Checking Your Own Blood Pressure
FREE-STANDING HEALTH STATIONS MAY BE FOUND IN THOUSANDS OF LOCATIONS ACROSS THE COUNTRY, AND NOW THE MILITARY IS UTILIZING THEM AS WELL, BUT ARE THEY ACCURATE?
You have probably seen one in nearly every pharmacy you frequent. Maybe you didn’t notice, but it was there. Maybe you have even taken a moment to try it out. What is it? A machine that can check your pulse and blood pressure in a matter of minutes, no nurse of doctor required, and best of all—it’s free. These free-standing health stations may be found in thousands of locations across the country, and now the military is utilizing them as well.
Why are these machines becoming so popular? The answer is relatively simple: everyone at some point worries about—or at least thinks about—their blood pressure. Cardiovascular diseases are the number one killer in the United States, and high blood pressure is an all-toocommon contributor.
In 2004, the American Heart Association estimated that 74 million people in the U.S. had high blood pressure. That’s nearly one in three people and the scary part is one third of those people don’t know they have hypertension, because generally there are not obvious symptoms of the condition. High blood pressure is a silent killer that can lead to stroke, heart attack, heart failure or kidney failure. The only sure way to find out if someone has hypertension is to have their blood pressure checked.
That’s where these self-service, free-standing blood pressure machines come in, allowing you to keep check on your blood pressure, without always needing to visit a doctor for the test. But first, let’s get a little technical here. These machines are officially called sphygmomanometers and they work by first placing your arm is inside a plastic tube that contains the blood pressure cuff. Once the machine is started, the cuff inflates and the reading begins. Typically, results are displayed in about a minute. Most machines display blood pressure and pulse rate. Some machines have a few more bells and whistles, including weight, body fat percentage, body mass index calculators, and even glucose monitors.
BLOOD PRESSURE
Blood pressure is the force exerted by circulating blood on the walls of blood vessels. Blood pressure is broken down into two numbers. The systolic pressure is the peak pressure in the arteries, occurring at the beginning of the cardiac cycle. The diastolic arterial pressure is the lowest pressure, during the resting phase of the cycle. The typical blood pressure of a healthy adult is 120 millimeters of mercury (mmHg) systolic, and 80 mmHg diastolic, or 120/80. Hypertension is generally considered to be present when a person’s systolic blood pressure is consistently 140 mmHg or greater, and diastolic blood pressure is consistently 90 mmHg or greater.
The use of self-service sphygmomanometers is making it easier to get a read on this small part of individual health. But the issue to be raised is: Are the machines generally accurate?
LifeClinic Health Management Systems is the world’s largest supplier of commercial, automated health kiosks. Their blood pressure kiosks can be found in more than 30,000 pharmacies worldwide. David Read, LifeClinic vice president, said that they have placed their self-service blood pressure machines on approximately 200 military installations.
“It’s all part of the preventive care movement,” said Read. “The most common locations are the cafeterias, or just outside the cafeterias, and at the fitness centers. It’s an easy way to educate and empower. Our devices raise questions… which we like.”
Read says military personnel may soon see more LifeClinic blood pressure kiosks. The company is currently working on a comprehensive submittal for a government contract with the General Services Administration. Read expects at least 20 to 25 units will be sold to the government, but estimates that final sales for the year may reach 50 or more.
Colonel Tom Williams is the director of the Army Physical Fitness Research Institute (APFRI) at the U.S. Army War College in Carlisle, PA. Williams told MMT that APFRI placed a LifeClinic blood pressure kiosk on campus in 2003. Located near the library entrance, the $11,500 machine measures blood pressure, weight and also calculates body fat.
One of the major goals of APFRI is to develop fitness guidelines for military personnel over the age of 40. Of course, one of the institute’s major initiatives is to reduce the incidence of heart disease and accompanying cardiovascular conditions, such as hypertension. The blood pressure kiosk serves as an integral part of APFRI’s plan.
“We bring them in and do an initial assessment of their blood pressure, said Williams. “We then encourage them to use the machine. We developed a little card that allows them to track and record their blood pressure over time. Our intent is to teach them that they can keep pushing the incidence of high blood pressure further and further into the future.”
Williams also said that people are encouraged to use the LifeClinic machine as frequently as possible, and during different times of the day and different stress situations, to develop a benchmark of knowledge. Since some people get nervous when they visit a doctor, the kiosk offers a way to get their results in an informal setting when they are comfortable and calm.
“A lot of people have come back and said it is very helpful, because it gave them the spontaneous ability to check their blood pressure. So, on a whim, they can stop and get it checked confidentially, and walk off with that knowledge.”
Williams claims the machine pays for itself quickly. He spoke of people who tracked their stats and one day happened to notice a big difference in their blood pressure. Those individuals immediately went to see a doctor and received fast treatment. He also said a War College graduate contacted him to inquire about getting a blood pressure machine for his civilian workplace.
The Defense Commissary Agency (DCA) has started to place blood pressure machines in commissaries. Currently, there are two free-standing machines: one at the Naval Base San Diego commissary, and one just recently added to the Peterson Air Force Base, Colo., commissary. The DCA is leasing the machines from KK&M Enterprises Inc. dba ScreenAmerica Wellness.
“Right now, we want to measure patron usage as we decide to procure these machines and expand usage to other stores,” said DCA’s Kevin Robinson. “For example, the blood pressure machine at San Diego was installed in conjunction with that store’s grand opening on April 20, 2007. Through October 3, the blood pressure machine at San Diego has had 614 uses. This equates to about six per day.”
Robinson said the introduction of blood pressure machines in the stores is just one facet of the Defense Commissary Agency’s commitment to promote a healthy lifestyle for the armed services community. For example, in July of this year, they partnered with industry to coordinate blood pressure and body mass index screenings for patrons at 76 commissaries.
“Disease prevention is a major priority in the military medical community,” said Robinson. “So we encourage any opportunity for our patrons to get checked before their health fails. In addition to blood pressure screenings, we also are emphasizing better nutrition as a way to improve health and prevent disease. We have started placing health and wellness centers in our stores to focus on nutritional needs. Our use of blood pressure machines in stores is part of the commissary’s ongoing efforts to help improve the health and wellness of its patrons.”
ACCURACY
But one might wonder if these machines are operating at a high level of accuracy. After all, errors in blood pressure readings could lead to serious issues.
When asked about accuracy, LifeClinic said its kiosks are accurate, claiming that the machine has a series of selfchecks to ensure accuracy. The kiosks are not subject to routine calibrations by the company, but Read said the machine’s software will pick up on any problem and the machine would refuse to give any readings if there was a mechanical issue. Further, Read pointed out, that their kiosks meet accuracy standards set by the FDA.
As a completely informal and unscientific survey, I choose five civilian locations, all located in southern Pennsylvania, to do a little comparison. All of the locations had the same model LifeClinic kiosk. I tested my blood pressure and pulse on each machine twice, with the second test immediately following the first reading. I should note that I performed all tests on the same morning, traveling immediately from one location to the next. The following are my results: [Figure 1]
You can see from the data that there was a 15-point range in my systolic pressure and an 11-point range in my diastolic pressure. My pulse fluctuated by ten points, as well. So is that range in numbers due to my body’s fluctuations or the machine’s accuracy? Placards on the LifeClinic kiosks point out that your blood pressure can range as much as 10 to 30 points within a few minutes. They recommend that you take your measurements over a period of time and obtain an average to give you the best indicator of your blood pressure. Those notices also insist that the machines are in no way a substitute for seeing your doctor for a blood pressure measurement.
Another point worth mentioning is that free-standing blood pressure machines use an oscillometric measurement system. This means that the machine uses an electronic pressure sensor to detect blood flow, as opposed to the traditional method where a medical expert uses a stethoscope and his or her ear to measure. Oscillometric monitors may produce inaccurate readings in patients with heart and circulation problems, which include arterial sclerosis, arrhythmia, or preeclampsia. Therefore, they cannot be trusted as a replacement for your doctor’s testing and advice.
Of course, you would never want to use one of these machines as a stand-in for your doctor’s medical expertise. But this technology has allowed individuals a greater hand in improving and tracking their own health. Being proactive and using available technology to keep tabs on your health is both responsible and the wave of the future. ♦