Citizen CH-618 User manual

DIGITAL BLOOD PRESSURE MONITOR
• Design and specifications are subject to change without notice.
• CITIZEN is a registered trademark of Citizen Watch Co., Ltd. Japan.
6-1-12, Tanashi-cho, Nishi-Tokyo-shi,
Tokyo 188-8511, Japan
E-mail: [e-mail]
http://www.citizen-systems.co.jp/
1901

Contents
................
01....... Blood Pressure Monitor Intended Use
02....... 1. What is blood pressure ?
02....... 2. Why is it useful to measure blood
pressure at home ?
.......... A. WHO blood pressure classications
.......... B. Variations in blood pressure
05....... 3. Important information before use of the
device
08....... 4. Device description
.......... A. Name of the parts
.......... B. Description of display symbols
10....... 5. Changing Batteries
11....... 6. Attaching pressure cuff
12....... 7. Correct measurement position
A

Contents
................
13....... 8. Symbol Dinitions.
15....... 9. How to measure.
.......... A. Inserting batteries in position.
.......... B. Setting date and time.
.......... C. Steps to take blood pressure
measurement.
.......... D. Storing recalling and erasing
measurement data.
.......... E. To change batteries.
19....... 10. Maintenance.
20....... 11. Safe-keeping.
20....... 12. To prevent malfunction.
21....... 13. Warning.
22....... 14. Specications.
B

1
MEDICAL DISCLAIMER
This manual and product are not meant to be a
substitute for advice provided by your doctor or other
medical professional.
You are not to use the information contained herein,
or this product for diagnosing or treating a health
problem or prescribing any medication. If you have or
suspect that you have a medical problem, promptly
consult your healthcare provider.
Measures human's Systolic blood pressure, Diastolic blood
pressure and pulse on wrist by oscillometric measurement
method.
The device is designed for home use and recommended for
use by adults aged 18 years and older with wrist circumference
ranging 135 ~ 195 mm (5.3~7.7 inch).
Blood Pressure Monitor Intended Use:

2
Blood pressure is a measurement of the force of blood owing
against the walls of the arteries. Arterial blood pressure is
constantly changing during the course of the cardiac cycle. The
highest pressure in the cycle is called the systolic blood pressure,
the lowest is the diastolic blood pressure. Both pressure readings,
the systolic and the diastolic are necessary to enable a physician
to evaluate the status of a patient's blood pressure. Many factors
such as physical activity, anxiety or the time of day, can inuence
your blood pressure. Blood pressure is typically low in the
morning and increases from the afternoon to the evening. It is on
average lower in the summer and higher in the winter.
1. What is blood pressure ?
Having one's blood pressure measured by a doctor in a hospital or
a clinic, and a group health checks, tend to stimulate nervousness
in the subject and may even create high blood pressure.
2. Why is it useful to measure blood pressure
at home ?
Medical practitioners generally recommend the “Rule of 3”, where
you are encouraged to take your blood pressure three times in a
row (at 1 minute interval), three times a day for three days. After
three days you can average all the results and this will give you
an accurate idea of what your blood pressure really is.

3
Also varies blood pressure in accordance with a variety of
conditions and so judgment is not possible on the basis of a single
measurement.
The blood pressure measured rst thing in the morning after getting
up, before taking any food and with the subject still, is known as the
fundamental blood pressure. In practice it is rather difcult to record
the fundamental blood pressure, but to come as near as possible
to measuring the blood pressure in an environment that is close
to this, is why it is useful to take the measurement at home.
A. WHO blood pressure classications
Standards for assessment
of high or low blood
pressure without regard to
age, have been established
by the World Health
Organization (WHO), as
shown in the chart. * Figure No.1
This chart is intended to be used as a guide in understanding
noninvasive blood pressure measurements. Please consult with
your physician for proper diagnosis.

4
B. Variations in blood pressure
The graph below illustrated the variations in blood pressure over
a whole day with measurement taken every ve minutes.
The thick line represents sleep. The rise in blood pressure at 4
PM (A in the graph) and 12 PM (B in the graph) correspond to an
attack of pain.
* Figure No.2
Individual blood pressures vary greatly both on a daily and a
seasonal basis. These variations are even more pronounced in
hyper tense patients. Normally the blood pressure rises while at
work and is at its lowest during sleeping period.
(Hyper tense: means a person who has high blood pressure
symptom.)
(Direct arterial pressure recording in unrestricted
man. Beven, Honour & Stott: Clin. Sci. 36:329.
1969)

5
Please rest for at least 5~10 minutes before taking the
measurement.
To allow your blood vessels to return to the condition prior to
taking the measurement, please wait at least 3~5 minutes
between measurements. You may need to adjust the wait time
according to your personal physiological situation.
If you have one of the circulatory problems as arteriosclerosis,
diabetes, liver disease, kidney disease, severe hypertension,
peripheral circulation and medical problem, please consult
your doctor or healthcare professional before using the device.
Wait 30 ~ 45 minutes before measurement if you’ve just
consumed caffeinated beverages or smoked cigarettes.
Blood pressure measurements should be interpreted by a
physician or trained health professional who is familiar with
your medical history. By using the unit regularly and recording
the results for your physician to interpret, you keep your
physician informed of the continuing trends in your blood
pressure.
Wind the cuff snugly around your wrist and the cuff must be at
the same level as your heart.
3. Important information before use of the device
* Do not use this manual and product as a substitute for
advice, diagnosing or treating a health problem or prescribing
any medication by your doctor.
* The device is not suitable for clinical use.
* This monitor is not intended for use in the MR environment.

6
Do not vibrate the unit during measurement, or the proper
measurement will not be achieved.
Perform measurement quietly in a relaxed position.
Do not wind the cuff over jacket or sweater sleeve, or
measurement cannot be done.
Keep in mind, that blood pressure naturally varies from time to
time throughout the day and also is affected by lots of different
factors such as smoking, alcohol consumption, medication and
physical activity.
People with a condition that causes circulatory problems
(diabetes, kidney disease, arteriosclerosis or poor peripheral
circulation) may get lower readings with this monitor that with a
blood pressure monitor that is used on the upper arm. Please
consult your physician to determine if your wrist blood pressure
accurately reects your actual blood pressure.
Blood pressure measurement determine with the unit are
equivalent to those obtained by a trained observer using
the cuff / stethoscope auscultation method. Within the limits
prescribed by the Standard of EN 1060-4.
We recommend you using the same wrist (preferably the left
wrist) and measuring around the same time each day.
Perform measurements in a quiet and relaxed environment at
room temperature.
This product is not suitable for:
Pregnant women
People with arrhythmias
Undergoing intravenous injection on any limb
Currently in a dialysis treatment
In pre-eclampsia condition

7
For those who have had mastectomy surgery (especially
whose’ lymph nodes removed), it’s recommend take a
measurement on the unaffected side.
When used among medical electronic equipments on the
same limb, pressurization of the cuff may cause temporarily
malfunction to other devices.
*Note!
1. Do not use the device on infants, children, or those who
cannot express their own intention.
2. The device is equipped with sensitive electronic components.
While measuring, avoid strong electrical or electromagnetic
elds, e.g. mobile phones, microwave ovens, etc; or it may
lead to temporary reading error or inaccuracy.
3. Consider the electromagnetic compatibility of the device (ex.
power disturbance, radio frequency interference etc.) Please
use it indoor only.
4. Over high frequency measurements may result in blood
ow interference, which is likely to cause uncomfortable
sensations, such as partial subcutaneous hemorrhage,
or temporary numbness to your wrist. In general, these
symptoms should not last long. However, if you do not
recover in time, please seek your medical practitioners for
help.

8
A. Name of the parts
4. Device description:
SETTING BUTTON
FUNCTION BUTTON
LCD DISPLAY
START/STOP BUTTON
(
STOP
START
Stand-by)
MRECALL MEMORY
BUTTON
WRIST CUFF
CARRYING
CASE
ALKALINE BATTERY
UM-4 (AAA) LR03 1.5 V x 2
* Figure No.3
*Caution!
Any articial changes to the
original device might result in
measurement error.
Substitution of a component
different from that supplied
might result in measurement
error.
mmHg
mmHg
/min
Pulse
USER
DIA
SYS
START
STOP
M
PM
2
1
:
AVG

9
PM
2
1
:
AVG
B. Description of display symbols
PULSE SYMBOL
LAST 3 READING
AVERAGE
LOW BATTERY
SYMBOL
HOUR：MINUTE
MONTH/DATE
SYSTOLIC
BLOOD
PRESSURE
DIASTOLIC
BLOOD
PRESSURE
PULSE
(ALSO REPRESENTS AS YEAR
UNDER SETTING MODE)
USER 1
USER 2

10
Remove the battery cover and insert 2 AAA LR03 alkaline
batteries into the battery compartment as shown.
5. Changing batteries
* Figure No.4
Remove the battery cover at the left side of the unit and insert
batteries into the battery compartment in accordance with ribbon
strip as shown, taking extreme care that the polarities + and - are
observed.
Important notice: to
take the batteries
out easily, just pull
the ribbon strip for
help.
*Note!
● Batteries are hazardous waste. Do not dispose of them
together with the household garbage. Please take the used
batteries to the recycling collection point according to your
local regulations.
● Keep the battery away from small children in case they
swallow it.
● To prolong the battery life and prevent damage caused by
leakage, remove the batteries from the device if the device
is not to be used for a long period.
● Memories (if any) will not be deleted during battery
replacement.
● After replacing the batteries, reset the date and time.

11
A. Wrap the pressure cuff around the wrist.
a. The display of the unit should be
placed on the palm side of the wrist.
b. The wrist should be bare.
6. Attaching pressure cuff
* Figure No.5
10 mm
(0.4 inch)
B. Fasten the pressure cuff snugly.
a. Do not pull strongly on the pressure
cuff.
b. Do not make the pressure cuff too
tight.
c. Leave approximately 10 mm (0.4
inches) between the sleeve and the
bottom of the palm of your hand.
Figure No. 5. * Figure No.5-1
135 ~ 195 mm
(5.3 ~ 7.7 inch)
*Note!
● Do not use this device if your wrist has any wound or injury.
● Do not wrap the cuff around any body part other than your
wrist.

12
It is extremely important for the measured values, that the cuff is
at the same height of the heart.
Higher or deeper position will give deviations from the true value.
7. Correct measurement position
Measurement while sitting down:
a. Sit down comfortably with your feet at
on the oor.
Please do not cross your legs during
measurements.
b. Position the blood pressure monitor on
your wrist.
c. Place your elbow on a table or other
object.
d. Use the armrest to position the arm so
that the pressure cuff is at the same
height as the heart.
e. Relax your hand with the palm facing up.
* Figure No.6

13
SYMBOLS
8. Symbol Denitions
Denitions
Pulse Symbol
Last 3 Reading
Average
This symbol appears when the battery power
is excessively low or the polarity reverses.
➔We suggest you replace all batteries with
new ones, and make sure the +/- polarities
are properly positioned.
Once pulse is detected, the symbol ashes
with each pulse beat.
➔Our suggestion:
Please do not talk or move during
measurements.
This symbol appears when LCD displays
average value of last 3 readings.
Low Battery
Symbol
User 1
User 2
Appears when the monitor is operated by
User 1.
Appears when the monitor is operated by
User 2.
AVG
1
2

14
Cuff has been placed
incorrectly.
SYMBOLS/
SYMPTOMS CONDITIONS/ CAUSES INDICATION/ CORRECTION
Measuring Error
Symbol
Measuring Error
Symbol
Note: If "EP" appears on the display, just return the device to your local
distributor or importer.
Shaking of the wrist
with the cuff on.
Ination pressure
exceeding 300 mmHg.
Air circuit adnormality.
Cuff tube may not be
plugged into monitor
correctly.
Can't determine blood
pressure measurement
data.
Wrap the cuff properly
so that it is positioned
correctly.
Switch the unit off,
then measure again.
Check cuff connection.
Measure again.
Measuring Error
Symbol
Measuring Error
Symbol shown on
display or the blood
pressure value is
displayed excessively
low or high.
Did you talk or move
during measurement?
Wrap the cuff properly
and keep steady.
Measure again.
Measure again. Keep
wrist steady during
measurement.
Worn-out batteries. Replace them with 2
new AAA (LR03) alkaline
batteries.
Battery polarities
have been positioned
incorrectly.
Re-insert the batteries in
the correct positions.
No power-on by
pressing
STOP
START
button

15
a. Open battery cover.
b. Refer to the picture in positioning batteries. (Figure No.4)
c. All LCD segments appear on the display in 3 seconds.
9. How to measure
A. Inserting batteries in position:
a. Press " " button over 2 secs ("year" starts ashing)
Press " " button to set the correct year
(2011,2012,…2026)
b. Press " " button ("month" starts ashing)
Press " " button to set the correct month (1,2,3,.....12)
c. Press " " button again ("date" starts ashing)
Press " " button to set the correct date
d. Press " " button again ("hour" starts ashing)
Press " " button to set the correct hour in 12-hour
format
e. Press " " button again ("minute" starts ashing)
Press " " button to set the correct minute (0,1,2,3,.....59)
f. Press " " button again to switch to normal time
(month, date, hour and minute appear on the display)
B. Setting Date and Time:
a. Wrap the cuff around the wrist (Refer to Wrapping of Wrist
cuff as Figure No. 5)
C. Steps to take blood pressure measurement:

16
b. Sit upright on the chair to have correct posture. (Refer to
Correct Posture in Taking Blood Pressure as (Figure No. 6)
c. Press"
STOP
START
"button. Press " " button to select USER
(
1
2
). Press "
STOP
START
" button again. All elements
display '888' in 3 seconds. Afterward, displays the updated
time. Pulse symbol will ash on the display and then the
air pressure will automatically pump up to 195 mmHg.
If blood pressure tends to be on the high level, the air
pressure will automatically increase to the required level for
measurement.
e. After taking blood pressure measurement, the Systolic
blood pressure, Diastolic blood pressure and pulse will be
on the display for 1 minute.
*Note!
• If the cuff does not stop inating, remove the cuff at once.
• To interrupt the measurement, you may press the
STOP
START
button. The cuff will deate immediately after a button is
pressed.
* Do not move or talk in the midst of taking blood pressure
measurement.
d. After the air pressure is increased, it will slowly decrease.
When the pulse is detected, will start ashing.
*Note!
Do not inflate the cuff until it is wrapped around your wrist.