Participants rested (for 15 min) quietly in a comfortable chair with their upper arm at heart level. BP was taken on the dominant arm and at the brachial artery with an automated noninvasive BP monitor (Omron M6 Comfort, HEM-7221-E, Omron Healthcare, Kyoto, Japan) in accordance with recommendations [24 (link)]. Since the accuracy of the BP measurements can be influenced by numerous factors, the methodology followed will be briefly described [25 (link),26 (link)]. To improve the accuracy of the BP measurements, participants remained silent, with the room also quiet. Participants sat in the chair comfortably, with legs uncrossed, and their back and arm supported. The middle of the cuff was positioned on the upper arm, with the arm elevated to be at the level of right atrium (i.e., the mid-point of the sternum). The lower end of the cuff was positioned 2–3 cm above the antecubital fossa. Participants were instructed to remove all clothing that covered the location where the cuff was placed. BP was measured three times, and the average of the last two measurements was used to represent resting systolic BP (SBP), diastolic BP (DBP), and heart rate (HR). Participants were not aware of the BP reading at the time of measurement. Mean arterial pressure (MAP) was calculated using the following equation: MAP = DBP + 1/3 (SBP-DBP).
M6 comfort hem 7221 e
Manufactured by Omron
Sourced in Japan
The M6 Comfort HEM-7221-E is a blood pressure monitor designed for home use. It measures the user's blood pressure and heart rate, and displays the results on a digital screen.
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8 protocols using m6 comfort hem 7221 e
1
Automated Noninvasive Blood Pressure Measurement
2
Evaluation of Omron M6 Comfort Blood Pressure Monitor
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The Omron M6 Comfort (HEM-7221-E) monitor was randomly selected and provided by the manufacturer (Omron Healthcare, Kyoto, Japan). It is a digital automatic device for home BP measurement at the arm level. The monitor uses a Fuzzy-logic inflation system controlled by an electric pump and an automatic pressure release valve for deflation. It records BP using the oscillometric method with a pressure range of 0–299 mmHg and a pulse rate range of 40–180 beats per minute. Systolic BP, diastolic BP, and pulse rate are displayed on a liquid crystal digital screen. The device can display a symbol on the liquid crystal digital screen if it detects an irregular heartbeat, defined by a heart rhythm that varies by more than 25% from the average heart rhythm detected while the unit is measuring BP. It includes memory for 90 measurements and can also calculate an average reading based on measurements from the last three readings taken within 10 minutes. The unit weighs approximately 380 g without batteries. Four AA alkaline batteries are needed, with an approximate capacity of 1,000 measurements. The single cuff included is made of semirigid nylon/polyester with dimensions of 152 × 600 mm, weighs approximately 240 g, and is applicable for arm circumferences ranging from 22 cm to 42 cm. A specific error message is given if the cuff is not applied correctly.
3
Comprehensive Health Assessment in HAI
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In HAI, the participants arrived at the clinic after having fasted for at least 4 h, before they completed a comprehensive test battery where multiple parameters of health were evaluated. Five trained research nurses collected all data with the support of two chief physicians (AN and PN). Waist- and hip circumference were measured using a measuring tape. Body height and weight were measured using a stadiometer (Holtain Limited, Crymych, Dyfed, UK) and digital scale (Avery Berkel HL 120, Taiwan), whereby the body mass index (BMI, kg/m2) was calculated. Blood pressure was measured using a digital automatic blood pressure monitor; Omron M6 Comfort HEM-7221-E (Omron Healthcare, Kyoto, Japan), after at least 15 min of rest. Fasting blood glucose was measured using the HemoCue 201 RT system (Radiometer Medical ApS, Denmark). Blood lipids were measured venously, and the samples were analyzed at the accredited laboratory at the department of clinical chemistry, Umeå University hospital. VAT was measured using a Lunar iDXA device with the CoreScan application (GE Healthcare Lunar, Madison, WI, USA). Participants reported smoking status and prevalent diabetes. Finally, all participants were sent home for 1 week with an accelerometer to assess PA.
4
Comprehensive Cardiometabolic Assessment Protocol
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Height and body weight were measured without shoes and in light clothing, and the body mass index (BMI) was obtained. A non-stretchable tape with a precision of 0.1 cm was used to assess waist circumference. According to a specified protocol, total cholesterol (mg/dl) levels were assessed in all participants from a non-fasting dried capillary blood test (fingertip puncture) using the REFLOTRON® Plus system (Roche Diagnostics, GmbH, Germany) [13 (link)]. Quantification of the entire lipid profile (HDL cholesterol, LDL cholesterol and triglycerides) was evaluated only in subjects in which total cholesterol was ≥ 200 mg/dL after fasting for 6 h or where total cholesterol ≥ 250 mg/dL regardless of fasting hours.
Blood pressure was measured in triplicate, after 5 min’ rest using an automated device [Omron M6 Comfort HEM-7221-E (Omron Healthcare, Kyoto, Japan)] at 2-min intervals, and the mean of the last 2 was calculated. The smoking habit (non-smoker, current or former smoker) was also documented. Smokers who stopped smoking ≥ 1 year prior to recruitment were considered former smokers.
Blood pressure was measured in triplicate, after 5 min’ rest using an automated device [Omron M6 Comfort HEM-7221-E (Omron Healthcare, Kyoto, Japan)] at 2-min intervals, and the mean of the last 2 was calculated. The smoking habit (non-smoker, current or former smoker) was also documented. Smokers who stopped smoking ≥ 1 year prior to recruitment were considered former smokers.
5
Comprehensive Health Assessment in Sweden
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Baseline data and selected covariates were collected in the HAI-study and through national registers. Specifically, height and weight were measured to calculate the body mass index (BMI, kg/m2). Blood pressure was measured using a digital automatic blood pressure device Omron M6 Comfort HEM-7221-E (Omron Healthcare, Kyoto, Japan) after a 15-min rest. Fasting blood glucose was measured using the HemoCue 201 RT system (Radiometer Medical ApS, Denmark), while blood lipids were analyzed at the accredited laboratory at the department of clinical chemistry, Umeå University hospital. Whole-body scans using a Lunar iDXA device with the CoreScan application (GE Healthcare Lunar, Madison, WI, USA) were performed to quantify visceral adipose tissue. Socioeconomic data (education, marital status, income) were collected from the registers of Statistics Sweden. Information on medications was collected from the Prescribed Drug Register, which covers all medications dispensed at pharmacies in Sweden since July 2005. Data on previously diagnosed medical conditions were collected from the National Patient Register (NPR), superintended by the Swedish National Board of Health and Welfare. The NPR covers all inpatient care in Sweden since 1987 and all secondary outpatient care since 2001.
6
Cardiovascular Risk Assessment Protocol
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The smoking status (never/current/former) was recorded. Smokers who stopped smoking ≥1 year prior to recruitment were considered former smokers. Blood pressure was measured in triplicate, after 5 min of rest using an automated device (Omron M6 Comfort HEM-7221-E (Omron Healthcare, Kyoto, Japan)) at 2-min intervals, and the mean of the last two was calculated. A dried capillary blood sample was used for the total cholesterol (mg/dL) measurement using a REFLOTRON® (Roche Diagnostics, GmbH, Germany).
7
Anthropometric and Smoking Measurements
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Body weight and height were measured without shoes and slight clothing, and body mass index (BMI) was determined from kilograms divided by height in meters squared. Waist and neck circumferences were assessed using a nonstretchable tape with a precision of 0.1 cm. Waist circumference was measured midway between the iliac crest and the lowest rib on the horizontal plane with the individual in a standing position. Neck circumference was assessed in a plane as flat as possible, closely below the laryngeal prominence, while standing erect with eyes facing forward. Blood pressure was assessed in triplicate after five minutes’ rest via an automated device (Omron M6 Comfort HEM-7221-E (Omron Healthcare, Kyoto, Japan)) at 2 min breaks, and the mean of the last two was calculated. Additionally, smoking habits (never, former or current smoker) were also known. Smokers who stopped smoking one or more years prior to visiting were considered former smokers.
8
Standardized Physical Activity Assessment
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All assessments were performed during daytime, with the ambition of standardizing and matching the exact time-of-day of assessments as far as possible. The research nurses in charge of assessments were blinded at all occasions apart from the final follow-up where blinding was not possible. All participants were informed to refrain from exerting any intense physical activity or consuming alcohol the day prior to each assessment, while being in a fasted state for at least four hours. Participants self-reported medication, smoking, diabetes, and any history of myocardial infarction or stroke. Blood pressure was measured using the digital automatic blood pressure device Omron M6 Comfort HEM-7221-E (Omron Healthcare, Kyoto, Japan) after a 15-min rest with the subjects in a supine position. Two measurements were made whereof the lowest one was recorded. Data on daily physical activity were obtained from the HAI-study where the participants physical activity were objectively assessed during one week of registration using Actigraph GT3X+ accelerometers (Actigraph, Pensacola, FL, USA), described in depth elsewhere [30 (link)].
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