INSTRUCTION MANUAL FOR DIGITAL BLOOD PRESSURE MONITOR

CH-432BS

CITIZEN is a registered trade mark of Citizen Holdings Co., Japan. CITIZEN es una marca registrada de Citizen Holdings Co., Japn. Design and Specication are subject to change without notice.

English

Contents
3 - GENERAL REMARKS 5 - PRECAUTIONS FOR USE AND MAINTENANCE 8 - IDENTIFICATIONS OF PARTS 10 - LOADING THE BATTERIES 11 - REMOVING THE BATTERIES 12 - USING AC ADAPTER (OPTION) 13 - MEASURING YOUR BLOOD PRESSURE 20 - KEY TO DISPLAY ICONS 21 - ABOUT BLOOD PRESSURE 22 - BLOOD PRESSURE Q&A 23 - BEFORE REQUESTING REPAIRS OR TESTING 24 - SPECIFICATIONS
Ensure that you have all the following components
Blood pressure monitor unit
(for monitor) 4 AA-size batteries

Instruction Manual

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GENERAL REMARKS

General remarks on blood pressure and blood pressure measurement
1. 2. 3. 4. 5. 6. 7. 8. To deate the cuff quickly, press the START/STOP switch. The attached cuff is suitable for arm circumferences of 22-32 cm. When attaching the cuff, the air hose should be placed on the inside of your arm on top of the artery.
As preparation for measuring your blood pressure, you should urinate and then remain relatively still for 10 to 15 minutes prior to measurement. Exercising, eating, drinking, smoking, etc., prior to measurement may affect the results. Your blood pressure varies constantly throughout the day. Measurements should be taken regularly at the same time each day. DO NOT place too much emphasis on the results of one measurement. Keep a continuing record of your blood pressure variations. A complete picture can only be obtained from a large number of readings. Emotional stress tends to cause your blood pressure to rise.
To obtain correct blood pressure measurements
1. Take ve or six deep breaths and then relax before measuring your blood pressure. If you are tense when taking the measurement, you will not get a valid reading. Your blood pressure will be elevated if you are anxious or irritated, suffering from lack of sleep or constipation, or have just taken some exercise or eaten a meal. Wrap the cuff around your arm and tighten it so that one nger can be inserted See page 13, 14) between the cuff and arm. ( DO NOT measure your blood pressure after bathing or drinking. If you feel the need to urinate, do so before measuring your blood pressure. Measure your blood pressure where the room temperature is around 20C. DO NOT measure your blood pressure when it is too cold (below 10C) or too hot (above 40C) in the room. DO NOT try to measure your blood pressure immediately after drinking coffee or tea or after smoking. Measure your blood pressure when you are relaxed and still. Keep the center of the cuff at the level of your heart and DO NOT move your arm or talk.

2. 3. 4. 5. 6.

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Self measurement is not therapy! In no event should you change the dosage of your medication prescribed by your physician.
GENERAL REMARKS 9. DO NOT measure blood pressure when the cuff has been on your arm for a few minutes or more. During this time, your arm will have built up a higher blood pressure and you will not get valid reading.
10. The gure below shows the blood pressure classications under the WHO standards.

SYSTOLIC (mmHg)

180 160
Grade 3 Hypertension (severe) Grade 2 Hypertension (moderate) Grade 1 Hypertension (mild) Remarks: The graph is not exact, but may be used as a guide in understanding non-invasive blood pressure measurements. The device is only intended for use by adults. DIASTOLIC (mmHg)
High-Normal Normal Optimal 90
Denitions and Classications of Blood Pressure Levels
Measure your blood pressure at the same time each day.
* Your blood pressure changes all the time. This means that data gathered over a long period has far more signicance than data from just one measurement. For this reason, you must measure your blood pressure on a daily basis. Ideally, you should measure your blood pressure at the same time each day, wherever possible.

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PRECAUTIONS FOR USE AND MAINTENANCE

Precautions for use

1. 2. If you suffer from heart disease, high blood pressure or other circulatory disease, consult your physician before using the monitor. If the cuff pressure feels abnormal or you experience any other irregularity while using the cuff, reduce the pressure immediately by pressing the START/STOP switch and then consult the sales outlet where you purchased the monitor.

4. 5. 6. 7.

Blood pressure measurement may not be possible for anyone with a weak pulse or arrhythmia. Repeated blood pressure measurement may cause problems such as congestion or swelling in some people. Frequently repeated blood pressure measurements will not give accurate results. Allow an interval of about 10 minutes between measurements. If you suffer from a severe problem with blood circulation in your arms, consult your physician before using the monitor. Failure to do so could be hazardous to your health. Measurement may not be possible for anyone with insufcient blood ow to the area where measurements will be taken or who suffers from a frequent irregular heartbeat. Consult your physician for advice on whether to use the monitor. DO NOT wrap the cuff around an injured arm.
10. DO NOT wrap the cuff around an arm in which a drip (intravenous infusion) is inserted, or which is being used for blood transfusion as part of medical treatment. Doing so could result in an injury or a serious accident. 11. DO NOT use the monitor in the vicinity of ammable gases such as those used for anaesthesia. Doing so could ignite the gases and cause an explosion. 12. DO NOT use the monitor in enriched oxygen environments such as a hospitals hyperbaric chamber or oxygen tent. Doing so could ignite the oxygen and cause a re. 13. DO NOT use mobile phones near the monitor as this could result in a malfunction. 14. If you use a cardiac pacemaker, consult your physician before using the monitor.

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If you think the measurement is abnormal or if measurement makes you feel unwell, discontinue use and consult your physician.
PRECAUTIONS FOR USE AND MAINTENANCE 15. Be sure to use this unit only for measuring blood pressure. DO NOT use it for any other purpose. 16. DO NOT use this unit on infants. 17. Blood pressure measurement may not be possible for anyone with common arrhythmias such as atrial or ventricular premature beats or atrial brillation.

Maintenance Precautions

1. DO NOT store the blood pressure monitor in locations exposed to direct sunlight, high temperatures (over 60C), low temperatures (below -20C), high relative humidity (over 95%) or excessive amounts of dust. DO NOT drop the blood pressure monitor or subject it to other shocks or vibration. Remove the batteries if the monitor will be left unused for a long period. DO NOT attempt to disassemble the monitor. DO NOT bend the cuff or the air hose excessively. If the monitor is very dirty, wipe it clean with a cloth moistened with sterilizing alcohol or a neutral detergent. Then wipe it with a dry cloth. NEVER clean the blood pressure monitor with thinners or benzene, as this could damage the monitor. To clean the cuff, wipe it with a moist cloth. Avoid hard rubbing, as this will cause air leakages. Take care also not to get water into the air hose.

2. 3. 4. 5. 6. 7. 8.

Symbols Explanation
: The CE marking is meant to provide information to market inspectors in the EU member countries. : Type B applied part : Refer to instruction manual before use : Appliance compliance WEEE directive : Manufacturer
The device has been tested and homologated in accordance with EN60601-1-2 for EMC. This does not guarantee in any way that the device will not be affected by electromagnetic interference. Avoid using the device in high electromagnetic environment.

Warning

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Nature and frequency of maintenance:
This product is designed for use over an extended period of time; however, it is generally recommended that it be inspected every two years to ensure proper function and performance.

Protect the nature environment: English
Please help to protect natural environment by respecting national and/or local recycling regulations when disposing of the battery and the product at the end of their useful live.

WEEE MARK

If you want to dispose this product, do not mix with general household waste. There is a separate collection systems for used electronics products in accordance with legislation under the WEEE Directive (Directive 2002/96/EC) and is effective only within European Union.
Reference European standard:
The blood pressure measuring device corresponds to regulation EN60601-1-2. Calibration: The blood pressure measuring device is generally recommended to have the monitor inspected every two years to ensure correct functioning and accuracy. Please contact a distributor.

Name : Address :

CITIZEN SYSTEMS(H.K.) LIMITED FLAT A-B, 4TH FLOOR, HUNG MOU INDUSTRIAL BUILDING, 62 HUNG TO ROAD, KWUN TONG, KOWLOON, HONG KONG

European Representative:

Name : Address : WvW electronishe Gerte Vertrieb GmbH Fintelmannstrae 20/Eingang, Martin-Heydert-Strae, D-14109 Berlin, Germany

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IDENTIFICATION OF PARTS
Component names <Main Unit>
Systolic blood pressure display Diastolic blood pressure/Pulse display
Air hose socket START/STOP Switch w Stand-by Pressurization setting switch (Ination level selector) Pressurization setting indicator

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Battery cover

<Cuff>

Air hose Blue marker

Air hose connector

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LOADING THE BATTERIES

(Batteries supplied with the unit should be loaded in compartment before you use the blood pressure monitor.)
Open the cover of battery compartment. Pressing the hook down, pull the cover toward you to open.

4 AA batteries

Hook Battery compartment
Battery cover * If the Blood pressure monitor is left unused for an extended period of time, the batteries should be removed from the compartment.

Lug (projecting section)

Place batteries in the compartment. Put the batteries paying attention to the positive and negative terminal symbols and.

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Close the battery cover.
Fit the lugs (projections) at the recesses.

REMOVING THE BATTERIES

When the icon is displayed or nothing appears in the display, replace the old batteries with four new ones. All four batteries should be changed at once. The memory is erased if the batteries are removed for replacement. It is recommended to make note of the data stored in memory prior to changing batteries. Do not use rechargeable batteries. Do not use alkaline and manganese batteries together. The monitor is powered by the batteries provided. Note that they may not last as long as indicated. When disposing of used batteries, comply with governmental regulations or environmental public institutions rules that apply in your country/area.

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Fitting the lugs of the cover at the mating recesses of the battery compartment body, push the hook to close the cover.
USING AC ADAPTER (OPTION)
Using the optional dedicated AC adapter (model: AC-230CZ) for the CITIZEN blood pressure monitor (CH-432BS) allows you to measure your blood pressure without having to worry about the amount of remaining charge in the batteries.

AC adapter socket

Insert the AC adapter plug into the socket on the blood pressure monitor. Plug the AC adapter into a mains power outlet.

AC adapter plug

If you plan to use the AC adapter for an extended period of time, remove the batteries. If the batteries are left in the compartment, electrolyte may leak from the batteries and cause a fault in the blood pressure monitor. If the AC adapter is used as the only power supply for the monitor, unplugging the AC adapter will erase the data stored in the monitors memory. It is recommended that you make a note of any important data. When only batteries are used to supply power to the monitor, the AC adapter should be unplugged from the monitor. Leaving the AC adapter plugged into the blood pressure monitor could cause a malfunction.
The dedicated AC adapter (model: AC-230CZ) for the CH-432BS is optional. The AC adapter is available from retailers stocking CITIZEN digital blood pressure monitors.

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MEASURING YOUR BLOOD PRESSURE 1 ATTACHING THE ARM CUFF
Unroll the arm cuff and thread the end through the metal hoop so that the side with the Velcro patch is on the outside.
Put the arm cuff around your arm so that the blue marker comes to the palm side.

Metal hoop

Adjust the position of the arm cuff so that the blue marker is located in the center of your arm and the hem of the cuff is 1 to 2 cm above your elbow.

Blue marker

* The cuff should be put on the bare arm or over a light-weight underwear. * If you wear a heavy-weight top, please remove it.

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MEASURING YOUR BLOOD PRESSURE
Pull the end of the arm cuff outwards so that the cuff is snug around your arm and then secure the end to the Velcro.
Place your arm on a table or the like, so that the center of the cuff comes to the height of your heart. * Carefully place the cuff on your arm, taking care to use the correct tightness. The tightness is correct if you can readily slide a nger between the cuff and your arm.
Relax your arm and lightly open your hand, with the palm upward.

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TIPS FOR OBTAINING ACCURATE MEASUREMENTS
Your blood pressure varies according to your posture, the time of day and a range of other factors. Ideally, you should measure your blood pressure in the same posture at the same time every day. Taking measurements while sitting 1 Place your arm on a table or similar surface with your forearm extended. It is important to have the arm cuff level with your heart. Open your hand slightly on the table so that your palm is facing up and your ngers are relaxed. Do not move your body or talk while taking the measurement.

Measurement in a reclining posture * Relax yourself to avoid placing pressure on the arm cuff.
Lie down, facing the celling. Lightly open your hand with palm up and straighten your arm. Relax your body, arm and ngers. Do not move your body or talk during measurement.
You may use your right arm to measure your blood pressure. Blood pressure rate is likely to differ by as much as 10mmHg when measured on the left arm instead of the right (or vice-versa). Measure your blood pressure on the same arm each day.

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Plug the air hose connector into the main unit.

Air hose socket

Plug the air hose connector rmly into the air hose socket on the main unit, as illustrated. Air hose connector
Set the pressurization setting value
The setting value should be at least 30mmHg higher than the normal systolic blood pressure value. If your systolic blood pressure value around 130mmHg, for example, set to 160. * Use the pressurization setting switch to select the pressurization setting, from 130, 160, 200 or 250mmHg. * The pressurization setting indicator (the red mark) changes to match the movement of the pressurization setting switch.
Pressurization setting indicator Red mark
Pressurization setting switch

Caution

Do not set a higher value than necessary. An excessively high setting could cause conditions such as congestion and swelling.

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Place the cuff at the height of the heart. Press the START/STOP switch (the yellow switch).
If the pressurization value exceeds 280mmHg, if pressurization feels abnormal, or if you want to stop the measurement process, press the START/STOP switch again. The cuff deates, and the power turns off. 1 The measurement is displayed for approximately two seconds.
* lights during the rst measurement performed after the battery is replaced.
The cuff is pressurized according to the chosen pressurization setting value.
* If the unit judges that pressurization is insufcient, it automatically repressurizes to the next higher pressurization value.If it is still insufcient, Err 1 is displayed and measurement is cancelled. Reset the pressurization setting value according to step 3, then press the START/STOP switch again.

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MEASURING YOUR BLOOD PRESSURE 3 Once pressurization is complete, lights and there is a pause before measurement begins automatically.
ashes each time a pulse is counted, and the pressure value is displayed on the diastolic blood pressure display. Once measurement is complete, the cuff deates and the measurement results (systolic/diastolic blood pressure values, pulse) are displayed.

* Systolic/diastolic blood pressure values (two seconds) and pulse (one second) are displayed alternately. * Provided there is no error in the measurement results, they are stored automatically.

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Finishing measurement.
Press the START/STOP switch to turn the monitor off. * When you want to stop measurement, press the START/STOP switch. The cuff is deated and measurement stops.

START/STOP Switch

AUTOMATIC POWER OFF FEATURE
After taking the blood pressure measurement, pressing the START/STOP switch will turn the monitor off. However, if you do not press the switch, the monitors Auto OFF function will automatically turn the monitor off after 3 minutes.

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KEY TO DISPLAY ICONS

Icon displayed

Condition/Cause
Displayed during measurement. Displayed during measurement.

Lit Flashing

Measurement is under way. Pulse detected.
PUL Err is displayed when the pulse value is below 40 or above 181.
If any of the following marks is displayed, take the specied action, then repeat the operation.
Icon displayed Condition/Cause Insufcient pressure. Appears when the blood-pressure could not be measured accurately. Corrective action
Apply cuff properly and measure again.
The pressure is 281 mmHg or higher.
If the pressure does not automatically decline during measurement, immediately press the START/STOP switch and turn the unit off. To take the measurement again, refer to P.16 and correctly re-apply pressure.

Replace the batteries.

Appears when the batteries are running low. Detected problem in the device.

Contact the vendor.

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ABOUT BLOOD PRESSURE

What is blood pressure?
The heart is a pump that circulates blood throughout your body. Blood is pumped from the heart at a constant pressure into arteries. This pressure is called the arterial blood pressure and represents, in general terms, your blood pressure. Blood pressure is indicated by several kinds of pressures, including the systolic pressure that occurs when the heart pumps blood, and the diastolic pressure that occurs when blood returns to the heart.

Artery Left atrium Left ventricle Left atrium Artery
The artery wall expands. Contraction

Left ventricle

Normal state is restored to the artery wall. Dilation
Your blood pressure changes all the time.
Your blood pressure differs according to your age, gender and a range of other factors. It is likely to be affected by your biorhythm during the day and by your posture, physical activities, mental activities, level of stress and even by the air temperature. The blood pressure of a healthy person generally varies within a day. [Example of blood pressure variations within a day]
Blood pressure value (mmHg)

Systolic blood pressure

Sleeping

Diastolic blood pressure

Time of day (Blood pressure values measured at ve-minute intervals through the day) Bevan AT, Honour AJ, Stott FH. Clin Sci 1969;36:32944.

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(Systolic)

(Diastolic)

BLOOD PRESSURE Q&A
Why is the blood pressure measured at home different from that measured by the physician or at a hospital? Your blood pressure may vary due to exercise, the ambient temperature or your mental state. When you have a physician or nurse measure your blood pressure, the pressure value is likely to be 10 to 20 mmHg higher than usual due to anxiety and/or stress. Knowing what affects your blood pressure helps you to better monitor your health. Why does the blood pressure obtained vary with measurement? Our blood pressure is adjusted by automatic nerve function. Blood pressure differs with every heart beat. We are likely to think that our blood pressure is constant, but it varies if you take measurements in repetition. Blood pressure is susceptible to the time of day, such as morning and afternoon, season and atmospheric temperature. In addition, blood pressure is easily affected by mental stress or emotional ups and downs. It tends to increase when you feel tension or decrease when you are relaxed. What is the benet of measuring my blood pressure at home? Blood pressure measurements taken at home give reliable data as they can be taken when you are in a stable and relaxed condition. Physicians place considerable importance on blood pressure measurements taken at home. You should measure your blood pressure at the same time each day and record the variations in your blood pressure.
Always consult your physician for an interpretation of your blood pressure readings and to determine the proper treatment.

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BEFORE REQUESTING REPAIRS OR TESTING
Make sure to check the following before sending your blood pressure monitor away to be tested or repaired.

Problem Checks Response

Display stays blank when you press the START/ STOP switch.
Check whether the batteries are dead. Check whether the batteries are installed the right way round ( and oriented correctly).

Replace all the batteries with new ones.
No measurements can be taken.
Check whether the measurement icon displayed.
Attach the arm cuff properly.
Check whether the arm cuff is applied correctly. Did you stay calm during measurement? Measure your blood pressure again, making sure to remain still.
Note that blood pressure measurement may not be possible for someone with an extremely weak pulse or cardiac arrhythmia (irregular pulse). Your blood pressure readings are abnormally high or low compared with those taken in hospital. Other phenomena See page 22. Remove the batteries from the unit and change them with new ones.

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Load the batteries in the correct direction.

SPECIFICATIONS

Model Number: Measurement system: Measurement Localization Cuff: Arm circumference range: Pressure Measurement range: Pulse Pressure Accuracy: Pulse Pressure Pulse LCD displays: Icons Switch: Ination: Pressurization setting: Deation: Rated voltage: Exhaust: Power supply: Alkaline Manganese Automatic Power Off function: Dimensions: Weight: Temperature Operating conditions: Humidity Temperature Storage conditions: Humidity Electric shock protection: Safety Classication: Battery duration: Accessories CH-432BS Oscillometric method Upper Arm Soft cuff 22.0 to 32.0 cm 0 to 280 mmHg 40 to 180 pulse/min 3 mmHg 5% of reading 3 digits 3 digits : Measurement icon, :Battery icon 2 (START/STOP, Pressurization setting) Automatic ination by internal pump Use the pressurization setting switch to select the pressurization setting, from 130, 160, 200 or 250mmHg. Automatic speed deation system controlled by internal electromagnetic valve. 3W ( : direct current) 6V DC Electromagnetic quick exhaust valve 4 AA batteries (R6P, LR6) or optional AC/DC adapter (6V DC, 0.6A) Approx. 1000 times (160 mmHg, once/day, 23C) Approx. 300 times Approx. 3 min. (after activated) 129(W) x 55(H) x 119(D) mm Approx. 240g w/o batteries cuff: approx. 150g 10C to 40C 30% to 85% RH -20C to 60C 10% to 95%RH Internal power unit Type B Equipment Set includes a cuff, 4 AA batteries (R6P) for the monitor, Instruction Manual.

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