IEEE Consumer Electronics Magazine - September/October 2020 - 45

Table 2. Compliance of the current state of the art and manuals of the 28 connected BPMs with regard to clinical recommendations.
Rec. 1

User
Manuals

Connected
Sensor

Temperature

-

25%

Rec. 2
No
noise

Rec. 3

Rec. 4
No
sports

Rec. 5
No
smoking

Rec. 6
No
alcohol

Rec. 7
No
coffee

Rec. 8
Back
straight

Rec. 9
Legs
uncrossed

25%

53.57%

50%

64.29%

39.29%

53.57%

28.57%

32.14%

@

@

@

@

@

Rest

Santamore
200811
Kusk
201312

@

Wijsman
201613

@

Lindahl
201714

@

@

@

@

@

measurement (Rec. 5-64.29%), whereas only half
of the sensor manuals mention that users should
not exercise before a measurement (Rec. 4). Also,
none of the manufacturers mentions all of the recommendations in their device's user manuals.
The least-cited conditions are that measurements
should be done at a comfortable temperature
(Rec. 1) and in a quiet room (Rec. 2).
Figure 4 details the number of recommendations that BPMs manual mention. We see that one
of the manuals, out of the 28 total manuals, does
not mention any of the nine recommendations
cited in Table 2, and none of them includes all of
the 9 conditions. In 18.52% of the manuals, only
one recommendation is mentioned-either the
recommendation on resting (Rec. 3-40%) or the
recommendation to keep legs uncrossed during
measurements (Rec. 9-60%). One manual (3.7%)
specifies both resting (Rec. 3) and noise level
(Rec. 2) recommendations. A majority of the manuals (33.33%) mention three recommendations, a
combination of rest (Rec. 3), no smoking (Rec. 5),
no coffee (Rec. 7), keeping a straight back (Rec. 8),
and keeping legs uncrossed (Rec. 9). In manuals
including four recommendations or more, the
most mentioned ones are in order of importance,
no smoking (Rec. 5-91.67%), no alcohol (Rec. 6-
83.33%), no coffee (Rec. 7) and no sports (Rec. 4)
(75% each), rest (Rec. 3-66.67%), temperature
(Rec. 1-58.34%), no noise (Rec. 2), and straight
back (Rec. 8) (50% each). The least mentioned one
is uncrossed legs (Rec. 9-33.34%).
All user manuals correctly state the different
levels of hypertension (cf., Table 1). However,

September/October 2020

91.3% of them do not tackle low blood pressure.
As a matter of fact, blood pressure optimal values are ranged between 90 and 120 mmHg for
the SBP and between 60 and 80 mmHg for the
DBP (cf., Table 1). A blood pressure value under
90/60 is low and might be dangerous to one's
health. These manuals indicate that the optimal
value is under 120/80 mmHg without taking into
consideration low values. The other 8.7% specify
low blood pressure.
We also analyzed manufacturers' websites.
While most of them respect recommendations in
their publicities, we identified two situations
that do not. In the first one, the person is in a
slouching posture trying to measure his/her
blood pressure using a wrist BPM whereas she
should keep his/her back straight (Rec. 8). The
second situation depicts a person measuring
his/her blood pressure using an upper-arm
device, while sitting on a sofa with his/her legs
crossed. This posture is incorrect as he/she has
to keep his/her legs uncrossed when performing
the measurement (Rec. 9).

Context-Aware System
Measurement contextualization is very
important as it helps personalizing diagnoses,
which leads to more accurate treatment.15 Performing blood pressure measurements in compliance with clinical recommendations is very
important as it guarantees a reliable measurement. Now, satisfying such conditions can be difficult. Moreover, current devices cannot ensure
that a measurement is performed in compliance

45
IEEE Consumer Electronics Magazine - September/October 2020

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