Category: A&D Medical

Undiagnosed High Blood Pressure – The Silent Killer

According to new estimates produced by The British Heart Foundation, four million people under the age of 65 in the UK are living with untreated high blood pressure with further analysis finding that 1.3 million of these people are under the age of 45. 

As well as significantly raising the risk of heart attack and stroke, it can also be the cause of an increased risk of vascular dementia, raised cholesterol and diabetes.

Getting your blood pressure under control is one of the most important things you can do to reduce your risk of having a heart attack or stroke.

Checking your own blood pressure with an A&D Medical clinically validated BP monitor is an easy and inexpensive way to understand if you are one of the millions of people across the UK living with undiagnosed high blood pressure and giving you the information needed to get the correct treatment and advice.

Taking a blood pressure reading takes less than 5 minutes and can be done in the comfort of your own home not just in a doctor’s surgery or pharmacy.   

Many people assume that high blood pressure is generally associated with older, overweight or unfit people. Though these conditions can lead to a high risk of heart attack and stroke, many people with an active lifestyle can also fall victim to this silent killer.

A considerable number of young people in the UK aged 16 to 24 unknowingly have risky high blood pressure too.

Stessful workplace environments are a major cause of high blood pressure with busy people all too easily putting the issue to the back of their minds.

Ordering an A&D Medical clinically validated BP monitor and getting your blood pressure under control is one of the most important things you can do to reduce your risk of having a heart attack or stroke.

With waiting lists at an all time high and the NHS under more pressure than ever before, acting now could give you the greatest opportunity to receive the life-saving treatmment you may need.

PMS Instruments stock a vast range of blood pressure monitors with different cuffs sizes to suit every individual.

So don’t become a statistic, order yours today and give yourself the best chance of taking the necessary steps to avoid long-term harm.

New UP-200 Pulse Oximeter

The A&D Medical UP-200 fingertip pulse oximeter is an easy to operate oximeter featuring one-button control. Designed to measure arterial oxygen saturation (SpO2) and pulse rate in adults it is suitable for use in hospitals, GP Practices or home use. Simply place the Pulse Oximeter on your finger, press the button, and the results are clearly shown in any direction on the easy to read autorotate LCD.

With its fast measurement response time the device is small, light-weight and portable making it easy to take measurements on the go. The power saving features prolong battery life, whilst the low battery indicator ensures you’re never caught out.

With its rotational display the UP-200 features different display modes and will display, SpO2%, pulse rate, pulse waveform and pulse intensity on its display. Compliant with the IEC 60601-1 Quality Standard, the UP-200 fingertip pulse oximeter is suitable for on the spot Sp02 measurements and has an IP ingress protection of 22.

Key Features

• LED display
• CE 0123 Marked
• Displays SpO2%, pulse rate, pulse waveform and pulse intensity
• Auto power off
• One button control
• Universal finger clip suitable for adults
• Lightweight and portable
• Autorotate view readings from any angle
• Requires 2 x AAA batteries (supplied)
• 2 year warranty

Supplied with

• Carry case
• Lanyard
• Instruction manual
• 2 AAA batteries

Cuff Size Matters

Blood pressure monitors with an upper arm cuff provide the most accurate blood pressure readings but using the correct cuff size is really important in order to avoid inaccurate results.

Ensure the cuff is the correct size

If the cuff you use is too small for the arm, your blood pressure reading will be artificially high. If your cuff is too large, you may get a lower-than-actual reading. This is known as miscuffing.

On people with big arms, a large cuff is needed and as a general rule the inflatable bladder in the cuff needs to encircle at least 80% of the arm. The width of the cuff should be at least 40% of the arm circumference.

Measure your arm

To make sure you are using the correct size cuff for your arm place a tape measure around the bicep, at mid-arm to measure the arm circumference in cm. The left arm is typically used.

Typical cuff sizes

Not all blood pressure monitors can use different sizes of cuffs. Check with us first to make sure your digital A&D Medical UA and UM series or Meditech ABPM device can.

Typical cuff size ranges are as follows but can vary by manufacturer. For A&D UA series monitors the following cuff sizes are available.

  • Small fits an upper arm between 16-24 cm
  • Adult fits an upper arm between 22-32 cm
  • Semi-large fits an upper arm between 23-37 cm
  • Wide range fits an upper arm between 22-42 cm
  • Large adult fits an upper arm between 31-45 cm

Wide range cuffs like that supplied with the A&D Medical UA-1020-W are becoming popular with clinicians as one cuff can be used across a wider arm circumference range. This monitor can also use a small cuff.

All A&D Medical and Meditech cuffs have visual range markers to make cuff positioning easier and ensure the correct size is used. When applied correctly the cuff should wrap snugly around the arm with just enough space to slide two fingertips underneath.

One cuff does not fit all and using the correct cuff size is important both for healthcare professionals in a clinical setting and the public when buying monitors for home use.

Identify More Hypertensives With A Waiting Room Blood Pressure Monitor

Guidance on preventing cardiovascular disease (CVD) was originally published in 2019 and was updated this year.  Optimal treatment of AF, high blood pressure and raised cholesterol is highly effective in preventing CVD events.

Over 40% of people with high blood pressure remain undiagnosed and of those diagnosed with high blood pressure, only 67% are optimally managed.

How do we diagnose and manage more effectively?

GP Practices are encouraged to actively screen patients and seek out hidden hypertensives. To the average practice this could mean hundreds of extra appointments for a simple blood pressure measurement.

They need help in the form of the easy to use, clinically validated A&D Medical TM-2657P waiting room blood pressure monitor.

Originally the idea of allowing patients to measure their own blood pressure was greeted with scepticism by some clinicians, but practice managers were quick to see the advantages.

Ideally located in a quiet corner of the waiting room, this type of monitor is designed for professional high volume use and automatically prints a reading, with the date and time, on a small slip of paper.

The patient usually shows this reading to the doctor or nurse at the beginning of the consultation and if the readings are too high or low they can then re-measure. In some practices patients hand results to a member of the reception team, who record it electronically for later review.

For practice managers, they offer good management and effective use of resources freeing clinical staff for other roles where they may be better utilised. Some practices report they ‘save’ up to 100 appointments per month on average.

For patients the feedback is positive and the monitors promote understanding and compliance.

Recently we have been involved in a couple of projects looking to target patients who don’t visit a GP regularly or have access to another healthcare provider. TM-2657P blood pressure monitors have been placed in public access buildings like Libraries and Pharmacies.

They have identified new undiagnosed hypertensives with elevated blood pressure and helped manage existing hypertensive patients promoting medication compliance.

PMS Instruments. Expertise, Experience and Trust for service, calibration and support.

These are the key words our customers associate with PMS Instruments, as well as being the fundamental foundations of our calibration and service department.

Back in 2016 I posted an article with a picture of an A&D Medical TM-2655P waiting room blood pressure monitor that had recorded a staggering 103,366 readings since we originally supplied it in 2004!

Since then, we have calibrated and serviced a number of A&D Medical waiting room blood pressure monitors that have recorded in excess of one hundered thousand readings!

At PMS Instruments as an ISO-9001 Quality Assured company we keep detailed service and calibration records for every item of equipment we service and repair.

What’s the secret of this reliability and low cost of ownership?

I am convinced it is regular, preventative and routine servicing by PMS Instruments which extends the ‘in service’ life of the monitors and prolongs the investment our customers make in their equipment.

How does the service you get from PMS Instruments differ?

The A&D Medical TM-2655P and TM-2657P waiting room blood pressure monitors are specialist instruments, requiring specialist knowledge and test equipment.

With every service and calibration PMS Instruments carries out, each monitor is subjected to an approved individual ISO-9001 quality assured Work Instruction. This comprises a series of up to 70 detailed steps our service engineers must follow, and which the product must pass, in accordance with the manufacturer’s service manuals.

You get so much more from PMS Instruments than the basic 10 minute on site functional test some companies offer.

Our popular Fixed Price Service and Support Plan includes:

  • Annual calibration of your device and detailed calibration certificate issued.
  • Priority unlimited telephone and technical support.
  • Fixed price servicing cost.
  • Fast priority response for all servicing and repairs.
  • 20% discount off non standard service items including pumps
  • Standard service parts and consumables including filters.
  • Replacement of the cotton cuff inner.
  • Supply of premium packing box and material included.
  • Courier collection and return included.
  • Priority turnaround time typically 3-5 working days from receipt of equipment.
  • Inclusive annual service and calibration to manufacturer’s specification.

You get what you pay for…

PMS Instruments’ service and calibration team are certified to ISO-9001 and use only genuine manufacturer approved spare parts.

Depending on the model it can take up to 90 minutes for our Service Engineers to adjust, calibrate and service an A&D Medical waiting room blood pressure monitor and we are the experts at it! Rapid turnaround time means minimum downtime and a full service and calibration certificate is issued.

Not convinced and still want to use another company?

Can the company you use tell you how many readings your waiting room blood pressure monitor has taken during its lifetime? If they can’t schedule your service and calibration with PMS Instruments and we will.

Monitoring Your BP At Home

Monitoring your blood pressure at home and can be a way to feel more in control of your own health and wellbeing. Your GP may even have recommended you take your own BP measurements at home so that you know your numbers.

But which home BP monitor to buy? There are so many now on the market, available from anywhere from your local supermarket to large online retailers. The options can seem over whelming. It needn’t be.

When choosing a BP monitor we would recommend you check for 3 things 

  1. Has it been clinically validated? This means it has been tested and approved by the British and Irish Hypertension Society (BIHS) and will it provide arcuate and reliable readings.
  2. Is it fully automatic as these are the easiest monitors to use at home.
  3. The cuff fits your arm. Cuffs come in a range of sizes but most monitors are supplied with a standard adult cuff which will fit an arm measuring 22-32cm. The cuff should wrap snugly around your upper arm, with just enough space to slide two fingertips underneath.

You can purchase an additional cuff which will fit your arm if your arm is either smaller or larger than a standard cuff size.

Or look for a monitor with a wider range cuff such as the A&D Medical UA 767S-W which is supplied with a wide ranging cuff which will fit an arm measuring 22-42 cm. For more of the monitors features Click here

The A&D Medical UA 767S + AFib is a popular choice for its proven record of reliability and wide use across the UK with GP surgeries and within the NHS. It also comes with a 5 year warranty. For more of the monitors features Click here 

PMS Instruments can supply you with a BP monitor to suit you, your needs and your budget.

The ISO 80369-5 BP Cuff Standard

ISO80369-5 was developed as an international standard to prevent cuff connection errors with different types of medical devices that use the same or similar connectors. Whilst connection errors were few and far between they could have fatal consequences.

The US Food & Drug Administration (FDA) reported several real life incidents involving misconnections.

In one a blood pressure cuff was accidentally connected to an Intra Venous (IV) catheter.

A patient had an IV catheter in their arm but no IV fluids had been started. The patient also had an automatic BP cuff fitted on the same arm for continuous monitoring. The BP cuff tubing was disconnected from the blood pressure monitor while the patient went to the bathroom.

When she returned, her spouse accidentally connected the BP cuff tube to the IV catheter and approximately 15 mL of air was delivered to the IV catheter by the blood pressure monitor.

Unfortunately the patient died from a fatal air embolus, despite resuscitation efforts.

As a precaution and so this can’t happen again new ISO connectors are being introduced on blood pressure cuffs to ensure correct device connections, even in complex working environments and avoiding fatal consequences.

Japanese company A&D Medical are one of the first manufacturers of clinically validated digital blood pressure monitors to have introduced ISO-80369-5 connectors to their blood pressure cuffs and monitors.

The latest UA-651SL Plus is compliant with the ISO80369-5 regulation. It features A&D Medicals latest 4th generation Electric Control Exhaust Valve (ECEV) which precisely controls cuff deflation.

This low cost digital monitor can use 4 different cuff sizes for arm sizes ranging between 16cm – 45cm, including small, adult and large cuffs.

In the UA-651SL Plus A&D Medical are one of the few manufacturers to have a model that can use small, adult and large adult cuffs.

It’s important to note that ISO80369-5 cuffs cannot be used with non-compliant ISO80369-5 blood pressure monitors and they are not interchangeable with earlier models.

Life Goes On

It’s very easy to forget that life, although not as we knew it, is still going on. Covid 19 has dominated our lives for the last 6 months and it looks set to continue that way for at least the next 6.

Many GP surgeries have put a temporary hold on offering 24 hour ABPM services

Some are using waiting room BP monitors in place of face to face measurements. Others are not using them at all to reduce the number of patients in the waiting room.

Some are not using the waiting room at all requesting that their patients wait outside the surgery until called directly into the consulting room.

There are so many different ways and we are all trying to provide the best service we can during these strange unprecedented times.

Now could be the perfect time to get your Surgeries BP monitors serviced, if they are not currently being used, so they are ready for when things return to a more normal service.

Some surgeries have decided to wait until they feel comfortable in offering monitoring again.

Either way however you are dealing with the current pandemic we will continue to offer service and calibration of A&D Medical waiting room BP monitors, Meditech ABPM monitors and ECG monitors.

I am pleased to report that for the 27th year running we recently passed the ISO9001 quality standard audit. We are registered to provide repairs and support services for a range of specialised medical instruments.

With us you can be assured that when your monitors are serviced they go through a  comprehensive assessment of up to 70 tests carried out by our own manufacturer trained engineers.

As all monitors are collected and returned by our courier the engineer does not have to enter your premises, therefore maintaining all of your existing covid-19 safety measures.

Despite the Pandemic we are maintaining our fast turnaround time which remains at 3-5 working days. All it to takes to arrange is a quick call or email to us and we will do the rest.

Nothing is normal right now but life does go on and you can be assured we are still here offering you our support and service.

Detecting Irregular Heartbeats (IHB)/AFib Using A&D’s Latest Blood Pressure Monitors.

A&D have a long history and pedigree in pioneering innovation and the development of blood pressure monitors with leading edge functions. With over 40 years of patient-focused thinking it has made them one of the leading blood pressure manufacturers in the world. Their latest clinically validated digital monitors feature a new 2nd generation IHB/AFib algorithm to detect an irregular rhythm during a measurement. 

It is currently available in the latest 2019 versions of the UA-767S AFib+ and UA-767S-W AFib+ from leading distributor PMS Instruments and will be available in more models soon.

It’s the latest development of an Irregular Heartbeat (IHB) detector and algorithm originally pioneered by A&D in 2014. With this feature as well as the existing World Health Organisation (WHO) blood pressure classification index introduced in 2003, A&D monitors really are at the Heart of Healthcare Technology.  

Why is the detection of Atrial Fibrillation important?

AFib is an irregular heart beat that can lead to strokes and other heart related conditions.

The NHS long term plan (NHSLTP) recently published ambitious targets for Atrial Fibrillation (AFib) and high Blood Pressure detection over the next 10 years.

For Atrial Fibrillation the targets are

That 85% of the expected number of people with AF are detected by 2029

That 90% of people with AF who are known to be at high risk of stroke to be adequately anti-coagulated by 2029.

The A&D UA 767S Afib+ and UA-767S-W Afib+ with %IHB/AFib detection could help with these aims.

The monitors classify the %IHB into 4 different grades showing how often an IHB has been detected during the measurement and illustrated by an icon.

0% no indication

1 – 9% grade 1

10 – 24% grade 2

25 – 100% grade 3

This feature is for monitoring purposes only and we recommend contacting your doctor if the grade is high.  

This new feature has been clinically validated and published in the Journal of Clinical Hypertension J Clin Hypertens. 2017;19:1143–1147 Tomoyuki Kabutoya et al. The paper concludes that the new algorithm had high diagnostic accuracy for detecting AF and a low false-positive rate.

New Fixed Price Service Package.

We are pleased to announce the introduction of new Fixed Price Service Plans for selected A&D Medical and Meditech devices including the Meditech ABPM-04/ABPM-05 and A&D TM-2655P/TM-2657P waiting room blood pressure monitors.

PMS Instruments are an approved A&D Medical and Meditech service and repair centre and our new Fixed Price Service Plan includes:-

  • 12 months priority software telephone and remote technical support
  • 12 months remote assist training and installation where applicable
  • Fixed price servicing cost including labour and service parts
  • Fast priority response for all servicing and repairs
  • Loan equipment (subject to availability)
  • FREE preventative maintenance and calibration check
  • Up to 70 point test procedure verifies equipment accuracy, patient safety and reliability
  • Fully insured courier collection and return included
  • Priority turnaround time typically 3-5 working days from receipt of equipment
  • Inclusive annual service and calibration to manufacturer’s specification
  • ISO-9001 Quality Assured service centre and Practice Index approved supplier
  • No need to pay to get this equipment serviced by 3rd party

We use genuine manufacturer approved spare parts, and adhere to recommended preventative and service procedures.

For pricing and to protect your equipment investment and ensure it is accurate, safe and reliable act today by calling 01628 773233 or email support@pmsinstruments.co.uk

Just one call or email is all it takes and we will do the rest.

Why Buy A Clinically Validated Blood Pressure Monitor?

The sales team at PMS often get asked the same questions from customers wanting to purchase a blood pressure monitor. Questions like which one would you recommend and which is the best one we sell will depend on the features a user is looking for and their budget.

One question we are always happy to answer is “What does clinical validation mean?”

Many customers are familiar with the CE mark on consumer electrical items.

Medical devices like blood pressure monitors must also have a CE mark by law. The CE mark means that, provided you use it correctly, the device will work properly and is safe but doesn’t mean it will necessarily give accurate readings or that it is clinically validated.

Whether you are going to record your blood pressure at home or in a clinical setting surely accuracy is the whole point of buying a monitor in the first place!

When a manufacturer like Meditech or A&D Medical state their product is “clinically validated” it means an independent validation of the device has been performed by a professional group

The most common validation protocols are the British and Irish Hypertension Society (BIHS), formerly British Hypertension Society, the European Society of Hypertension International Protocol (ESH-IP), and the Association for the Advancement of Medical Instrumentation (AAMI).

While each of the protocols may have many similarities, there are some differences in their testing requirements. In many cases, however, a product that passes one protocol may also satisfy the criteria of other protocols as well. Recently, the AAMI, ESH, and ISO experts agreed to develop a single universally acceptable standard (AAMI/ESH/ISO), which will replace all previous protocols.

Often, the clinical validation report is published in a peer-reviewed journal like Blood Pressure Monitoring.  Publication in a peer-reviewed journal is essential because of the rigorous review processes a clinical validation must go through to make sure there are no protocol violations and the chosen validation protocol has been adhered to.

The time and conditions demanded by the various protocols are extremely difficult to fulfil as a large number of subjects have to be recruited, a wide range of blood pressures are required and it can be difficult to recruit skilled staff . They can also be expensive.

There is a great overview of the detailed process involved from the Working Group on Blood Pressure Monitoring of the European Society of Hypertension here.

For these reasons not every blood pressure manufacturer will conduct a clinical validation.

PMS Instruments only distribute blood pressure monitors from manufacturers that do. Clinical validation provides so much more than a CE mark!

Whether you are a healthcare professional, or someone looking to keep a check on their blood pressure at home a clinically validated blood pressure monitor from Meditech or A&D Medical gives you the confidence to know you’re using a reliable, accurate device to make a clinical decision.

A&D Medical clinical validation studies

Validation of the A&D UM-211 device for office blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010
Fania, Claudio; Albertini, Federica; Palatini, Paolo
Blood Pressure Monitoring, October 2017,22(5):302-305

Validation of the A&D UM-201 device for office blood pressure measurement according to the European Society of Hypertension International Protocol Revision 2010
Fania, Claudio; Albertini, Federica; Palatini, Paolo
Blood Pressure Monitoring, August 2017,22(4):234-237

Validation of the fully automated A&D TM-2656 blood pressure monitor according to the British Hypertension Society Protocol (equivalent to TM-2657P)
Zeng, Wei-Fang; Liu, Ming; Kang, Yuan-Yuan; Li, Yan; Wang, Ji-Guang
Blood Pressure Monitoring, August 2013,18(4):223-226

Validation of the A&D BP UA-651 device with a wide-range cuff for home blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010
Benetti, Elisabetta; Fania, Claudio; Palatini, Paolo
Blood Pressure Monitoring, June 2015,20(3):164-167

Validation of the A&D BP UA-651 device for home blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010
Benetti, Elisabetta; Fania, Claudio; Palatini, Paolo
Blood Pressure Monitoring, February 2014,19(1):50-53

Validation of the A&D UA-1020 upper-arm blood pressure monitor with six different-shaped or different-sized cuffs according to the British Hypertension Society protocol
Zeng, Wei-Fang; Kang, Yuan-Yuan; Liu, Ming; Li, Yan; Wang, Ji-Guang
Blood Pressure Monitoring, October 2013,18(5):272-277

Validation of the A&D UA-1020 upper-arm blood pressure monitor for home blood pressure monitoring according to the British Hypertension Society Protocol
Zeng, Wei-Fang; Kang, Yuan-Yuan; Liu, Ming; Li, Yan; Wang, Ji-Guang
Blood Pressure Monitoring, June 2013,18(3):177-181

Validation of A&D UA-778 blood pressure monitor in children
Narogan, Marina V.; Narogan, Marina I.; Syutkina, Elena V.
Blood Pressure Monitoring, October 2009,14(5):228-231

Validation of A&D UA-85X device for blood pressure measurement
Bonso, Elisa; Ragazzo, Fabio; Palatini, Paolo
Blood Pressure Monitoring, December 2008,13(6):339-341

Validation of A&D TM-2430 upper-arm blood pressure monitor for ambulatory blood pressure monitoring in children and adolescents, according to the British Hypertension Society protocol
Yip, Gabriel Wai-Kwok; So, Hung-Kwan; Li, Albert Martin; Tomlinson, Brian; Wong, Sik-Nin; Sung, Rita Yn-Tz
Blood Pressure Monitoring, April 2012,17(2):76-79

Validation of the A&D UM-101 professional hybrid device for office blood pressure measurement according to the International Protocol
Stergiou, George S.; Giovas, Periklis P.; Gkinos, Charilaos P.; Tzamouranis, Dimitris G.
Blood Pressure Monitoring, February 2008,13(1):37-42

Meditech clinical studies

Reproducibility of 24-h ambulatory blood pressure and measures of autonomic function
Morrin, Niamh M.; Stone, Mark R.; Henderson, Keiran J.
Blood Pressure Monitoring, June 2017,22(3):169-172
Brief Report

Obstructive sleep apnea increases systolic and diastolic blood pressure variability in hypertensive patients
Shi, Jing; Piao, Jingyan; Liu, Bin; Pan, Yujiao; Gong, Yongtai; Deng, Xianzhu; Sun, Weiyan; Lu, Shuang; Li, Yue
Blood Pressure Monitoring, August 2017,22(4):208-212
Clinical Methods and Pathophysiology

The influence of physical training status on postexercise hypotension in patients with hypertension: a cross-sectional study
Imazu, Alexandre A.; Goessler, Karla F.; Casonatto, Juliano; Polito, Marcos D.
Blood Pressure Monitoring, August 2017,22(4):196-201
Clinical Methods and Pathophysiology

Clinical practice of ambulatory versus home blood pressure monitoring in hypertensive patients
Paolasso, Jorge A.; Crespo, Florencia; Arias, Viviana; Moreyra, Eduardo A.; Volmaro, Ariel; Orías, Marcelo; Moreyra, Eduardo Jr
Blood Pressure Monitoring, December 2015,20(6):303-309
Clinical Methods and Pathophysiology

The association of night-time systolic blood pressure with ultrasound markers of subclinical cardiac and vascular disease
O’Flynn, Anne Marie; Ho, Emily; Dolan, Eamon; Curtin, Ronan J.; Kearney, Patricia M.
Blood Pressure Monitoring, February 2017,22(1):18-26
Clinical Methods and Pathophysiology

Myocardial ischemia during everyday life in patients with arterial hypertension: prevalence, risk factors, triggering mechanism and circadian variability
Uen, Sakir; Un, Ismail; Fimmers, Rolf; Vetter, Hans; Mengden, Thomas
Blood Pressure Monitoring, August 2006,11(4):173-182

Development of normative ambulatory blood pressure data in children: Marianne Soergel and the Arbeitsgruppe Pädiatrische Hypertonie
Blood Pressure Monitoring, June-August 1999,4(3):121-126

Making ambulatory blood pressure monitoring accessible in pharmacies
James, Kirstyn; Dolan, Eamon; O’Brien, Eoin
Blood Pressure Monitoring, June 2014,19(3):134-139

Simultaneous recording of blood pressure and ST-segment with combined, triggered ambulatory 24-h devices
Uen, Sakir; Vetter, Hans; Mengden, Thomas
Blood Pressure Monitoring, February 2003,8(1):41-44

Silent myocardial ischaemia in treated hypertensives with and without left ventricular hypertrophy
Stojanovic, Milos M.; O’Brien, Eoin; Lyons, Simon; Stanton, Alice V.
Blood Pressure Monitoring, February 2003,8(1):45-51

The twenty year wait has been worth it!

The new A&D Medical TM-2440 and TM-2441 Ambulatory Blood Pressure Monitors are now available to pre-order from lead distributor PMS Instruments. They replace the old TM-2430 which PMS originally introduced in 1998.

Engineered in Japan, they are the 4th generation of A&D ABPM monitor PMS Instruments have launched in the UK and easily the most advanced to date. Both new models have a number of new innovative premium features.

With the launch of 2 new ABPM monitors at once the twenty year wait has been worth it!

The A&D TM-2440 Classic abpm comes as standard with fast measurement time, silent operation and with a world first in an A&D ABPM, IHB (Irregular Heart Beat) analysis technology.

This ground breaking technology pioneered by A&D in 2001 is now used worldwide assisting in the opportunistic detection of arrhythmias – which include AFib (or Atrial Fibrillation). It features Oscillometric waveform measurement analysis and with the new analysis software you can check the waveform record for each measurement.

The TM-2441 Premium ABPM with it’s all in one design concept offers the clinician and patient complete flexibility, providing Ambulatory (ABPM), Home (HBPM), Office (OBP), Automatic Night Blood Pressure (ANBP), and Automatic Self Blood Pressure (ASBP) measurement/monitoring in one device.

In addition to the Irregular Heart Beat analysis technology, it records environmental factors including Activity using a built in Accelerometer, Temperature and Air Pressure. The new TM-2441 provides additional more insightful view of the patient beyond just blood pressure recording and heart rate information – helping build a better picture for clinical decision making.

Both models for the first time are available with 4 different cuff sizes small, adult, large adult and extra-large adult with sizes fitting an arm circumference from 15-22cm right up to 36-50cm.

The new AND Analysis software allows PDF reports to be exported to popular clinical management systems like EMIS and SystmOne and is compatible with the old TM-2430.

The TM-2440/TM-2441 feature both USB and Bluetooth communication, use just 2 AA batteries and at just 120g, the TM-2440 is one of the smallest, lightest ABPM monitors on the market.

To discuss competitive upgrades or arrange a demonstration or trial call us today.

Ideal Professional BP Package

Up until now many Hospitals and GP Practices have purchased low cost digital blood pressure monitors designed originally for home or retail use. As good as some of these monitors are they are not necessarily designed for repeated use on a daily basis or designed to stand up to the rigours of Hospital or Primary Care use.

Monitors in these environments can be subjected to drops and knocks associated with a busy ward or unit.

Expensive vital signs type monitors are available but with extra features not necessarily needed by all.

The A&D Medical UM-201 aims to sit somewhere between these two camps and is aimed at the clinician looking for simple one button operation, accurate readings, cost effectiveness whilst anticipating heavy daily use. It concentrates on features customers actually want, like a large LCD display, long cuff tube, fast measurement times and simple one button operation.

The durable and chemical resistant body and cuffs are easy to clean and disinfect with common antiseptic agents and the low whole life running costs make this suitable for the Hospital environment. The UM-201 features A&D’s latest Electronic Constant Exhaust Valve (ECEV) for enhanced measurement accuracy as well as Irregular Heartbeat Detection (IHB) technology.

We recently introduced a UM-201 Pro package which includes a small (16-24 cm), adult (22-32cm) and large (31-45cm) cuffs as well as a mains adaptor. At £99 it is proving a popular package and for most the complete professional blood pressure solution.

 

What’s the future for manual blood pressure measurement devices?

Since 10 April 2014 and the implementation of EU Commission regulation no 847/2012 the sale of new Mercury sphygmomanometers to the healthcare sector has been banned.

The alternative? Electronic manual sphygmomanometers like the A&D UM-102A mimic the Mercury sphygmomanometer but have none of the inherent disadvantages. These devices blend the best of modern, reliable vertical LCD technology, with the traditional advantage and reassurance of a manual measurement whilst listening to Korotkoff sounds with a stethoscope.

Unlike Mercury sphygmomanometers, devices like the A&D UM-102A sphygmomanometer don’t require routine cleaning or maintenance and can be used at any angle with a wide range of cuffs sizes and on patients with arrhythmias.

There is no oxidisation of the LCD which could alter the dynamic response and readings can be read to a single digit mm/Hg. Most importantly, if a product like the A&D UM-102A gets dropped you won’t end up with a contaminated treatment room and an expensive and time consuming mercury spill to clean up!

Alternative clinically validated Mercury free sphygmomanometers are available, so clinicians do still have a choice as to whether they use a manual method to record blood pressure with a stethoscope or an automatic device.

Manual devices, like the A&D UM-102A, are more tactile to use and can provide the clinician with additional useful information, like regularity or strength of pulse, provided they are used correctly and users have proper training.

A history of A&D Medical

A History of A&D Medical

At PMS Instruments we’re proud of the fact that we are the UK’s largest distributor of A&D’s innovative blood pressure monitors for both home healthcare & healthcare professionals and have been since 1989!

A&D are an established and trusted blood pressure brand and with our near 30 year experience with them in the UK and Ireland I thought it a great opportunity to provide a little history, as PMS Instruments have been with them all the way!

Who are A&D? A history of innovation.

A multi-national Japanese company established in 1977 A&D are world leaders in measurement technology and launched their first blood pressure model the UA-102, in 1979. They use their unique skills in analog-to-digital and digital-to-analog conversion technology to produce state-of-the-art equipment, including electronic balances, scales, weighing indicators and of course blood pressure monitors.

Success by investing heavily in Research & Development.

In 1984, they introduced their innovative oscillometric blood pressure measurement technology. Over time and backed up by numerous independent clinical studies the oscillometric method went on to become the standard method for digital blood pressure monitoring in both home healthcare and professional healthcare markets throughout the world.

2001 saw the first introduction of their unique Irregular Heartbeat Indicator in blood pressure monitors closely followed in 2003 by another innovation, the World Hypertension Society (WHO) blood pressure classification index. Both technologies are still in use today and found in millions of A&D blood pressure monitors worldwide.

Other innovative products like the iconic TM-2655P waiting room blood pressure monitor followed in 2002 with the Mercury free UM-101 sphygmomanometer arriving in 2005. New updated versions of these models were introduced last year (TM-2657P, UM-102).

Keeping up to date with Telemedicine, Telehealth and Wellness Connected.

In 2015, A&D launched their Wellness Connected app, giving patients the option of syncing their Blood Pressure results to their smartphone or tablet allowing users to manage and monitor their health, in one simple, easy-to-use app.

The latest innovation in A&D’s product range, the UM-201 Blood Pressure Monitor, has just been validated to the International Protocol and offers one-touch Oscillometric measurement, variable cuff sizes & is clinically validated for accuracy.

Why buy an A&D BP monitor and why buy it from PMS Instruments?

If I am asked this question I happily remind potential customers that A&Ds “Honmono” philosophy means they are one of the few manufacturers to focus on the consumer and professional blood pressure markets and as noted above have a proven pedigree and track record of accuracy and reliability.

Whether it is a monitor for home use, 24 hour ABPM or waiting room BP monitor here’s why you should purchase your A&D BP monitor from PMS Instruments.

  • Largest UK Distributor of A&D blood pressure monitors
  • NHS Supply Chain partner
  • ISO-9001 approved service, repair and warranty partner
  • Extensive A&D experience
  • 5* independent customer service approval
  • Latest current models in stock
  • Extensive range of spare parts and accessories from stock
  • Free demonstration and loan on some models

Are we doing enough to diagnose high blood pressure?

How often do you “Think BP”?

Did you know that in the UK alone, according to the British Heart Foundation (BHF), there are an estimated 7 million people with undiagnosed high Blood Pressure who don’t know they are at risk. Over 24% of people in England are estimated to have high Blood Pressure. At least half of all heart attacks and strokes are associated with high BP and it is a major risk factor for chronic kidney disease, heart failure and cognitive decline.

If these are the challenges facing Primary and Secondary Care the question is what can GP Practices, Hospitals and Clinical Commissioning Groups do to diagnose more patients with high blood pressure?

Can we do BP better and “Think BP”?

The BHF Guidance recommends key areas and stresses that clinicians should “Think BP” at every opportunity. I have separated their recommendations into a couple of key areas below where I think existing technology available from PMS Instruments could help.

Think BP in the Waiting Room— Consider giving patients access to a self-test blood pressure station in GP waiting rooms and Hospital Outpatient clinics. Professional, clinically validated monitors like the A&D Medical TM-2657P are designed for high volume use have been popular with GPs for many years and are now being used in Hospitals. They save both time and money in the long run and especially in a Hospital setting like a Renal Unit free up members of staff for other clinical duties.

Think BP during a consultation-Think BP and increase opportunistic screening in your GP Practice or Hospital. Make blood pressure testing routine for all patients attending clinics such as Renal, Sexual Health, Asthma, COPD, Diabetes, weight management, smoking cessation and other clinics. Patients can record their blood pressure in the GP or Hospital waiting room before they attend the clinic. The printed results can then be handed to the clinician during consultation saving time and staff resources.

For a trial, demonstration or to find out more about the TM-2657P call us today on 01628 773233.

PMS Instruments. Expertise, Experience and Trust for service, calibration and support.

These are the key words our customers associate with PMS Instruments as well as being the fundamental foundations of our calibration and service department.

I recently posted on Facebook a picture of an A&D Medical TM-2655P waiting room blood pressure monitor that had recorded a staggering 103366 readings since we originally supplied it in 2004!

Having visited the R&D centre in Japan I know the engineering quality, research and development that A&D Medical put into the design and manufacturer of their products but was intrigued and asked one of our service engineers to give me the service history of the monitor over the last 12 years.

We keep detailed service and calibration records for every item of equipment we service and repair. The monitor had a new cuff mechanism fitted in 2007 which we replaced under warranty but other than that had had no other parts fitted just regular, routine and preventative maintenance.

What’s the secret of this reliability and low cost of ownership?

I am convinced it is regular, preventative and routine servicing by PMS Instruments which extends the in service life of the monitors and prolongs the investment our customers make in their equipment.

Why do I think this? There are any number of medical companies that visit GP surgeries in the UK offering to service and calibrate a wide range of blood pressure monitoring equipment. That may be the case but the TM-2655P and TM-2657P waiting room blood pressure monitors are specialist instruments, requiring specialist knowledge and test equipment.

So what are you actually getting from us and how does our service differ?

With our service and calibration service each monitor is subjected to an approved individual ISO-9001 quality assured Work Instruction. This comprises a series of up to 70 detailed steps our service engineers must follow and which the product must pass in accordance with the manufacturer’s service manuals. You get so much more from PMS Instruments than the basic 10 minute on site functional test some companies offer.

You get what you pay for?

Depending on the model it can take up to 90 minutes for our Service Engineers to adjust, calibrate and service an A&D Medical waiting room blood pressure monitor and we are the experts at it! Rapid turnaround time means minimum downtime and a full service and calibration certificate is issued.

Not convinced and want to use another company?

To ensure you are getting a proper and professional service for your A&D Medical waiting room blood pressure monitor and compare like for like ask your current service provider these questions.

  • Are you authorised by A&D Medical to work on this equipment?
  • Have the service engineers working on your equipment been on an A&D training course?
  • Do you follow a preventative service and maintenance schedule?
  • Do you perform an internal inspection of the equipment?
  • Do you check and replace routine original service parts?
  • Do you use an A&D Medical BP Checker?

Was it yes to all of these?

I was happy for the customer that their A&D Medical waiting room blood pressure monitor had provided so many years of reliable and trouble free service.

Has your TM-2655P monitor reached 100000 + readings during its lifetime yet? If your current service company can’t tell you call us on 01628 773233 and we will.

The secret by the way is Test Mode 41 or is it 42!

The missing 5.5 million with undiagnosed high BP.

A new resource – Blood Pressure – How Can We Do Better? – has just been launched and can be accessed at the British Heart Foundation website.

It has been developed by stakeholders including GPs, nurses and pharmacists working with organizations including NHS England, Public Health England, the British Heart Foundation, the Stroke Association and the Royal College of General Practitioners.

It is well known that high blood pressure affects one in four adults in England and is one of the leading causes of premature death in England. At least half of all heart attacks and strokes are associated with high blood pressure.

Treatment thankfully is very effective – for every 10mmHg reduction in blood pressure, the risk of a life changing heart attack or stroke is reduced by 20%.

What’s the challenge?

Finding undiagnosed hypertensives, around 25000 in the average CCG or 5.5 million in England, unaware of their increased risk and not receiving treatment is the challenge. It’s also worth remembering that of those diagnosed with high BP, one in three, are not treated to target.

GP Practices and Clinical Commissioning Groups (CCGS) need to do things differently to improve detection and increase opportunistic screening.

What practical steps should GP Practices take?

Think BP! Whether in routine consultations, or in nurse led clinics, like COPD, asthma and diabetes. Encourage opportunistic screening and ensure identification of poor BP control is the responsibility of all clinicians.

Think BP! In accordance with NICE CG127 guideline on Hypertension always offer ambulatory 24 hour blood pressure monitoring or when appropriate home blood pressure monitoring to confirm a diagnosis of high BP. Ensure BP equipment is serviced and calibrated regularly by reputable third parties with experience of the devices you use.

Think BP! Use clinically validated waiting room self-test BP monitors like the A&D Medical TM-2657P to make it easier to collect BP data, save appointment time and empower patients to actively use this equipment.

Think BP! Advise patients of the option to buy clinically validated low cost blood pressure monitors like the UA-767S from established suppliers so they can monitor their blood pressure at home.

There is also a role for Clinical Commissioning Groups (CCGs) who need to do things differently to improve detection, support GP Practices and increase opportunistic screening.

They can use the BHF website to see how many people in their CCG have undiagnosed high blood pressure.

How do we diagnose more patients with high blood pressure?

Time pressured consultations and other clinical priorities are a factor and simply mean in many instances there isn’t enough time to record a blood pressure. The answer is the wider adoption of technology like the A&D Medical TM-2657P waiting room BP monitor and doing things differently.

How does it work?

Patient self-measurement of blood pressure using A&D waiting room blood pressure monitors have been used in the UK since PMS Instruments introduced them in 2002. They are an established part of many GP Practices hypertension diagnosis and management pathways. Put simply the patient records their blood pressure which is printed on a paper slip. This is then shown to the clinician during the consultation. The readings can be input to the patient’s clinical record.

What does the future for detection and management of high BP hold?

With no extra capacity at present the situation won’t be improved by GP’s working harder. It may be improved by doing things differently, changing the system and the wider adoption of new technology. If you are a GP Practice, CCG or GP Federation and want to find out more about the latest BP measuring technology contact me.

Blood Pressure And Diabetes

Having diabetes can increase your risk of developing high blood pressure and other cardiovascular problems, because diabetes adversely affects the arteries and can cause atherosclerosis – a narrowing of the arteries. This can cause high blood pressure, which if not treated, can lead to further blood vessel damage, stroke, heart failure, heart attack or kidney failure.

High blood pressure can also increase the risk of diabetes complications such as diabetic eye and kidney problems.

What are the symptoms of high blood pressure?

Usually, high blood pressure causes no symptoms. This is why it is so important to have your blood pressure checked on a regular basis, either during a visit to your doctor or diabetic nurse, or through home blood pressure monitoring – using equipment such as A&D’s UA-767S device ideal for consumer home use.

This model makes it easy to track you blood pressure over time and features an Irregular Heartbeat Indicator and World Hypertension Society blood pressure classification index.

Information on how to correctly measure blood pressure can be found on the British Hypertension Society website. At £36 the monitor can be purchased here

The right monitor for the job?

All blood pressure monitors are really all the same aren’t they? Which is the most accurate? I’m confused as all BP monitors seem to be the same. What about reliability and durability?

These are some of the questions our sales team are frequently asked and it’s true many digital blood pressure monitors offer similar features and claim to offer similar “clinically validated accuracy”.

But what about durability and reliability?

Continue reading “The right monitor for the job?”