Hem 907

BP was measured using a digital blood pressure monitor (OMRON HEM-907; Omron Healthcare, Kyoto, Japan). Prior to having their measurements taken, participants were required to be in a seated position for 15 min, using an appropriately sized cuff with the artery indicator at the correct anatomical position. The BP monitor was set to take three measurements at one-minute intervals, and the average was recorded. The American Academy of Pediatrics cut off values were used to define elevated BP (≥120 mmHg systolic and <80 mmHg diastolic), and hypertension (>130/80 mmHg) [19 (link)].

Blood pressure is measured via a digital blood pressure monitor (OMRON HEM-907; Omron Healthcare, Japan) placed on the non-dominant arm. Participants are requested to lie down in a dimly lit, temperature controlled (approximately 22–24 C) room. After 10 min of rest, the monitor takes three measurements with an interval of 2 minutes between each measurement. The monitor measures systolic pressure, diastolic pressure, and heart rate and determines the average of the three measurements separately. The three measurements, as well as the average values, are recorded.

The Greenlight 300 (Accoson, Essex, United Kingdom) and Omron HEM-907 (Omron, Kyoto, Japan) devices have been validated based on the European Society of Hypertension protocol.^{[5 (link),6 (link)]} To ensure the accuracy of the piezoresistive manometer, we performed the validation procedure described in our previous study.^{[7 (link)]} In the present study, no difference more than 3 mmHg was observed for the 4 devices applied in the before- and after-use validation tests. Therefore, the previously defined validation criteria were fulfilled.^{[8 (link)]} As the inter-device differences were not significant, the devices were not rotated among observers. No device malfunctions were observed.

The sociodemographic factors of participants were obtained using a pre-tested structured questionnaire. Anthropometric measurements including height, weight, and waist circumference were ascertained using standardized techniques [28 (link),29 ]. A universal surrogate measure of body weight status, body mass index (BMI), was computed as the ratio of weight (kg) to height² (m²), and was classified according to the WHO (2000) [30 ]. The percentage of body fat of the participants was measured using the body fat monitor HBF-306 (Omron Matsusaka Co. Ltd., Matsusaka, Japan) with an accuracy of up to 0.1%. Blood pressure was assessed using a Digital Automatic BP monitor (OMRON HEM-907, Omron, Kyoto, Japan), while the physical activity level was obtained using the validated Global Physical Activity Questionnaire (GPAQ) [31 (link)]. The adequacy of physical activity among the participants was ascertained according to the recommendation by the WHO whereby an individual should perform more than 600 Metabolic Equivalent (MET) minutes of total physical activity per week, with MET (Metabolic Equivalent) defined as “the ratio of a person’s working metabolic rate relative to the resting metabolic rate” in the GPAQ analysis guide [32 ].