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      Validation of the Omron HEM-1040 Blood Pressure Monitor According to the American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization 81060-2:2013 Protocol

      research-article
      1 , 2
      Vascular Health and Risk Management
      Dove
      blood pressure monitoring device, accuracy, protocol, standard, validation

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          Abstract

          Objective

          The accuracy of the Omron HEM-1040 automated oscillometric upper-arm blood pressure (BP) monitoring device, designed for home self-measurements in adult populations, was tested according to the American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization (ANSI/AAMI/ISO) 81060–2:2013 protocol.

          Methods

          The requirements of this protocol were precisely followed with the recruitment of 85 individuals in whom sequential systolic BP (SBP) and diastolic BP (DBP) were measured in the same (left) arm and who fulfilled the inclusion criteria involving the ranges of arm circumference, SBP, and DBP.

          Results

          The mean device-observer difference in the 255 separate pairs of BP data was −2.7 ± 7.14 mmHg for SBP and −3.3 ± 5.70 mmHg for DBP. The data were in accordance with criterion 1 of the ANSI/AAMI/ISO 81060–2:2013 standard requirements (≤ 5 ± ≤ 8 mmHg). In addition, the mean device-observer difference in the 85 participants was −2.7 ± 5.89 mmHg for SBP and −3.3 ± 4.99 mmHg for DBP, fulfilling criterion 2 with a standard deviation of ≤ 6.39 mmHg for SBP and ≤ 6.09 mmHg for DBP.

          Conclusion

          The OMRON HEM-1040 BP monitor fulfilled the requirements of the ANSI/AAMI/ISO validation standard.

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          Most cited references6

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          Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis.

          The benefits of blood pressure lowering treatment for prevention of cardiovascular disease are well established. However, the extent to which these effects differ by baseline blood pressure, presence of comorbidities, or drug class is less clear. We therefore performed a systematic review and meta-analysis to clarify these differences.
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            Home blood pressure monitoring in the 21st century.

            Home blood pressure monitoring provides multiple measurements in the usual environment of each individual, allows the detection of intermediate hypertension phenotypes (white-coat and masked hypertension), and appears to have superior prognostic value compared to the conventional office blood pressure measurements. Accumulating evidence suggests that home blood pressure monitoring improves long-term hypertension control rates. Moreover, it is widely available, relatively inexpensive, and well accepted by patients. Thus, current guidelines recommend home blood pressure monitoring as an essential method for the evaluation of almost all untreated and treated patients with suspected or treated hypertension. Validated automated upper-arm cuff devices with automated storage and averaging of readings should be used. The home blood pressure monitoring schedule for 4 to 7 days with exclusion of the first day (12-24 readings) should be averaged to provide values for decision making.
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              Effect of overcuffing on the accuracy of oscillometric blood pressure measurements

              Overcuffing (using too large a blood pressure [BP] cuff), is known to artificially lower auscultatory BP measurements; however, its effect on oscillometric readings is unclear. The possibility that overcuffing biases oscillometric readings is currently widely disregarded. We sought to confirm that overcuffing lowers auscultatory readings and to assess its effect on oscillometric measurements. Community-dwelling adults (aged ≥18 years) with arm circumferences within the standard range of 25-32 cm were recruited. Using primarily the International Standards Organization 2009 protocol, we compared the standard Baum adult (25-35 cm) to the large adult (33-47 cm) cuff. The standard cuff was considered the "reference standard." In Phase I, auscultatory measurements were performed by two trained observers. In Phase II, oscillometric measurements were performed. Each phase was analyzed independently using paired t-tests and by generating Bland-Altman plots. Of 108 participants, 87 contributed data for Phase I, 85 for Phase II, and 69 were common to both phases. Phase I mean age was 38.0 ± 18.5 years, mean arm circumference was 28.0 ± 1.9 cm, and 21% had a past hypertension. The Phase I results confirmed that overcuffing reduced auscultatory BP measurements by 3.6 ± 5.1/2.8 ± 4.0 mm Hg (P-values <.0001 for both). For Phase II, mean age was 39.3 ± 18.3 years, mean arm circumference was 28.0 ± 1.9 cm, and 22% had past hypertension. Mean BPs were 112.2 ± 13.1/67.8 ± 7.3 mm Hg for the large cuff and 117.8 ± 13.3/71.2 ± 7.1 mm Hg for the standard cuff (5.5 ± 5.9/3.4 ± 5.2 mm Hg lower with the large cuff; P-values <.0001).Overcuffing leads to a clinically important downward bias in oscillometric measurements. An upper size limits for oscillometric cuffs should be specified.
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                Author and article information

                Journal
                Vasc Health Risk Manag
                Vasc Health Risk Manag
                vhrm
                vhriskman
                Vascular Health and Risk Management
                Dove
                1176-6344
                1178-2048
                29 December 2020
                2020
                : 16
                : 571-575
                Affiliations
                [1 ]Department of Cardiology, Biwako Central Hospital , Otsu City, Shiga 520-0834, Japan
                [2 ]Department of Technology Development, Omron Healthcare Co., Ltd , Mukou City, Kyoto, Japan
                Author notes
                Correspondence: Hakuo Takahashi Department of Cardiology, Biwako Central Hospital , 1-21-27, Hieidaira, Otsu City, Shiga520-0016, JapanTel +81-775290201Fax +81-775020116 Email takahash304@gmail.com
                Author information
                http://orcid.org/0000-0002-6860-8691
                Article
                287016
                10.2147/VHRM.S287016
                7778435
                1a382ed0-f6c2-40f0-930f-b405ee781be9
                © 2020 Takahashi and Saito.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 15 October 2020
                : 10 December 2020
                Page count
                Figures: 0, Tables: 0, References: 7, Pages: 5
                Categories
                Original Research

                Cardiovascular Medicine
                blood pressure monitoring device,accuracy,protocol,standard,validation
                Cardiovascular Medicine
                blood pressure monitoring device, accuracy, protocol, standard, validation

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