Automatic Blood Pressure Measurement and Technology Used

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Definition of Blood Pressure

The heart is responsible for supplying tissues and body organs with blood. Whenever it beats, it transfuses blood into the vast vessels of the circulatory system. As the blood is transported around the body vessels, it puts pressure on them. As a result, blood pressure (BP) is a concept used to explain the strength with which an individual’s blood exerts force on the arteries as it is pumped and circulated around the body. Blood-pressure readings are determined in two values. First, Diastolic blood pressure that is felt on the walls of the blood vessels whenever the muscles relaxes. In other words, relative to systolic pressure that is the higher value, the diastolic pressure is lower (Muntner et al., 2018). Second, systolic blood pressure is experienced whenever the heart muscles contracts causing a heart beat and pumps blood rich in oxygen throughout the blood. Blood pressure is determined in millimetres of mercury units and the measurements are always issued in pairs. The first value is the systolic or upper value and the second value is the diastolic or the lower value.

How It Is Measured

It is imperative to determine and measure blood pressure on more than one occasion since it tends to incur changes in the course of the day. It can also incur fluctuations because of issues such as pain, stress, exertion or temperature changes. For this reason, if an individual’s blood pressure is established to be high, that does not necessarily imply that it is always extreme. A blood pressure reading obtained at the office of the doctor can sometimes be misleading (American heart Association, 2017b). Visiting a doctor makes some individuals nervous and anxious. As a result, this may cause their blood pressure to increase.

To get readings that are reliable and credible, blood pressure is determined on varying days while a person is at rest. In other words, it implies relaxing, sitting down, and waiting for close to three minutes before taking the readings so that the circulatory system is in a relaxation state (American Heart Association, 2017a). The upper arm which is the commonly used body organ in determining blood pressure is placed in a resting position on a table at almost the similar height as the heart while measurements are being taken. In some occasions, it is possible for an individual to measure their blood pressure on their own with the help of a tool known as Sphygmomanometer for manual readings or a digital blood pressure monitor for taking automated measurements (Lawes et al., n.d). One advantage associated with the upper arm is that it has been proven to produce more accurate results depending on its position to the heart. However, the only demerit is that the results from the upper arm also depend heavily on the posture since it tends to impact the accuracy of the results.

There are other places on the body that can be instrumental in determining blood pressure. Fingers and wrists can be used in monitoring blood pressure. Yet, tests and research have established that wrists or finger blood pressure devices can sometimes be inaccurate relative to other forms of monitoring blood pressure. For instance, Yamashita, & Irikoma, (2018) have conducted a research on the reliability of wrist blood pressure self-measuring at home. In the research, the authors aim at establishing the reliability of blood pressure determination with wrist monitoring devices and this research had not been previously done under real life situations. However, the findings of the research revealed that the accuracy of wrist blood pressure measuring devices relies heavily on the positioning of the heart. Based on 721 selected subjects, the population-based research identified several discrepancies between home-based measurements and the office measurements. As such, the employment of wrist devices for measuring blood pressure at home results into falsely elevated measurements of blood pressure. In fact, devices that are used in measuring blood pressure on wrists or fingers are highly sensitive to the position of the body (Lawes et al., n.d). For instance, to achieve near accurate readings, it is recommended that the wrist and the arm should be at a similar level with the heart. Even then, it is imperative to note that the blood pressure measurements determined from the wrist are less accurate and usually higher relative to those taken at the upper arm (Yamashita, A., & Irikoma, 2018). One reason is that the wrist arteries are less deep and narrower relative to those in the upper arm. Some individuals experience difficulties measuring their blood pressure at the upper arm because of the pain or the extensiveness of their arm. In such instances, determining blood pressure at the wrist is an acceptable option for them (Heart Foundation, n.d). However, the costs involved in getting monitoring devices for performing this function successfully is high compared to other forms of monitoring. For instance, based on Amazon prices, an approved medical wrist Digital Blood Pressure Monitor costs around U.S $9.063 to 11.78 per piece whereas fully automatic blood pressure monitor costs less than $ 9. Furthermore, an arm type blood pressure from Amazon retailers’ costs less than $ 8.5. It is not possible to get a device for monitoring wrist or finger blood pressure going for less than U.S. $ 9.

How to Measure Blood Pressure Using Automatic Monitors?

It is common for individuals to measure their blood pressure. Some of them may require performing this activity to treat or manage a certain condition. As such, it is important to keep a log or a record of the measurements especially if the readings are taken at home. They will be instrumental in helping the doctors notice any changes in blood pressure throughout the day. To measure blood pressure at home, an automatic monitor will be useful. It is important to select the type of automatic monitor that best meets your demands. For this reason, there are certain features that need to be taken into account. First, the size of the Cuff since it depends on the length and the extensiveness of the arm (Yamashita, A., & Irikoma, S. (2018). There have been growing suggestions for anyone who wants to use an automatic monitor to ask the orpharmacist, nurse or doctor to assist them in choosing the required size. The readings can be inaccurate if the cuff size is wrong. Second, the price since a device’s cost may be a primary factor when choosing an automatic monitor (American heart Association, 2017b). Home blood pressure units possess varying units. It is important to carry out appropriate research before settling. Finally, display and sound are also crucial when selecting an automatic monitor. Research and tests have indicated that wrist and finger monitoring devices tend to provide inaccurate measurements because they are highly sensitive to body temperature and placement

Automatic monitors are one of the most prominent instruments for determining blood pressure. They are simpler and easier to employ relative to aneroid units. They possess a stethoscope and a gauge in one unit. Besides, it also has an error indicator. The BP readings are easily shown on a screen that makes them simpler to use as opposed to a dial. Some of its units possess a paper printout that offers individuals a log of the measurements. Furthermore, the cuff inflation is either manual or automatic based on the model of the Automatic monitor (Muntner et al., 2018). The deflation activity is automatic. Consequently, one of the advantages associated with automatic monitors is that they are useful when dealing with hearing-impaired patients. It makes it possible for an individual to get their readings without necessarily listening to their heartbeat CDC (n. d).

There are some limitations associated with taking blood pressure measurements using an automatic monitor. An irregular heartbeat or the movements of the body can impact its accuracy levels. An irregular heartbeat or the movements of the body can impact its accuracy levels. An irregular heartbeat makes it challenging for blood to flow and can put extended pressure on the normal functioning of the heart. In the process, it makes the heart weak which makes it challenging for the Monitors to detect accurate levels of blood pressure (Yamashita, & Irikoma, 2018). Dangerous arrhythmias of the heart such as atrial fabrication can occur which makes it more difficult to take blood pressure readings using automatic monitors. It is a requirement that when taking blood pressure using an automatic monitor, the Arm should be positioned at the same height as the arm. As such, in case of any movement, there is a high chance that the accuracy levels of the readings will be affected. Some automatic monitors only work perfectly when they are embedded on the left arm. As a result, this can make them difficult for some patients to find them useful (Tuh, n.d). Besides, they are more expensive and need batteries to function.

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To take blood pressure readings with the help of an automatic blood pressure monitor, it is imperative to find a comfortable place. It should have a good back support at a desk or a table. Before taking the readings, it is important to sit quietly for about five minutes. Ensure that the arm is placed in a relaxation state on a table top at the same height as the heart with feet flat on the floor (Tuh, n.d). Then a patient is required to stretch their arm out and palm upward. The cuff is placed on the bare upper arm just above the elbow bend. Furthermore, it is important to ensure that the tubing is at the arm centre so that the sensors project at the right position. Ensure that the cuff is evenly tight and that a person can only slip about two fingertips at the edge of the cuff. Finally, ensure that your skin does not feel much pain whenever the cuff is inflating.

Measurements during Inflation and Deflation

There are certain steps that are followed when using an automatic Monitor. First, the patient is required to press the power button top switch on the monitor. On the automatic monitors, the inflation of the cuff will be automatic as soon as the button is pressed. After the inflation is complete, the monitoring device will exhale the air out slowly. It is at this point that the readings of the blood pressure are displayed on the screen (U. S Department of Health and Human Services, n.d). The rhythmic relaxation and contraction of the heart causes a change in the blood pressure along the blood vessels walls. In the process, the blood vessels start pulsating to the rhythm that is similar to the heart beat. The pulsation is detected with piezo sensors or pressure sensors placed at a relevant part of the human body such as the upper arm. The pulses that are detected by the automatic monitors are known as oscillometric. The pressure signal emerges from the vessels of the blood is detected using the pressure sensors in the monitors (Yamashita, & Irikoma, 2018). The signal is later filtered and amplified to ensure that the heart signals are separated from the rest of the other body signals. The monitor uses a timer as a reference for computing the rate at which the heart is beating. It will indicate both readings for diastolic and systolic pressures. After recording the readings starting with the systolic pressure measurements in front of the diastolic, press the exhaust button to ensure that all the air in the cuff has been let out (U. S Department of Health and Human Services, n.d.). In case of any repeat, it is highly recommended to wait for approximately 2 to 3 minutes before going through the process again.

Measurements during Inflation

During inflation, the automatic blood pressure monitors determines the oscillations of blood when the heart is experiencing an inflation phase. For automatic monitors such as OMRON-MIT, Systolic blood pressure is taken without necessarily over-inflating the cuff higher relative to the true stylostic pressure. After taking the reading without over-inflating the cuff, it is immediately deflated rapidly. In other words, a sudden increment in the oscillations implies that the blood vessels are experiencing systolic pressure. Moreover, the point of maximum oscillation amplitude showcases the mean arterial pressure. For this reason, the total time taken for an automatic BP monitor for deflation and inflation is shorter compared to the one taken by conventional deflation devices. During inflation, the automatic monitor tends to detect blood pressure measurements at a quick rate compared to the deflation technique without necessarily compromising reading’s reliability. In this case, it leads to early treatment of illness and complications caused by high or low blood pressure. Moreover, detecting blood pressure during the inflation phase helps an automatic monitor preclude errors and inaccuracies associated with other oscillatory monitors since it helps to precisely measure blood pressure when the arterial vessels are being pressed. Furthermore, immediate determination of blood pressure during the inflation process does not cause or allow any delay in pressure transmission something that is common during the deflation phase.

Measurements during Deflation

Automatic non-invasive blood pressure devices are also signed in such a way that they are able to detect blood oscillations when the heart is deflating. Therefore, during the deflation process, the cuff pressure is elevated higher than the systolic pressure. However, to some individuals, this additional cuff pressure may result into adverse implications such as pain, enoustasis and compartment syndrome. During this process the slowness in detecting the oscillations may result in inaccuracies. As a result, compared to the inflation method, the chances of inaccuracies are high.

How to Calculate Your Average Blood Pressure Readings

After entering data in the chart, the average readings need to be sets since they are the true values of an individual blood pressure. The first step that is required in finding the average BP is to enter the readings into a worksheet. Fill out a worksheet chart. The chart should have two readings in the morning and two readings in the evening. Second, add the readings in one line except for the day 1 readings and write own the total amount as shown in the table below. Write the number of readings taken and counted each time. It is imperative to count only those boxes that possess values excluding the First day. To find the average, divide the total by the number of readings taken. To find out the weekly averages, it is recommended to take all the diastolic pressures for each day and device them by the number of days on that week minus the first day. The same process is repeated for Stylostic pressure.

Are Automatic Blood Pressure Monitors More Accurate Relative to Manual?

Reliability and accuracy of Blood Pressure Measurement Monitors in different health settings is an increasing concern despite the ever-improving promotion of measurement techniques. Manual BP measurements in some instances can produce accurate results when using a mercury manometer that is closely related to Mean Awake Ambulatory blood pressure. A number of researches works such as (Muntner et al., (2018) have shown that an accurate and reliable Blood Pressure readings for a manual device needs around 14 minutes. The duration encompasses a conversation between the patient and a physician and a period of rest to ensure that there are lower or reduced levels of white coat anxiety. Because of the increasing concerns associated with manual BP measures and overestimation, new suggestions and recommendations have been suggested. As a result, greater reliance on automated monitoring machines helps in eliminating the cases of white coat anxiety. Furthermore, it also helps in improving reliability since it reduces and eliminates many elements that are influencing impreciseness in taking measurements.

The manual BP measurements especially those that depend on sphygmomanometer have now existed for over a century. Based on the developments in BP recording techniques, mercury techniques are now disappearing from clinics. Nonetheless, Mercury Sphygmomanometer is still the commonly used reference point until an alternative monitoring device is in place. Research studies that are peeping the automated Monitors against the manual BP monitors have indicated that manual technique possess some extra levels. Yet, this variation can be cut if some guidelines used in automated monitoring techniques are closely and strictly adhered to. For instance, if the patients relax in a conducive room then the results can be more reliable. On the other hand, if multiple instruments are used in making a decision on the patient’s BP condition, the chances of white coat hypertension are high. There could remarkable reduction in anxiety if the patient is left alone in the room and this is where automated BP monitors becomes more reliable relative to the manual BP monitors.

Based on research undertaken by Selvaraj et al., (2015), automated blood pressure monitors tend to produce readings that are more reliable and accurate relative to the manual systems. Experts suggest that individuals with high blood pressure need to monitor their situation on a regular basis at home. In doing so, it offers individuals an idea of how they are performing between office visits and can act as a motivation to take good care of their health. It is also instrumental in assisting doctors in making quick adjustments on a patient’s medication to ensure that the blood pressure is maintained in the healthy zone. However, some of the home blood pressures are not as accurate and reliable as expected. For instance, (Selvaraj et al., 2015) indicates that manual blood pressure monitors may experience inaccuracy levels in around 5% to 15% of patients based on the accuracy threshold. Since a number of doctors depend highly on Home based measurements as a guideline of making treatments, such inaccuracies and unreliability could make individuals to either take less or much blood pressure medication. Automatic BP managers are clinically proven and validated to have accuracy levels of blood. Automatic Blood pressure has an accuracy of +-3mgHg or 0.02 of reading

Automated BP monitors are reliable because manual devices rely heavily on the environmental conditions. There is a high chance that the patients BP can be higher when administered by physicians as opposed to when they are done by nurses. They could also be affected if they are taken in non-office settings compared to office settings. Furthermore, if recorded in routine clinics, manual BP devices could be 15-18mmHq more relative to automated BP device measurements. Findings from Muntner et al., (2018) tends to offer support to the idea that manual BP monitoring device could be serve as a reference point relative to automated devices. The research shows that manual BP on a frequent basis tends to show higher readings. As such, it is imperative to note that, the level of reliability between the automated BP monitoring devices and manual BP devices depends on the setting, the environment, and the time required getting the readings.

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