Friday, June 17, 2016

Dad just buy you blood pressure monitors the uncertainty

Father's day is here, just wages, of course, want to buy some gifts for Dad under as filial piety.

"Three highs" (high blood pressure, high cholesterol, high blood sugar) is old and has become the most common chronic diseases in the world, from 2000 to 2015, deaths accounted for 41% deaths in hypertensive patients. MUMU sphygmomanometer for Lei Feng NET (search for "Lei feng's network", public interest) provided a copy of the data: at present in their user, one out of 10 people 2.3 people suffering from high blood pressure. Although men and women users is almost flat, but male patients with essential hypertension is far higher than female patients.

Dad, just buy you blood pressure monitors the uncertainty?

Home blood glucose meter on the market taking into account the most invasive, for his father to buy a home blood pressure monitor became the choice of many young people. And now the smart blood pressure monitor main intelligent point is measured on synchronization and subsequent processing of the data. After each test all acquired data can be found in multiple devices and multiple platforms simultaneously.

Just search on search engines, however, is not difficult to find this kind of question:

Electronic blood pressure monitor accuracy?

What is the difference for mercury sphygmomanometers and electronic Sphygmomanometers?

Want to give MOM and dad to buy a blood pressure monitor, what brand is good?

Electronic sphygmomanometer is accurate than mercury blood pressure monitors?

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"Son, I used a few days, feeling how this blood pressure monitor uncertainty? And hospitals to measure the results of same. "

"……"

If you cannot figure out the father's question, my father will tell you, don't buy this gadget.

Spirit of Lei feng's spirit of serving, so we send blood to father no worries, a small series of attempts to answer them at those blood pressure monitor questions.

"Quasi" standard

Simply put, our usual understanding of blood pressure monitor is a noninvasive, invasive blood pressure monitor, there are, but is generally used in the ICU at the hospital, in that we're talking about is non-invasive blood pressure monitors, in accordance with principle into auscultation and oscillometric method two.

Common forms of the former mercury sphygmomanometer, through doctors listen to the pressure in the cuff is in the process of reducing blood pressure value corresponding to the sound interpretation of the blood. This blood pressure monitor is the most traditional and minimum blood pressure monitor, can still see use in hospitals are generally fans of professional, and not single operation. So as an adult fashion, we generally don't choose to buy this for my father.

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Incarnation of the latter is very popular in recent years, "smart" sphygmomanometer is generally called electronic blood pressure monitors, through algorithms to analyze blood flow caused by pressure fluctuations.

Current blood pressure monitor clinical gold standard for auscultation method, evaluation of digital blood pressure monitor is actually by auscultation and comparing it to achieve. In other words, oscillometric algorithm and parameters, but also in the auscultatory method set on the basis of.

Why Auscultation is more accurate?

First, the mercury a sense of pressure, direct and objective, as long as the device does not appear the quality problem, then there is no such thing on the measurement error, secondly, oscillometric method is based on changes in the amplitude of oscillation, by an algorithm to infer the value of blood pressure, because different manufacturers differ in the algorithm, and thus may have subtle differences.

At present many of the digital blood pressure monitor comes with the screen, and can synchronize data on your mobile phone, such as the iHealth blood pressure monitor, but some blood is displayed directly on the mobile phone shows few like MUMU sphygmomanometer.

Mi Jia first iHealth blood pressure monitor is the choice of using a mobile phone direct replacement screen approach. According iHealth Marketing Manager Wang Junshan, was pure Internet do not screen blood pressure monitor, is to know whether people use to pay, but then the second generation still choose to do one blood pressure monitor screen, on the grounds that found that blood pressure monitor or parents, the majority of the audience.

This is evident from the data provided by MUMU was confirmed in: user user reached 42.5% over 50 years of age (Figure 1), while over 45 years purchased a crowd the only 20% of the (unknown not to do the calculation).

Dad, just buy you blood pressure monitors the uncertainty?

Figure 1: age distribution of users

Dad, just buy you blood pressure monitors the uncertainty?

Figure 2: buying distribution

In the survey, 30% the user wants to add a screen display, without mobile phones be used independently to facilitate them; and 22% users who want the hardware voice prompt function, convenient for the elderly. However, regardless of how the population distribution, 80% value to the users of precision measurement and monitoring, even more than the simple operation (60%).

So, as the gold standard of the auscultatory method due to various operational constraints cannot enter the home environment; so how do digital blood pressure monitor to judge its accuracy?

2005 edition of the Guide to prevention and treatment of hypertension in China in 3.4.1 clinic blood pressure provides that:

Choose the standard mercury sphygmomanometer or with the international standards for inspection of electronic blood pressure monitors measurement.

International standards are: United States medical device inspection issued by the Association of AAMI standards and the accuracy of the assessment programme and United Kingdom society of hypertension BHS new programmes launched in 1990. Simply put, if by AAMI or BHS certification of electronic blood pressure monitors, can generally be considered to be highly accurate blood pressure monitor, you can buy with confidence to the elderly.

With the iHealth blood pressure monitor two cases, domestic standard including GB instructions listed on 9706.1-2007 (part one of the medical electrical equipment: General requirements for safety), YY 0670-2008 (automatic measurement of noninvasive blood pressure monitors); JJG692-2010 (verification regulation of noninvasive automatic blood pressure monitor); YY 0505-2012 (electromagnetic compatibility-requirements and tests).

Hardware solves the problem, but the real problem is still to come.

Bias exists

In fact some of the older people will find themselves in hospital referral or in community hospitals doing auscultation blood pressure checks when and at home using oscillometric method for measuring blood pressure values have a deviation, is this why?

This involves three aspects of the problem.

First is the effect of white doctors, in the face of the doctor's time, measured stress cause blood pressure to rise. Old man's blood pressure fluctuations are relatively more affected by the mood, and this may have led to "uncertainty" appearance.

The second is, who has been in a State of fluctuation of blood pressure, even if two blood pressure measurements are the same time, there may also be different, let alone a location and equipment changes have taken place. Even old man brings home blood pressure monitors to hospitals to compare, this comparison will also be fuzzy because of the change in blood pressure.

There is an unavoidable issue, is the measurement of mode of operation. Even in the manual, the manufacturer will unavoidably marked notes, but because of improper operation and measurement are not allowed to exist.

So even the best electronic blood pressure monitor manufacturer, said only in the accuracy of the algorithm and the sensitivity of the sensor to work on, but if you want to swear, that exactly the same data and logging data in the hospital, in fact, is not practical.

After reading this article, when Daddy feel your blood pressure monitors are not allowed to, and concerned when you can use science to make him feel relieved.

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Dad, just buy you blood pressure monitors the uncertainty?

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