1. What is the advantage of storing native cuff pressure curves(oscillograms)?

Oscillogram storage allows to verify measurement results and thus increases the monitoring veracity.

In several cases motion artifacts, deep respiratory waves or arrhythmia may cause errors in blood pressure measurement. If the physician uses only the table with measurement data while processing monitoring results, the verification control of separate measurements is not possible and thus analysis of a 24-hour BP profile can't be considered accurate.

While operating the BPLab monitor the physician has the opportunity to view oscillograms saved together with the measurement results, exclude inaccurate measurements and thus to increase the veracity of the analysis of a 24-hour BP profile. Today this method is considered the most reliable.

The picture below shows an "out-of-order measurement". In this case it is impossible to determine the reason for a short-term BP rise without additional information.

Picture 1. An "out-of-order" measurement that requires verification.

Pictures 2,3; Examples of correct measurements.

Pictures 4,5 Examples of incorrect measurements(subject to manual exclusion).

2. What do I do if the device does not pump air necessary to measure the blood pressure?

Most probably one of the elements of a pneumatic system is letting the air out. Please check if a pneumatic hose or a cuff let the air out. If they do then it's time to renew them. If they don't please contact our technical support team.

3. What is the class of accuracy of the monitor?

According to the results of clinical trials held in compliance with the protocol close to BHS the BPLab ambulatory blood pressure monitor has the A/B grade. The clinical trials were held by the Department of New Diagnostic Methods of Moscow Cardiologic Research Institute.

In 2002 BPLab was validated through ESH-2001 protocol specifications.

4. If I buy a monitor right now won't it become out of date if a new version of algorithm comes out?

No, it won't. New software version will be easily adapted to your monitor free of charge.

Please contact our Technical support team for more information.

5. What is the difference between BPLab Standard and BPLab Advanced models?

BPLab Standard allows to measure blood pressure, pulse rate and cuff pressure but doesn't provide an opportunity to record ECG fragments. Functional characteristics of this model increase the veracity of 24-hour BP monitoring results owing to the opportunity of native cuff pressure curves(oscillograms) verification.

BPLab Advanced records blood pressure, pulse rate, cuff pressure and 2 leads ECG fragments. The ECG record is taken simultaneously with cuff pressure record. This gives the opportunity to verify measurements results with the highest reliance and take record of additional hemodynamic parameters(for example, Pulse Transit Time).

6. Why the BPLab monitor doesn't use an auscultatory channel(Korotkoff method)?

The manual method of blood pressure measurement by Korotkoff sounds is the main diagnostic and therapy's effectiveness estimation method for blood pressure pathology inside clinical environment.

However application of auscultatory technique in ambulatory monitoring has significant drawbacks and limitations: very high sensitivity to microphone's position over the artery and the requirement of a direct contact with patient's skin. As the experience shows during ambulatory monitoring microphone position and direct contact with patient's skin requirement is often violated and all that makes accurate blood pressure measurement impossible and auscultatory high-accurate technique ineffective.

The BPLab ambulatory blood pressure monitor applies oscillometric technique of BP measurement. We managed to create a high-accurate algorithm of BP measurement(in full conformity with ESH-2001 International Protocol).

At the same time BPLab combines all the advantages of oscillometric technique:

• the method is resistant to noise
• BP indices are weakly dependent on the cuff's position and it's movement along the arm of the patient
• oscillometric technique allows to record blood pressure through a thin layer of clothes making the ambulatory monitoring a more comfortable procedure.
• oscillometric devices allow to measure blood pressure when the auscultatory method is not applicable: at perpetual sounds, weak Korotkoff sounds.

Both auscultatory and oscillometric measurement techniques have substantial problems that influence measurement veracity. Some manufacturers use both channels to increase measurement veracity. That makes such devices very expensive but doesn't guarantee 100% veracity. BPLab Standard and BPLab Advanced provide the opportunity to verify measurement results by viewing native cuff pressure curves(oscillograms). Today this method is considered the most reliable.

7. What is the pediatric mode for and what is the difference between pediatric and adult mode?

Pediatric mode guarantees safe blood pressure monitoring for children.

Normally the maximum level of systolic BP for children under 14 is 180 mmHg, while adult's maximum cuff pressure index of 300 mmHg is too high for children and may lead to an injury.

That's why for patients under 14 the pediatric mode is switched on, the cuff pressure in this case won't exceed 200 mmHg.

8. What indices should a BP monitoring report contain?

A typical BP monitoring report contains average daily, average diurnal and nocturnal systolic, diastolic, average hemodynamic blood pressure values, pulse pressure and pulse rate, hypertension daily, diurnal and nocturnal time index for systolic and diastolic blood pressure, variability of systolic, diastolic and pulse pressure, pulse rate for sleep and wakeful state time periods and daily index of BP parameters (nocturnal BP dropping degree).

While reading the actual data taken from a daily profile it's interpretation should be done in juxtaposition with the existing norms of average values of BP, pressure load, variability and two-phase BP rhythm. The interpretation of the analyzed indices is performed applying the patient's journal data. The quality of patient's sleep is very important and when it is bad a two-phase BP rate interpretation is inexpedient.

All the BP monitoring indices are taken on the report's first page for user's convenience.

If BP monitoring was performed at the same time with an intake of an antihypertensive drug it is necessary to specify the drug, the dosage and the periods of an intake. In such a case it is necessary to estimate the effectiveness of an antihypertensive therapy with relation to it's impact on BP monitoring indices.

9. What are the requirements set to antihypertensive drugs with relation to it's impact on BP monitoring indices?

With relation to it's impact on BP monitoring indices an antihypertensive drug should satisfy the following requirements:

• it shouldn't change normal circadian BP rhythm
• it should improve BP monitoring indices
• it shouldn't influence normal BP variability
• it should normalize a high BP variability
• it should provide an optimal BP control in the morning hours

10. Can I change the batteries during BP monitoring?

Yes, you surely can, but first please make sure that the clock on the monitor shows the right time, then press the Start/Stop button, change the batteries and make sure the clock settings haven't changed.