Global Medical Shop - New Delhi

The human body is a synchronized system of various organs, their functional orchestration, and a feedback mechanism controlled by the brain. One of the vital organs-heart functions as a pump to push blood in different parts of the body to supply oxygen and food. Blood moves through a closed network of blood vessels-arteries and veins and exerts pressure on their walls. This pressure is termed as “Blood Pressure” or simply- BP. In simpler words, it is the measure of how hard your heart is working to meet the needs of the body.

What are the implications of high/low BP?

BP is considered as one of the vital signs of the good or poor health of the body and is measured in millimetres of mercury (mmHg). In a healthy body, it is considered that the highest pressure exerted by heart, when it pumps, should be 120mmHg (Systolic BP). Similarly, the lowest pressure when the heart rests between two heartbeats should be 80mmHg (Diastolic BP). When BP is consistently above or below these standards, it is high BP and low BP and is referred to as “Hypertension” and “Hypotension” respectively. Both can occur due to specific reasons, for example, low BP can be due to the diseased state of the body. But, both can have serious implications like-

• Long-term: Risk of strokes, kidney failure, heart attacks, and blindness.
• Short-term: Frequent headaches, dizziness, blurred vision, and bleeding nose.

BP is affected by factors like heredity, nutrition, stress, inappropriate sleep, extreme temperatures, and exercise. The most critical of them is stiffness of arteries with biological ageing. One of the many degenerative things that occur in the body due to old age is the loss of elasticity of major arteries. The heart has to work harder to pump blood, hence, BP levels rise. Maintaining a healthy BP level is critical at all ages, especially in old age. Elderly can do the same by doing the following-

• Maintaining a healthy weight
• Healthy eating and social habits
• Mild daily exercise
• Keeping track of BP

What is a blood pressure monitor?

The device which is calibrated to measure the BP is known as the Sphygmomanometer or the Blood Pressure Monitor, and it comprises of-

• An inflatable Cuff to be wrapped around the arm, at a vertical height at the same level as the heart, to restrict the blood flow when wrapped around the arm.
• A Mercury or Mechanical Manometer with a vertical glass column containing mercury or a gauge respectively.
• A Rubber Ball connected to the Cuff with a pipe to inflate the Cuff.

There are two basic methods- Auscultatory and Oscillometric, employed to measure the BP, and accordingly, classified into two types- Manual and Digital BP monitors. Manual ones can be further bifurcated as- Mercury and Aneroid based on the presence or absence of the Mercury column.

Auscultatory Method:

This method uses Korotkoff sounds to identify Systolic and Diastolic BP. The Cuff wrapped around the upper arm chokes the artery. A stethoscope is placed to the brachial artery at the elbow, to listen to a pounding sound when the air pressure is slowly released. It is caused by the highest pressure when blood starts flowing for the first time after it was occluded. Air pressure is released until the whooshing can no longer be heard. It is noted as Diastolic BP.

Oscillometric Method:

The process is the same, but the only difference is that there is no listening device, like Stethoscope, and the method is based on the measurement of the oscillations caused by the arterial pressure pulse. When the blood starts flowing in the vessels, they produce oscillations and continue until the blood flow is normalized. The oscillations are measured and calculated to arrive at the SBP and DBP.

Why seniors need a home BP monitor?

With age, the wear and tear of arteries happen, and they tend to become stiff, obstructing blood flow. Even with a healthy aged person, these conditions might come silently as no symptoms eventuate. The best way to keep a check on any such possibility is to keep a periodic log of BP at home. Seniors can keep a home BP monitor to measure BP, which will help them in many ways:

• They need not frequently visit the doctor.
• Home BP monitors are easy to manoeuvre without training.
• They feel confident and satisfied which adds on to their positive and healthy lifestyle.
• It is critical when on medication, as sudden change can happen, especially if they are on BP lowering drugs.
• Keeping a track on BP or maintaining a log is easy when you have a home BP monitor.
• Taking consultation, remotely from a physician, is easy as they can prescribe better.

What are the different types of home monitors? Based on the principles they use, the classification is done as- Manual and Digital or Automatic.

• Manual: Uses auscultation principle and includes the inflatable Cuff, Mercury filled the vertical vessel, and the air inflating rubber ball. The air pressure in the inflated Cuff is slowly released and using the stethoscope, palpitating sounds are noticed. With the release of air pressure, the mercury in the tube drops and readings for SBP and DBP are noted. Trained medical practitioners use them, with accuracy, even in patients with high-risk. They are also termed as “Mercury Sphygmomanometer.”

• Aneroid Sphygmomanometer: Has a gauge to measure the SBP and DBP.

• Automatic: The principle behind the automatic or the digital BP monitors is called- Oscillometric Method. It has an inflatable Cuff, which can be inflated either manually or automatically using a battery operating device. They are electronic devices and are easy to use, portable and are advisable for regular users. You do not need the training to use them.
• Connected and app-based monitors: These are pipe-less or wireless devices which are compact in design and use the advanced technology of mobile applications. They have a Cuff, connected to Bluetooth of a smartphone. Patients can download the application associated with the device, and the cuff automatically measures the SBP and DBP once it is activated by the mobile application. They are accurate and clinically validated, simple to set up, easy to use, extremely portable, lightweight, and can display a range of evaluated data. They store huge data which can be interpretive in graphs, charts, and can also be shared with doctors through emails.

Factors to consider when purchasing a BP monitor

The need for a BP monitor at home arises for the following:

• Patients on BP medications, to monitor the effectiveness of the drug,.
• Patients with critical heart ailments like- Coronary Heart Disease, diabetes, or any other kidney disease,
• Pregnant Females,
• Patients who require close monitoring of BP, and
• The elderly.

Therefore, it is just not that simple to buy any BP monitor. You must take into consideration the following while doing so:

• • Upper arm cuff vs. wrist mount: The wrist monitors, though compact and lightweight, are not as accurate as upper arm cuffs.
  • Cuff size: A smaller Cuff means high pressure and a larger means of low pressure, resulting in inaccurate BP measurements.
  • Display: The display must be easy to read and understand, and user buttons must be large.
  • Adjustable inflation level: In any automatic monitor, the Cuff is inflated to a level which might be uncomfortable for some. The presence of an adjustable inflation key can reduce the excess pressure as it allows programming.
  • Memory: Data storage feature with single to multiple interfaces. The connected and App-based monitors can even be shared with your doctors via emails; sharing of data in charts and graphs is also possible.
  • Mains power adapter: Usually the digital monitors are battery-run, but there are few which have the additional option of running on mains.
  • Irregular heart rate display: Few can flag or alert irregular heart rates of measurements.
  • Hypertension indicator: The presence of an indicator highlighting or flashing an alert on hypertensive measurements.
  • Ease of use: The easy set-up, faster understanding, and readable display are basic factors to be kept in mind during your purchase.
  • Features that are necessary for you: Amongst a plethora of features, you need to check and decide which one suits your specific need.

• Cost: Depending on your budget, finalize your choice. The cost of a few brands, for consideration, are:

After purchase Once you have made the purchase and taken the first reading yourself, do get the same cross-checked by visiting your physician. Ask your physician to take the reading by using a manual sphygmomanometer. Share your readings so that the correctness of your monitor can be determined. In case of any variation, go through the user manual to re-calibrate your BP monitor.