There is an outsized marketplace for a vital sign of blood pressure measuring device not only in clinical medicine but also among the general public where the demand for self-measurement of the vital signs is growing rapidly. For consumers, whether medical or lay, accuracy should be of prime importance when selecting a tool to live a vital sign.
However, most devices haven’t been evaluated for accuracy independently using the 2 most generally used protocols: British Hypertension Society (BHS) protocol and therefore the standard set by the US Association for the Advancement of Medical Instrumentation (AAMI).1,2
The Working Group on Blood Pressure Monitoring of the European Society of Hypertension has decided to review blood pressure measuring devices regularly to guide purchasers.3 For this first report devices that there’s published evidence of independent validation using these protocols are surveyed.
Because most vital sign devices haven’t been independently validated, only a fraction of the various devices available is surveyed. Devices that have been validated recently for which results have not yet been published were not included, but this shortcoming should be addressed in the future.
Summary Points of Blood Pressure Measuring Device
- Two manual sphygmomanometers have been validated, one is recommended
- Five devices for clinical use in hospitals have been validated, two are recommended
- 23 devices for self-measurement of blood pressure have been validated, five are recommended
- 24 devices for ambulatory measurement of blood pressure have been validated, 16 are recommended Identification of devices.
This review was based on two previous surveys (which should be consulted for early validation studies that are not reproduced in this review),7,8 and computerized search programs were used to identify validation studies in the literature published up to December 2020.
Blood pressure measuring devices were divided into two broad categories: manual sphygmomanometers, which include mercury and aneroid devices; and automatic sphygmomanometers, which include devices for clinical use in hospitals, for self-measurement of blood pressure, for ambulatory blood pressure measurement, and for measuring blood pressure in community settings.
Types of Blood Pressure Devices
Blood pressure measurement devices are categorized as manual sphygmomanometers, digital non-portable for an upper arm with automatic inflation, digital portable for an upper arm with automatic inflation, digital portable for wrist with automatic inflation, and digital portable for finger with automatic inflation.
In recent testing by Consumer Reports, 29 models were tested with trained medical personnel conducting 6,000 readings on men and ladies. The upper arm cuff devices were found to be more accurate than wrist devices.
The AHA recommends an automatic, cuff-style, upper-arm monitor. The Omron brand (Figure 1) continues to be rated high by Consumer Reports. Recent testing by Consumer Reports also rated Rite Aid, A&D Medical, and ReliOn (Walmart) high for consistent accuracy.
For manual sphygmomanometers, the sphygmomanometer (blood pressure cuff or machine) consists of an inflatable cuff and two tubes; one tube is connected to the pressure hand control bulb and therefore the other tube to the pressure gauge (Figure 2).
The size of the patient determines the size of the cuff selected. There are several cuff sizes. The cuff width should be 20% greater than the diameter of the arm. When a cuff is just too narrow, the vital sign reading is just too high; when the cuff is just too large, the reading is just too low.
Selection Criteria for BP Cuff Size
Arm Circumference Usual Cuff Size
22-26 cm Small Adult
27-34 cm Adult
35-44 cm Large Adult
Source: American Heart Association
The stethoscope, a listening aid that magnifies sound is employed with manual devices and consists of two earpieces that are connected by tubes that carry the sound to the earpieces from the end piece, which is placed over the artery (Figure 3).
Dental professionals should invest in quality stethoscopes that detect sound easily. Providers should not have to strain to hear sounds. Replace parts to existing stethoscopes or replace the entire stethoscope if necessary.
The Best Blood Pressure Monitors for Home Use
- Our pick. Beurer BM55. The best home blood pressure monitor.
- Budget pick. A&D UA-767F. A simple monitor for up to four users.
- Also great. Omron Evolv. A smart monitor for wireless data transfer.
A sphygmomanometer has three parts: a cuff which will be inflated with air, a pressure meter (manometer) for measuring atmospheric pressure within the cuff, and. a stethoscope for listening to the sound the blood makes as it flows through the bronchial artery (the major artery found in your upper arm).