HW 02-2 ACCURACY OF THE ELECTRONIC MANOMETER AND THE OSCILLOMETRIC METHOD: WHAT DEVICES TO USE AND ON WHOM?

Until the early part of the 1980 s, home blood pressure (BP) was measured mainly by devices based on the Korotkoff method, in which Korotkoff sounds are detected by a microphone set in a cuff as the BP values are taken. However, when the cuff is not wound in the right place, it causes misalignment between the microphone and an artery, leading to inaccurate measurements. Noise from outside the cuff is also a problem.A mercury sphygmomanometer is generally used with the Korotkoff method. However, mercury mines, mercury use and mercury disposal are receiving increasing attention, and the Minamata Convention on Mercury treaty was adopted in 2013. Upon the treaty's enforcement, the manufacture, import and export of mercury-added products will be banned in 2020 (in principle), and thus mercury sphygmomanometers will also be banned as a mercury-added product.The Japanese Society of Hypertension (JSH) has set up a working group for "the Minamata Convention on Mercury and mercury sphygmomanometers," and in 2016 the JSH issued a statement regarding both the use of mercury sphygmomanometers and a sphygmomanometer designed to replace mercury manometers. The oscillometric method, which came to light in the early 1980 s, has no mercury-related issues and has improved the accuracy and usability of home sphygmomanometers.The oscillometric method detects the vibration of the blood vessel wall (i.e., the pulse wave) by using a pressure sensor. A cuff acts as the pressure sensor, and no microphone is necessary; there is thus no risk of misalignment between the microphone and an artery, or of outside noise. This simple design may reduce the rate of device failures. Oscillometric-method devices are so easy to use at home and their use results in so much less error that the reliability of BP values obtained with these devices is greatly improved. Thus, the oscillometric method is the 'mainstream electronic manometer.'Today, I introduce research findings obtained using an electronic manometer that is based on the oscillometric method, and I explain the usefulness of home BP measurement by an electronic manometer, beyond office BP measured by a mercury sphygmomanometer.