- 
Blood-pressure-and-other-measurements-in-one-location

There are many cardiovascular health parameters and nearly as many diagnostic devices for their measurement, but few as universal as the simple blood pressure (BP) measurement. Yet despite the simplicity of measuring BP, particularly with today’s automated measuring devices, it provides a wealth of information to those who know how to read it.

The importance of BP and BP measurements is, of course, in-built in every physician before they even leave medical school. Hypertension is an important risk factor for a variety of CVDs and cardiovascular system-related conditions like chronic kidney disease (CKD), retinopathy and dementia [1,2, 3, 4].

Hypotension, on the other hand, is less well known among the general public as there generally aren’t any preventive programmes available since the condition is most often caused by acute cardiovascular events, anaphylaxis, septic shock, some medications, endocrine issues and only rarely by lifestyle factors (e.g. vitamin B-12 and folic acid deficiency) [5]. However, both can be equally damaging to the human body, necessitating regular BP check-ups in at-risk patients. But what are they and what other comorbid conditions might they have in addition to hypertension and hypotension?

There are several well-defined risk factors for hypertension, classified as a BP ≥ 140/90 mmHg, although their exact contribution to hypertension and its severity is difficult to determine [6, 7]. The vast majority, up to 95% of hypertensive patients have essential (idiopathic) hypertension, i.e. with no identifiable cause [8]. Secondary hypertension affects the remaining 5% of patients with hypertension and has an identifiable cause—one of the most common being renal artery stenosis.

Individuals with hypertension are at greater risk of CVDs, specifically for those of atherosclerotic aetiology since it is a risk factor for atherosclerosis itself [10, 11, 12].

This includes coronary artery disease (CAD), which is 2.3 times deadlier in hypertensive patients, stroke, cognitive decline, dementia and retinopathy [13, 14, 15]. Lastly, hypertension is a risk factor for peripheral artery disease (PAD) and CKD [16, 17].

Hypotension, on other hand, is more of a physiological state than a condition (disease). Regarded as a BP of 90/60 mmHg or less, it is generally not an issue in otherwise healthy patients without symptoms and is often associated with good health and fitness. Most common symptoms of hypotension are light-headedness and dizziness and even syncope if the BP falls low enough [18]. And like in hypertension, there are several, often overlapping and complex causative conditions. The most serious ones are acute conditions like haemorrhagic shock, heat exhaustion and heat stroke [19, 20].

Accurate BP measurement is therefore essential for proper diagnosis of hyper or hypotension and indirectly underlying causes and there are many devices on the market that offer that. However, no two are alike, both in accuracy and reliability, and in any additional features that would rationalise this simple diagnostic procedure even further and beyond BP measurement. There are a few that cover those aspects well, but only one with integrated support for automatic entry of measurements directly in the patient’s electric health record (EHR) and seamless sharing of data with interested parties.

The MESI mTABLET BP diagnostic tool

The traditional method of measuring BP using a mercury sphygmomanometer is generally recognised as the gold standard for clinical use but is only as accurate and reliable as the equipment used, assuming the examining physician is competent in its use. The reality is unfortunately quite different. On the part of the equipment there are issues with calibration and proper maintenance, leading to significant errors and/or inappropriate cuff size [20, 21, 22].

Physicians are also to blame, whether due to inappropriate training, rounding off numbers to the nearest zero or for underestimating the effect of white coat hypertension [23, 24, 25]. Lastly, and unrelated to their clinical utility, mercury sphygmomanometers have nearly disappeared due to environmental concerns about mercury and its toxicity to humans [26, 27].

There are many alternative measuring devices/methods available, some more comparable with the auscultatory method than others, but none as versatile as the MESI mTABLET BP. Unlike virtually any other BP measuring device, it offers a complete diagnostic solution that goes beyond assessing BP, primarily through integrated support for EHRs. Another important feature is the option to easily expand the diagnostic functionality of the MESI mTABLET with several other diagnostic modules.

The MESI mTABLET BP specifically is comprised of the MESI mTABLET and the wireless BP module supporting 3 cuff sizes. Additionally, the module is battery powered, enhancing its user-friendliness, and has multiple modes of operation. Besides showing a simple numerical BP result, the MESI mTABLET has the option of graphical presentation of pulse waveforms. Combined with easy access to all other medical data for a specific patient, this enables the physician a more comprehensive evaluation of a patient’s cardiovascular fitness and the need for possible treatment or referral to a specialist.

Blood pressure measurement is one of the most typical diagnostic procedures performed by invariably every general practitioner as a part of a standard medical check-up and by cardiologists and other specialists for assessing a patient’s cardiovascular fitness. However, it also becomes an important part of the variety of a patient’s medical history, saved in their EHR and available on the MESI mTABLET BP, which offers seamless sharing of data between healthcare professionals.