP devices, and I think that would have been helpful.
But the point here is that that size matters when it comes to BP cuffs and oscillometric devices. It matters a lot. It might even matter more than the math inside the device—although that matters too. So if you find yourself in need of a home blood pressure device, the first thing that you need to do is make sure that the cuff that comes with it is the right fit for your arm. Your doctor can help you figure this out if you bring it with you to the doctor’s office. If the cuff isn’t the right size, contact the manufacturer and see if they have a cuff that is.
In fact, even when you are having your blood pressure measured in a doctor’s office, it’s not a bad idea to ask the clinician taking your BP to double-check the sizing of the cuff to your arm, as other studies have shown that using the incorrectly sized cuff in clinical settings is commonplace as well.
While data that points to inaccuracies with home blood pressure devices is important, for professionals in the medical world, it’s not exactly news. And while asking how to make home BP devices better is fine, we should also be asking if there are more accurate alternatives to home BP. And the answer is yes. 24-hour Ambulatory Blood Pressure Monitoring (ABPM) is widely considered to be the gold standard for assessing a patient’s blood pressure.
Unfortunately, the reimbursement for ABPM in the United States is currently quite low, and only valid for diagnosing white coat hypertension. In other countries, like the U.K., ABPM is becoming recognized as an important tool for treating general hypertension, and is therefore being treated as such by government and private payers.
At SunTech, our goal is to continue to evolve our Oscar 2 ABPM devices to make them more patient friendly, and allow them to deliver more valuable clinical data, so that clinicians can make better diagnoses and treatments. It doesn’t happen overnight, but we’ll get there.
Blood Pressure Basics
Taking a patient’s blood pressure has become a routine practice for medical staff. Unfortunately, training in this area is often met with a very high-level overview and is sometimes neglected in regards to the overall mechanics of manual or automated methods in accurate blood pressure measurement techniques.
Research has proven that ambulatory blood pressure monitoring (ABPM) is the best way to determine true blood pressure available to physicians today. Results from an ABPM device will always 1 provide a level of insight unavailable with other forms of blood pressure measurement. However, there are eight situations in which ABPM is especially useful in providing accurate readings to properly diagnose hypertension.
According to the Centers for Disease Control and Prevention (CDC), nearly 70 million American adults have high blood pressure—that’s 1 in every 3 adults. More alarming is that only about half (52%) of people with high blood pressure have their condition under control.
With those overwhelming numbers, it goes without saying that raising awareness about how to reduce hypertension – with or without medication – is critical.
For accuracy purposes, some diagnostic tests require a little preparation on your part. So, what do you need to do before you have a cardiac stress test? According to a recent publication by the Heart and Vascular Team at the Cleveland Clinic, the following tips are good to know before you step on the treadmill:
No clinician would argue that blood pressure measurement is an important part of most patient consultations. But an increasing body of clinical evidence seems to indicate that improper blood pressure technique is fairly common.
In an effort to contribute to the conversation of proper blood pressure technique, we’ve created a clinical training video unlike any other. It’s entertaining and funny, but also grounded in the best practices supported by the American Heart Association and the latest clinical research.
If you enjoy watching, feel free to pass it along to any clinical professional who measures blood pressure. Share it! Tweet it! But at the very least…make sure you watch it!
Let’s be honest, a cardiac stress test can be just that – stressful! So how do physicians know when it’s appropriate to use this as a way to evaluate how well a patient’s heart is handling its workload? Well, it’s actually by considering a few different factors. Is the patient healthy enough to walk on a treadmill or bike on an ergometer? What if the patient presents healthy, yet there is a family history of heart disease? After evaluating those parameters, the question then becomes which type of stress test [see previous blog] should the patient actually undergo? The good news - there may now be further guidance for physicians when it comes to making this decision, specifically for males who are at risk.
Have you ever read the instructions for use for a product that you purchased? Let’s be honest, a majority of us simply do not take the time to read the instructions that come with a product; especially if it is something we believe we are familiar with already. I mean, who has the time, or patience, to sift through all of the warnings and the over simplified step-by-step description of how to use something in order to find that one little nugget of information that might actual improve your user experience? And besides, aren’t we supposed to be saving trees?
But wait. What if we told you that the instructions are there because not all products are created equal? Take the omnipresent blood pressure cuff for example. You’ve used one you’ve used them all, right? Wrong. Not every cuff is identical. There are many varieties, sizes, and shapes and each of those has specific, appropriate applications.
We appreciate the value of even five minutes gained in a day by tossing the instructions aside and charging forward. But in the case of blood pressure cuffs, the instructions for fitting are even more important, no matter how simple they may seem. Having the right sized cuff and placing that cuff properly on the patient’s arm are integral to the accuracy of any blood pressure measurement. And for automated blood pressure measurement devices, the cuff is the sensor which collects the necessary data to derive the blood pressure values. Applying an unsuitable cuff to your patient can generate erroneous results, and therefore affect a patient’s diagnosis and/or treatment.
Reading the instructions for use will help you learn to select the appropriate cuff size for your patient as well as how to apply it properly, thus ensuring the data you collect is accurate and useful. But, for all you visual learners, we have created five new videos to help with placement of some of the cuffs we offer at SunTech Medical: Orbit Cuffs for use with our Oscar 2 ABPM system, and for the Tango stress monitors Orbit-K Cuffs for everyday use, and Single Patient Use Kits as a Disposable Cuff option for the Stress Lab.
My mother was recently diagnosed with high Blood Pressure (BP). She talked to her doctor about the best ways to help control her high BP. The doctor prescribed a blood pressure medication and recommended she should eat more fruits and vegetables in addition to adding 30 minutes of exercise to her daily routine.
I was happy that the doctor recommended a healthy lifestyle to her in addition to the medication. I wouldn't call myself a health nut, maybe an enthusiast – which is why I liked the idea of alternatives for her. Recently, I read a study in the American Heart Association journal Hypertension, about how drinking a cup (250ml) of beetroot juice a day could help lower High BP.
Each year, the World Hypertension League designates May 17th as World Hypertension Day. With over 1.5 billion worldwide suffering from hypertension (high blood pressure), we at SunTech Medical would like to do our share to draw attention to this single biggest risk factor for death linked to heart disease, stroke, kidney disease and diabetes. For more information on World Hypertension Day and tips on prevention and treatment of Hypertension, you can visit the World Hypertension League website and download the World Hypertension Day brochure today.
On April 7th, the World Health Organization (WHO) celebrated their annual World Health Day in order to draw international attention to important global health issues. Each year, the WHO highlights a different global health concern and, and we found it noteworthy that the focus of this year is controlling high blood pressure.
As part of their efforts, the WHO released a new publication, “A Global Brief on Hypertension” (link below), which is now available as a free download at the official WHO website. The brief describes how hypertension is contributing to the growing burden of heart disease, stroke and kidney failure and premature death and disability. The WHO authors explain how hypertension is both preventable and treatable and provides guidance on how governments, health workers, civil society, the private sector and individuals can reduce hypertension and its impact.
When thinking about the healthcare industry it is easy to become overwhelmed due to the sheer volume of what it encompasses and its ever-evolving nature. One continuing focus and challenge that cuts across the entire industry is the management of healthcare information, including BP measurement and other vital signs data. I had the opportunity earlier this month to attend the 2013 Healthcare Information and Management Systems Society (HIMSS) conference and exhibition held in New Orleans, LA which is entirely dedicated to this topic. Specifically, the HIMSS show brings together professionals from the healthcare industry with a goal of leveraging information technology (IT) and management systems for the improvement of healthcare delivery.
Ah, love. Valentines Day brings it front and center – roses, candy, and sentiments to loved ones. Aside from the moments of terror and corresponding spike in blood pressure that can be brought on by the realization that you have forgotten to plan for this celebration, the emotion of love can be of invaluable help in reducing stress and blood pressure.
As we look forward to the coming new year, we wanted to take a moment to look back at the most popular posts from this year. We'd like to wish all of our friends and followers of Blog@SunTech a Happy Holidays and safe New Year. Unless claims that the end of the world is upon us are true, we'll see you next year!