New Technology to Improve Reading Accuracy of Home Blood Pressure Monitoring
In order to measure BP accurately, the cuff must be wrapped correctly and proper posture of the patient during the measurement is essential. Users can find it difficult to 
wrap the cuff in the correct position, especially if they are inexperienced. If the cuff is wrapped incorrectly then the result is less accurate. In addition, irregular pulses due to arrhythmias lead to inaccurate BP readings. Home monitoring devices equipped with automated cuff wrapping and a display indicating correct positioning have been introduced.80 These devices can detect irregular pulses that cause inaccurate BP readings. Moreover, they detect noises and wave pulses within the cuff that are caused by arm movements. These device functions may help provide more accurate BP readings.80
The latest development in HPBM technology is Intelli wrap cuff technology. This features a longer inflatable area within the cuff that wraps all the way round the arm. This reduces pressure loss on the brachial artery, increasing the ‘acceptable range’ of placement and thus reducing the impact of cuff placement on accuracy (see Figure 2). It is also pre-formed, enabling it to be easily fitted with one hand.
An ongoing study evaluated a validated oscillometric device (Omron M6-Comfort; HEM-7321-E) coupled with the Intelli wrap cuff in subjects (planned n=50) aged 50.7 ± 16.0 years with arm circumference 33.3 ± 4.4cm, body mass index 32.8 ± 7.9 kg/m2 and in stable clinical condition. Interim data from this study has recently been presented and shows that incorrect positioning of a conventional cuff significantly affects BP measurement results, with the greatest overestimation of BP when the bladder centre is displaced by 90° laterally or by 180° compared with the correct position. When the Intelli Wrap cuff was used, there was no significant effect resulting from cuff position. BP values obtained with the oscillometric device tended to be lower than those obtained by reference method because of relative undercuffing with the mercury device equipped with standard size cuff in subjects with a large arm circumference.81