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Advice from the BP Measurement Experts

Errors in Images Depicting BP Measurement - No Wonder You’re Doing It Wrong!

Errors in Images Depicting BP Measurement - No Wonder You’re Doing It Wrong!

Two years ago, we published a blog titled, “You’re Doing It Wrong: New Study on BP Measurement." This post came about after a group of researchers assessed BP measurement technique at a large academic health science center and their results indicated that most clinicians are - simply put - doing it wrong.

While recently attending the 2014 Annual Scientific Meeting of the American Society of Hypertension (ASH), we learned of a new study1 by Drs. Clarence and Carlene Grim. Their research assessed the accuracy of BP measurement technique in online articles that included videos or photographs of BP testing. Their study, “ Blood pressure measurement is almost never shown being done correctly in TV/print news reports, or online reports/sources regarding BP news stories, reports that the majority of online images and videos depicting BP measurement were depicting people that were doing what? You guessed it - doing it wrong.

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JNC 8 BP Guidelines: To Treat or Not to Treat Hypertension?

JNC 8 BP Guidelines: To Treat or Not to Treat Hypertension?

As word gets out about the controversial blood pressure guideline changes published by the Eighth Joint National Committee (JNC 8), the big question for clinicians is “what impact does this have on how we treat patients?” Fortunately, Duke University researchers are looking into this for you. An April 2014 JAMA analysis states that almost 6 million Americans currently taking BP medications might be able to throw them away based on new guidelines and another 13.5 million previously-diagnosed patients with uncontrolled hypertension now meet healthy blood pressure benchmarks.

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You Want to do What with That?

You Want to do What with That?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.

 

 

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Pay-For-Performance Achieves Better Hypertension Control?

Pay-For-Performanc Achieves Better Hypertension Control?As the Affordable Care Act becomes more established here in the US, one of the many new initiatives it brings to bear is pay-for-performance. Pay-for-performance is an incentive that encourages physicians to deliver a higher quality of care, as opposed to a reimbursement model that drives more tests and procedures. While similar to the system the National Health Service (NHS) has had in the UK for several years now, there is much debate over whether this method will improve the healthcare situation in the US. One group of researchers recently tested the pay-for-performance model by using the rate of hypertension control as their quality metric.

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Blood Pressure Measurement Technique— A Candid Discussion

Audio Series by SunTech MedicalLet’s be clear. I work for the marketing department of a medical device manufacturer, so I earn my paycheck by promoting this company and its products to the clinical community and developing new products that we can successfully convert into $$$. But is it possible to achieve these goals as well as actually helping people to get and stay healthy? Let me put it this way—if it weren’t, I’d quit.

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Central BP Measurement Takes Center Stage at ESH 2013

AtCor Medical SphygmoCor XCEL

Latest trends in blood pressure measurement technique have shifted to central blood pressure (CBP) and understanding its affect on us. This topic was prevalent at the recent European Society of Hypertension (ESH) meeting in Milan, especially with regards to understanding how CBP can be used in the future to guide clinical cardiovascular treatment. CBP is your aortic blood pressure near the heart and can be obtained both invasively and noninvasively. The invasive process involves inserting a pressure sensor into the aorta, which is not very desirable especially when reliable noninvasive products exist today.

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Meaningful Use Incentives Becoming Less Meaningful

Healthcare providers are frustrated with EMRIs it just me, or are healthcare providers becoming increasingly fed up with all of the new, fancy-schmancy healthcare IT 'solutions' that seem to be proliferating faster than ever before? Meaningful Use incentives have been the catalyst for the adoption of electronic medical records at an unprecedented rate, but some clinicians, administrators, and facility managers are beginning to question the value of what they've bought into as they struggle to electronically capture patient information—things like blood pressure, temperature, exam results, and other vitals.

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Get Out of the Office for Better BP Measurement

Out of Office BPThough we state it often, we at SunTech Medical aren't the only ones touting the utility of monitoring BP outside of a clinical setting. A recent article published by a northeastern regional news website advocates for the use of home BP (HBPM) and ambulatory BP monitoring (ABPM) to diagnose and monitor hypertension. An estimated 50% of patients experience either white coat hypertension or masked hypertension. Therefore, as Dr. David Landers is quoted in the article, "'One blood pressure reading in the office is not useful. What you need is more data points.'"

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ESH Releases New Guidelines on Hypertension and BP Measurement

ESH and ESC Guidelines 2013This year marked the 23rd scientific meeting of the European Society of Hypertension (ESH) on "Hypertension and Cardiovascular Protection". While the ESH annual meeting is always filled with the latest in hypertension research, this year's highlight was the presentation of the newest edition of the ESH/ESC (European Society of Cardiology) Guidelines for the management of arterial hypertension.

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FDA Calls for Connector Standardization

Click to view the video on SunTech's Cuff Standardization ProgramTubing misconnections, wrong route errors, catheter misconnections or Luer misconnections: the FDA isn't picky about what you call them – they want them eliminated. Multiple and sometimes fatal connection errors between various medical devices, including blood pressure cuffs, have led to the need for standards designed to eliminate this potential. The intent is to achieve this by designating specific connectors for defined types of devices. Blood pressure cuffs are one of the device groups identified by the FDA for standardization1.

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May 17th is World Hypertension Day

World Hypertension DayEach 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.

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Telehealth Monitoring May Win Big with New Government Regulations

telemedicineDoes anybody like government imposed penalties? Well, as is normally the case , it depends where you are as a stakeholder.

Readmission penalties drafted in the Affordable Care Act are set to kick in starting October 2013 in the form of Medicare reimbursement cuts to hospitals who have high rates of readmissions for certain health conditions including heart attack, pneumonia and heart failure. Other conditions will be included starting in 2015.

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World Health Organization Releases 2013 Global Brief on Hypertension

Diagnosing Hypertension

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.

 

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Striving for Interoperability of BP Devices and Vital Signs Data at HIMSS 2013

Healthcare InteroperabilityWhen 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.

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5 Observations about EMR Integration and Interoperability

EMR IntegrationIt’s no secret that information technology is quickly becoming one of the most important components of the healthcare system, and device interoperability with the EMR is undoubtedly a key piece of the HIT puzzle. Here are five observations about EMR integration and interoperability that should help shed some light on the importance and complexity of this issue.

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Love Lowers BP and Healthcare Costs

Love Lowers BPAh, 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.

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Top 5 Blog Posts of 2012

Holiday trees illustration

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!

  1. You're Doing It Wrong: New Study on BP Measurement
  2. Top 7 Reasons You Should Be Using Automated Blood Pressure for Cardiac Stress Testing
  3. Determining BP Device Accuracy: Who Has It Right
  4. 5 Myths About Vital Signs Automation and EHR's
  5. 3 Things to Consider When Measuring Your BP at a Kiosk
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Don't Break a Hip: How ABPM Can Help

As we have all heard time and time again hypertension is a prevalent public health issue, but it affects the elderly at a much higher rate. A newly published study now warns that "caution" is needed when initiating new antihypertensive drugs to treat elderly patients. The findings, published last month in the Archives of Internal Medicine (AIM), showed that elderly patients had a 43% increased risk of having a hip fracture within the first 45 days following the start of new antihypertensive treatment.1 It is reportedly "'the first study to demonstrate an immediate increased risk of hip fracture on initiation of antihypertensive drug therapy in community-dwelling hypertensive elderly patients'". The researchers also hypothesized that the most likely cause of the hip fractures were falls related to orthostatic hypotension, which can have symptoms such as dizziness and fainting.2


The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC), the American Society of Hypertension (ASH) and the National Institute for Clinical Excellence (NICE) recommend regular monitoring for patients who start antihypertensive therapy. So how can we best monitor these patients? JNC and NICE both recommend the use of in-office measurement.3,4 ASH encourages the use of Ambulatory or Home BP monitoring.5
"elderly patients had a 43% increased risk of having a hip fracture within the first 45 days following the start of new antihypertensive treatment"

Ambulatory BP monitoring (ABPM) is widely recognized as a tool for diagnosing hypertension. But it is also a useful tool for monitoring the efficacy of antihypertensive treatment, evaluating optimal BP control in patients with postural hypotension, and aiding in the assessment of patients with hypotensive symptoms that occur with antihypertensive medication.4,6

Clearly, as the AIM study has shown, monitoring could be beneficial for some patients at the onset of antihypertensive treatment and ABPM would be an ideal candidate given its proven value for this specific application. But we want to hear your thoughts. How do you monitor elderly patients starting antihypertensive drug treatments in order to monitor for orthostatic hypotension?

Sources

  1. Archives of Internal Medicine: The Risk of Hip Fracture After Initiating Antihypertensive Drugs in the Elderly, http://archinte.jamanetwork.com/article.aspx?articleid=1392493#METHODS
  2. Heart Wire: Starting BP meds ups risk of hip fracture in elderly, http://www.theheart.org/article/1477231.do?utm_medium=email&utm_source=20121121_EN_Heartwire&utm_campaign=newsletter
  3. NICE Quick Reference Guide: Hypertension, http://www.nice.org.uk/nicemedia/live/13561/56015/56015.pdf
  4. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, http://hyper.ahajournals.org/content/42/6/1206.long
  5. ASH Position Paper: When and how to use self (home) and ambulatory blood pressure monitoring, http://www.ashjournal.com/article/S1933-1711(08)00047-8/abstract
  6. New England Journal of Medicine: Ambulatory Blood-Pressure Monitoring, http://www.nejm.org/doi/full/10.1056/NEJMra060433
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Should Manual BP Get the Boot

Manual BP MeasurementThere's a bit of a debate going on in October's issue of the Journal of Hypertension about the best way to measure blood pressure. Everyone agrees that it should be done using a cuff placed over the brachial artery, but the similarities sort of end there.

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Our Blood Pressure is Rising Over Pediatric Studies

Pediatric Hypertension ScreeningAt Blog@SunTech, monitoring blood pressure on a regular basis is a common point of discussion especially as it relates to hypertension. Blood pressure measurement is an important part of overall health assessment and is typically the first piece of data collected for any office visit...with the exception of one rather important field of practice.

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