Measuring systolic blood pressure: The request could not be satisfied
Measure Your Blood Pressure | cdc.gov
Measure your blood pressure regularly to help your health care team diagnose any health problems early. You and your health care team can take steps to control your blood pressure if it is too high.
Why do I need to measure my blood pressure?
Measuring your blood pressure is the only way to know whether you have high blood pressure. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it.
Where can I get my blood pressure checked?
You can get your blood pressure measured
- By a health care team member at a doctor’s office.
- At a pharmacy that has a digital blood pressure measurement machine.
- With a home blood pressure monitor that you can use yourself.
Take this form pdf icon[PDF – 105 KB] with you on your first blood pressure visit to record important blood pressure-related information.
What affects a blood pressure reading?
Many things can affect a blood pressure reading, including:
- Nervousness about having your blood pressure taken. This is called “white coat syndrome.” As many as 1 in 3 people who have a high blood pressure reading at the doctor’s office may have normal blood pressure readings outside of it.1
- What you ate, drank, or did before your reading. If you smoked, drank alcohol or caffeine, or exercised within 30 minutes of having your blood pressure measured, your reading might be higher.2
- How you are sitting. Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.2
It’s important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke.
A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health.
A reading that says your blood pressure is higher than it actually is may lead to treatment you don’t need.
Close
What is the correct way to measure blood pressure?
Learn the correct way to have your blood pressure taken, whether you’re getting it checked at the doctor’s office or checking it yourself at home. Use this checklist:
- Don’t eat or drink anything 30 minutes before you take your blood pressure.
- Empty your bladder before your reading.
- Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
- Put both feet flat on the ground and keep your legs uncrossed.
- Rest your arm with the cuff on a table at chest height.
- Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
- Do not talk while your blood pressure is being measured.
If you are keeping track of your blood pressure at home, use these additional tips.
How do health care professionals measure my blood pressure?
First, a health care professional wraps an inflatable cuff around your arm. The health care professional then inflates the cuff, which gently tightens on your arm. The cuff has a gauge on it that will measure your blood pressure.
The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. This process is quick and painless. If using a digital or automatic blood pressure cuff, the health care professional will not need to use a stethoscope.
The gauge uses a unit of measurement called millimeters of mercury (mmHg) to measure the pressure in your blood vessels.
If you have high blood pressure, talk to your health care team about steps to take to control your blood pressure to lower your risk for heart disease and stroke.
Use this list of questions to ask your health care team pdf icon[PDF – 173 KB] to help you manage your blood pressure.
How can I measure my blood pressure at home?
Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring.
SMBP means you regularly use a personal blood pressure measurement device away from a doctor’s office or hospital—usually at home. These blood pressure monitors are easy and safe to use. A health care team member can show you how to use one if you need help.
Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their health care team than if they don’t use SMBP.3
Use these additional tips for SMBP:4
How often should I measure my blood pressure?
Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. People who have high blood pressure may need to measure their blood pressure more often than people who do not have high blood pressure.
What should I do if my blood pressure numbers are high?
If you are concerned about your blood pressure numbers, talk to your health care team. They can help you make a plan to manage high blood pressure.
No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range.
Shareable Handouts and Tools
How does one know the true systolic number of a blood pressure?
Dear Christopher,
Below is a method that I use to measure blood pressure. You can find further information in most textbooks of Physical Diagnosis.
Technique of Measuring Blood Pressure
1.
The subject should be sitting in chair with his feet on the floor (sitting with the legs hanging off of the examination table will falsely raise the blood pressure).
2. Apply the fully deflated cuff snugly around the upper arm and place the marked area over the inside (medial) aspect of the elbow which is over the brachial artery.
3. While palpating the radial pulse, inflate the cuff and note the pressure reading at the point the pulse is extinguished. This estimates the systolic blood pressure.
4. Apply the stethoscope over the brachial artery above the elbow joint just below the cuff.
5. Inflate the cuff to a reading which is at least 15 mmHg above where the pulse was extinguished. Inflating the cuff too rapidly to high pressures may cause discomfort and result in a temporary increase in the pressure over the baseline.
6. Listen for the onset of the Karotkoff sounds which is the systolic pressure.
7. Drop the pressure slowly (2 mmHg per beat) until the sounds disappear. This is the diastolic pressure.
Points to Remember:
An alternate method is to arbitrarily pump the cuff to 200 mmHg and listen for the sounds. This is not recommended because (1) It may cause pain. (2)The pressure may actually be higher than 200 and one could have inflated to the level of the ‘auscultatory gap’ which is a pressure range in some patients where the sounds may actually temporarily disappear which can cause significant underestimation of the systolic pressure.
If you hear an occasional sound at the beginning of step 6 above, it could be do to a variation of the pressure of a single beat which is common in the presence of an irregular heart beat. Repeat the measurement until you get a clear reading during a period regular rhythm (if possible). Accurate measurement of the blood pressure by this technique depends on the presence of a regular rhythm. In patients with frequent premature beats and atrial fibrillation, the pressure varies from beat to beat.
By auscultation, one can better estimate the pressure. Digital devices essentially measure one systolic and one diastolic pressure and assume the rhythm is regular. The varying RR intervals will often lead to inaccurate readings of both the blood pressure and the pulse. The digital pressure recording should not be trusted in the presence of an irregular rhythm.
In patients with severe respiratory distress (eg., asthma) or pericardial tamponade, the pressure will vary significantly with the respiratory cycle (pulsus paradoxus). The degree of paradox is the pressure difference from the onset of all sounds to the appearance of sounds during the entire respiratory cycle (consistent sounds). A paradox reading of >10 mmHg is considered abnormal.
Finally, in some individuals, one can hear Karotkoff sounds close to zero. In this case, the point at which the sounds become muffled is considered the diastolic pressure. It is appropriate to give 3 readings in this situation. For example: 130/70/15 or 150/70/0.
One last point: When measuring the pressure in a patient for the first time, measure it in both arms. A consistent difference of >10 mmHg is a sign of possible arterial obstruction which may need to be investigated. The correct pressure is obviously in the arm with the highest reading.
I hope this answers your question. Sincerely.
Checking Your Blood Pressure at Home
You don’t always have to go to your doctor’s office to have your blood pressure checked; you can monitor your own blood pressure at home. This is especially important if your doctor recommends that you monitor your blood pressure on a regular basis.
Tips for Checking Your Own Blood Pressure
There are certain factors that can cause blood pressure to temporarily rise. For example, blood pressure normally rises as a result of:
- Stress
- Smoking
- Cold temperatures
- Exercise
- Caffeine
- Certain medicines
Try to avoid as many of these factors as you can when taking your blood pressure.
Also, try to measure your blood pressure at about the same time each day. Your doctor may want you to check your blood pressure several times during the day to see if it fluctuates.
Before Checking Your Blood Pressure
- Find a quiet place to check your blood pressure. You will need to listen for your heartbeat.
- Make sure that you are comfortable and relaxed with a recently emptied bladder (a full bladder may affect your reading).
- Roll up the sleeve on your arm or remove any tight-sleeved clothing.
- Rest in a chair next to a table for 5 to 10 minutes. Your arm should rest comfortably at heart level. Sit up straight with your back against the chair, legs uncrossed. Rest your forearm on the table with the palm of your hand facing up.
Step-by-Step Blood Pressure Check
If you purchase a manual or digital blood pressure monitor (sphygmomanometer), follow the instruction booklet carefully.
The following steps provide an overview of how to take your left arm blood pressure on either a manual or digital blood pressure monitor. Simply reverse the sides to take a blood pressure in your right arm.
1. Locate your pulse
Locate your pulse by lightly pressing your index and middle fingers slightly to the inside center of the bend of your elbow (where the brachial artery is). If you cannot locate your pulse, place the head of the stethoscope (on a manual monitor) or the arm cuff (on a digital monitor) in the same general area.
Continued
2. Secure the cuff
Slide the cuff onto your arm, making sure that the stethoscope head is over the artery (when using a manual monitor.) The cuff may be marked with an arrow to show the location of the stethoscope head. The lower edge of the cuff should be about 1 inch above the bend of your elbow. Use the fabric fastener to make the cuff snug, but not too tight.
Continued
Place the stethoscope in your ears. Tilt the ear pieces slightly forward to get the best sound.
3. Inflate and deflate the cuff
If you are using a manual monitor:
- Hold the pressure gauge in your left hand and the bulb in your right.
- Close the airflow valve on the bulb by turning the screw clockwise.
- Inflate the cuff by squeezing the bulb with your right hand. You may hear your pulse in the stethoscope.
- Watch the gauge. Keep inflating the cuff until the gauge reads about 30 points (mm Hg) above your expected systolic pressure. At this point, you should not hear your pulse in the stethoscope.
- Keeping your eyes on the gauge, slowly release the pressure in the cuff by opening the airflow valve counterclockwise. The gauge should fall only 2 to 3 points with each heartbeat. (You may need to practice turning the valve slowly.)
- Listen carefully for the first pulse beat. As soon as you hear it, note the reading on the gauge. This reading is your systolic pressure (the force of the blood against the artery walls as your heart beats).
- Continue to slowly deflate the cuff.
- Listen carefully until the sound disappears. As soon as you can no longer hear your pulse, note the reading on the gauge. This reading is your diastolic pressure (the blood pressure between heartbeats).
- Allow the cuff to completely deflate.
Continued
You’ll get the most accurate reading if your arm is held straight.
If you released the pressure too quickly or could not hear your pulse, DO NOT inflate the cuff again right away. Wait one minute before repeating the measurement. Start by reapplying the cuff.
Continued
If you are using a digital monitor:
- Hold the bulb in your right hand.
- Press the power button. All display symbols should appear briefly, followed by a zero. This indicates that the monitor is ready.
- Inflate the cuff by squeezing the bulb with your right hand. If you have a monitor with automatic cuff inflation, press the start button.
- Watch the gauge. Keep inflating the cuff until the gauge reads about 30 points (mm Hg) above your expected systolic pressure.
- Sit quietly and watch the monitor. Pressure readings will be displayed on the screen. For some devices, values may appear on the left, then on the right.
- Wait for a long beep. This means that the measurement is complete. Note the pressures on the display screen. Systolic pressure (the force of the blood against the artery walls as your heart beats) appears on the left and diastolic pressure (the blood pressure between heartbeats) on the right. Your pulse rate may also be displayed in between or after this reading.
- Allow the cuff to deflate.
Continued
If you did not get an accurate reading, DO NOT inflate the cuff again right away. Wait one minute before repeating the measurement. Start by reapplying the cuff.
4. Record your blood pressure.
Follow your doctor’s instructions on when and how often you should measure your blood pressure. Record the date, time, systolic and diastolic pressures. You should also record any special circumstances like any recent exercise, meal, or stressful event.
At least once a year, and especially after you first purchase your blood pressure monitor, bring your monitor with you to your doctor’s visit to check the machine’s accuracy. This is done by comparing a blood pressure reading from your machine with one from the doctor’s office machine.
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Digital Blood Pressure Measurement
Blood pressure is the force of the blood against the wall of any blood vessel.
The blood pressure measurement is written in numbers. The systolic (sis TAU lick) blood pressure is the top number. The diastolic (dy a STAU lick) blood pressure is the bottom number (for example, 110/60).
- The systolic blood pressure is the pressure of the blood against the artery walls when the heart contracts (beats).
- The diastolic blood pressure is the pressure of the blood against the artery walls between heartbeats, when the heart relaxes.
Doctor’s Orders
Take the blood pressure on the child’s
- Right arm
- Left arm
- Right leg
- Left leg
Take your child’s blood pressure every day at the same times:
_____________, _____________, _____________, _____________, _____________, and _____________.
When to Call the Doctor
Call your child’s doctor:
- If the top number is: above ______ or below ______ for ______ blood pressure readings or for ______ hours.
- If the bottom number is: above ______ or below ______ for ______ blood pressure readings or for _______ hours.
Other instructions:
____________________________________________________________________________________________________
____________________________________________________________________________________________________.
Assemble the Blood Pressure Unit
It is important to read the manual that comes with the blood pressure unit.
Follow these 5 steps to get your blood pressure unit ready to use.
- After you open the device, insert the batteries. The battery compartment is on the back of the device (Picture 1).
- Remove cover from the bottom plate, as shown.
- Insert 4 batteries (size AA). Always use AA long life batteries or alkaline 1.5 volt batteries. Do not use rechargeable batteries.
- If a battery warning appears in the display, replace the batteries. Connect the tube.
- Insert the cuff tube into the opening on the side of the device, (Picture 2).
How to Take a Blood Pressure Reading
- Place the cuff snugly about 1 inch above your child’s elbow, usually on the left arm (Picture 3).
- Press the On/Off/Memory button to turn on the many symbols will appear in the display window for 2 seconds. A blinking 0 appears in the display.
- Grasp the bulb with the hand opposite of the arm the cuff is on. Pump the bulb to fill the cuff with inflate the cuff to a number at least 30 mmHg higher than the expected top pressure. See Average Blood Pressure by Age chart below.
- When the cuff is inflated, lay down the bulb. Have your child relax and sit quietly. The measurement now proceeds on its own. As the device measures the blood pressure, the numbers always show in the window. If no measurement takes place, a flashing arrow pointing up will show in the display. Pump the bulb again to a higher number.
- When the device senses a pulse, a heart symbol in the display starts to flash. You will hear a beep for each heartbeat.
- When the measurement is complete, the systolic and diastolic blood pressure and the pulse show in the display. Quickly release the cuff pressure.
| Age | Blood Pressure |
|---|---|
| Premature | 55-75/35-45 |
| 0-3 Months | 65-85/45-55 |
| 3-6 Months | 70-90/50-65 |
| 6-12 Months | 80-100/55-65 |
| 1-3 Years | 80-105/55-70 |
| 6-12 Years | 100-120/60-75 |
Quickly release the cuff pressure.Keeping a Record
It is It is important to keep a record of your child’s blood pressure. Use the Daily Blood Pressure Record on the next page, a regular calendar, or Helping Hand HH-3, Daily Record.
- Write your child’s blood pressure in the box for that day. For example, if your child’s blood pressure is 120/60 and 122/62 on the first day, you would record it as shown in the example below.
- Take the record with you whenever your child sees the doctor.
Digital Blood Pressure Measurement (PDF)
HH-II-213 4/16 Copyright 2016, Nationwide Children’s Hospital
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Blood Pressure> Auscultatory Method | ||||||||||||||
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The relaxed subject sits on a chair with the lower arm supported as before. The blood pressure cuff is placed on the subject’s right arm, allowing 1 inch between the bottom of the cuff and the crease of the elbow. | |||||||||||||||
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The brachial pulse is palpated just above the angle of the elbow (the “antecubital fossa”). | |||||||||||||||
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One group member puts on a stethoscope, with the earpieces
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The diaphragm is placed over the brachial artery in the space between the bottom of the cuff and the crease of the elbow. At this point no sounds should be heard. | |||||||||||||||
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The subject should now lie on his or her back for five minutes. The systolic pressure and diastolic pressure are recorded. Then the subject stands up, and the pressures are immediately recorded once more. | |||||||||||||||
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Explanatory NotesThe laminar flow that normally occurs in arteries produces little vibration of the arterial wall and therefore no sounds. However, when an artery is partially constricted, blood flow becomes turbulent, causing the artery to vibrate and produce sounds. | |||||||||||||||
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When measuring blood pressure using the auscultation method, turbulent blood flow will occur when the cuff pressure is greater than the diastolic pressure and less than the systolic pressure. The “tapping” sounds associated with the turbulent flow are known as Korotkoff sounds. Remember that these sounds are not to be confused with the heart sounds produced by the opening and closing of the heart valves. | |||||||||||||||
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Summary of the auscultatory method: | |||||||||||||||
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Initially the cuff is inflated to a level higher than the systolic pressure.  Thus the artery is completely compressed, there is no blood flow,
and no sounds are heard. The cuff pressure is slowly decreased. At the point where the systolic pressure exceeds the cuff pressure, the Korotkoff sounds are first heard and blood passes in turbulent flow through the partially constricted artery. Korotkoff sounds will continue to be heard as the cuff pressure is further lowered. However, when the cuff pressure reaches diastolic pressure, the sounds disappear. Now at all points in time during the cardiac cycle, the blood pressure is greater than the cuff pressure, and the artery remains open. | |||||||||||||||
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>>For a QuickTime video with sound, click here
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Errors in blood pressure readings: The cuff is not of the proper size: if the cuff is too small
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To continue with the next section: the Electrocardiogram, click here | |||||||||||||||
This can be tested by tapping lightly
At some point, the sounds will disappear. 
If the cuff is
What Are Systolic and Diastolic Blood Pressures?
The measurement of a person’s blood pressure is recorded as two different numbers—the systolic blood pressure and the diastolic blood pressure. These two numbers reflect different aspects of the pressure being exerted by your blood as it pulses through your arteries.
When your heart pumps blood into your arteries, it pushes the blood along under a head of pressure. Doctors measure your blood pressure as a way of quantifying the force being exerted by this moving blood against the walls of your arteries.
Because the heart beats, the blood flow through the arteries is not steady (as with a fire hose), but pulsatile, and the flow of blood, and the pressure it exerts, fluctuate from moment to moment.
The Blood Pressure Reading
- Your blood pressure reading is written as 120/80.
- It is spoken like this: “120 over 80.”
- The systolic blood pressure reading is the higher number.
- The diastolic blood pressure reading is the lower number.
- The units are millimeters of mercury (mmHg).
Both the systolic and diastolic pressures are important. If the readings are too high, hypertension may be present. If the blood pressure readings are too low, there may be insufficient blood flow to critical organs, such as the brain.
Verywell / JR Bee
What Is Systolic Blood Pressure?
The pressure exerted by your blood flowing through your arteries is not constant but is dynamic, and constantly reflects what the heart is doing at a given moment.
When the heart is actively beating (an event called “systole”), it is ejecting blood out into the arteries. This dynamic ejection of blood into the arteries causes the pressure within the arteries to rise. The peak blood pressure reached during active cardiac contraction is called the systolic blood pressure.
A “normal” systolic blood pressure when a person is sitting quietly is 120 mmHg or below.
High Systolic Blood Pressure
When a person is exercising, during periods of emotional stress, or at any other time when the heart is stimulated to beat more strongly than at rest, the force of cardiac contraction increases—and the systolic pressure goes up.
The increase in systolic blood pressure that occurs during these conditions of cardiac stress is entirely normal. This explains why it is so important to measure the blood pressure during periods of quiet rest before diagnosing hypertension.
Low Systolic Blood Pressure
If the systolic blood pressure is lower than normal, systolic hypotension is said to be present. If systolic hypotension is severe enough, it can cause lightheadedness, dizziness, syncope, or (if it lasts long enough), organ failure.
Systolic hypotension can occur if the blood volume becomes too low (as with severe dehydration or a major bleeding episode), if the heart muscle becomes too weak to eject the blood normally (a condition known as cardiomyopathy), or if the blood vessels become too dilated (as in vasovagal syncope).
A common condition that produces systolic hypotension is orthostatic hypotension.
What Is Diastolic Blood Pressure?
The diastolic blood pressure is the pressure the blood exerts within the arteries in between heartbeats, that is, when the heart is not actively ejecting blood into the arteries.
After the heart is finished contracting, the cardiac ventricles relax momentarily so that they can be refilled with blood, in preparation for the next contraction. This period of ventricular relaxation is called “diastole,” and the blood pressure during diastole is called the diastolic blood pressure.
A “normal” diastolic blood pressure during quiet rest is 80 mmHg or below. In hypertension, the diastolic blood pressure is often increased during quiet rest.
Diastolic hypotension (when the diastolic blood pressure is low) may be seen with dehydration or with bleeding episodes, or if the arteries become abnormally dilated.
Quiet Rest for Accuracy
Blood pressure is a very dynamic thing. The level of your blood pressure depends on the activity of your heart and the elasticity of your arteries. As we have seen, the blood pressure is actively changing from moment to moment as the heart cycles between systole and diastole.
In addition, your systolic and diastolic blood pressure (the highest and the lowest blood pressure reached during any given cardiac cycle) can change substantially from minute to minute depending on your state of activity, your state of stress, your state of hydration, and several other factors.
What this means is that, in order to diagnose hypertension accurately, it is important to control for as many “external” factors as possible.
The standard recommended by experts requires the blood pressure to be taken in a calm, warm environment after you have been resting quietly for at least five minutes.
Measuring blood pressure this way is a challenge in today’s typical, harried doctor’s office, making the accurate diagnosis of hypertension much more of a challenge than it should be. This is why most experts today recommend recording the blood pressure over an extended period of time, with ambulatory monitoring, before making the diagnosis of hypertension.
A Word From Verywell
Systolic and diastolic blood pressures represent the pressures within the blood vessels during different parts of the cardiac cycle. Accurately measuring both of these values is important in diagnosing and managing hypertension.
90,000 To whom, why and how to measure blood pressure
The level of blood pressure is one of the brightest indicators of the state of health. True, most often the need to monitor blood pressure is remembered for diseases of the cardiovascular system. In fact, everyone should know all about their pressure, because it changes for different reasons.
What is blood pressure?
Blood pressure (BP) – the pressure that blood exerts on the walls of the arteries.It is uneven and fluctuates depending on the phase of the heart. In systole, when the heart contracts and throws another portion of blood into the vessels, the pressure increases. And in diastole, when the heart relaxes and fills with blood, the pressure in the arteries decreases. Blood pressure on the walls of the arteries in systole is called “upper” or systolic, and in diastole – “lower” or diastolic. It is customary to write the blood pressure value through a fraction: the first is the upper, the second is the lower.
BP is one of the most important indicators of the cardiovascular system.In most healthy people, it is relatively constant.
But under the influence of stress, physical exertion, overwork, drinking a large amount of liquid and under the influence of other factors, its value can change. Usually, such changes are either not too frequent, or not too strong, and do not exceed 20 mm during the day. rt. Art. – for systolic, 10 mm. rt. Art. – for diastolic. But, here, a repeated or persistent decrease or increase in pressure that goes beyond the normal range may turn out to be an alarming signal of the disease and requires an immediate visit to a doctor.
Norms of blood pressure according to WHO classification
| Blood pressure (category) | Upper arterial pressure (mm Hg) | Lower arterial pressure (mm Hg) |
| Hypotension (decreased) | below 100 | below 60 |
| Optimum pressure | 100-119 | 60-79 |
| Normal pressure | 120-129 | 80–84 |
| High Normal Pressure | 130-139 | 85–89 |
| Moderate hypertension (high) | 140-159 | 90–99 |
| Moderate hypertension | 160-179 | 100-109 |
| Severe hypertension | over 180 | over 110 |
The “cosmonaut pressure” is considered ideal – 120/80 mm.rt. Art. However, many doctors agree that everyone has their own ideal, and therefore they often ask about the “working” pressure of the patient. Working blood pressure is the usual constant interval of blood pressure, which provides a person with good health. Since this interval is individual, for someone 115/80 with a working 130/90 may turn out to be reduced, although it fits within the normal range. And, conversely, with a working 110/80, 130/90 can become increased. Knowing the working pressure helps the doctor to timely identify the pathology, more accurately diagnose and choose the right treatment.
However, it is worth remembering that pressure beyond the lower and upper limits of the norm is not a worker for a healthy person. And a normal state of health in this case is only an additional reason to seek the advice of a specialist.
Who needs to monitor blood pressure and how?
One of the most common disorders in blood pressure regulation is hypertension. Often behind it lies hypertension, leading to myocardial infarction, stroke and other serious complications.Unfortunately, arterial hypertension is often asymptomatic, so everyone needs to monitor blood pressure. People prone to its increase, susceptible to risk factors for the development of hypertension and experiencing its symptoms should be especially careful and measure blood pressure from time to time. For the rest, annual control during the period of medical examination is quite enough. But for those with a confirmed diagnosis of arterial hypertension, it would be good to make friends with a tonometer and check the pressure level at least twice a day – in the morning and in the evening.
It is imperative to measure blood pressure when weakness, dizziness, headache, darkening, “veil” in the eyes, tinnitus, shortness of breath, pain and heaviness in the region of the heart or behind the breastbone appear, or when other symptoms appear that usually accompany an increase or decrease in pressure …
It is also worth monitoring blood pressure during exercise, especially when selecting a load.
How to measure blood pressure correctly?
If the measurement of blood pressure is planned, then one hour before it, you should not drink alcohol, drinks containing caffeine (tea, cola, coffee) and smoke, and five minutes before the measurement, ensure yourself a state of rest.
At the first visit to the doctor, the pressure is measured on both hands alternately. If the results differ by more than 10 mm. rt. Art.
, then in the subsequent measurement is carried out on the arm with a large value of blood pressure. However, the normal readings are about the same. The difference between them is more than 10 mm. rt. Art., speaks of an increased risk of diseases of the cardiovascular system and death from them, or about an existing pathology.
BP is usually measured while sitting or lying down. The hand on which the measurement is taken should be free from clothing and squeezing objects, relaxed and motionless.To avoid unwanted stress, it can be placed on an object that provides a fulcrum, such as a table or the edge of a bed. It is best to position the limb so that the elbow is at the level of the heart. The arm should not have arteriovenous fistulas for dialysis, traces of the incision of the brachial artery, lymphedema.
The cuff is placed on the shoulder 2 cm above the elbow bend. It is important that it fits snugly around your hand, but does not squeeze it.
Ideally, BP is measured twice at 2 minute intervals.If the result differs by more than 5 mm. rt. Art. – after 2 minutes, carry out the third measurement and calculate the average value.
The method of measuring pressure depends on the device with which it is carried out, and is indicated in the instruction manual.
How to choose a pressure measuring device?
A device for measuring pressure is called a tonometer. There are two types of tonometers – mechanical and electronic (automatic and semi-automatic).
A mechanical tonometer is inexpensive, reliable, lasts a long time, guarantees high measurement accuracy, is easy to use, but requires certain skills and is more difficult to use without assistance.
The electronic tonometer is convenient and simple, you can easily cope with it yourself. In addition to devices that measure pressure on the shoulder, there are those that measure it on the wrist. Such a tonometer can be carried with you, which is sometimes important for some hypertensive patients.
And devices with a large dial come in handy for the elderly. Many of the electronic blood pressure monitors show the pulse, remember the data of the last measurements and are equipped with some other functions, the quantity and quality of which largely depends on the price of the device.But automatic and semi-automatic devices are more expensive than mechanical ones, less accurate and may last a little less. In addition, in some diseases, blood pressure is very difficult to measure with an electronic tonometer, for example, with atrial fibrillation.
When purchasing a tonometer, be sure to pay attention to the presence of instructions in Russian, a passport of the device, a warranty card and the absence of visible defects. And when buying an electronic device – also for the country of origin. Japanese and German devices are traditionally considered the best.
If the choice fell on a mechanical tonometer, it is worth remembering that you need a phonendoscope for it. It is often not included in the package.
Pressure gauges are best purchased from a pharmacy or specialty store. Measurement accuracy and service life cannot be guaranteed if the device is purchased hand-held.
The average cuff width should be 13–17 cm, for children – a little less, for overweight people – a little more.
Before use, the tonometer should be checked and, if necessary, adjusted.It is easier and more correct to do this with the help of a doctor.
How to measure blood pressure with a mechanical tonometer?
Not everyone can independently measure pressure with a mechanical tonometer, so the help of another person is desirable.
In addition to a tonometer, you will need a phonendoscope for measurement.
Phonendoscope – a device for listening to sounds accompanying the work of internal organs. It consists of a “head” that is applied to the body, tubes that conduct sound, and tips that are inserted into the ears.
Measurement order:
- A cuff is applied to the shoulder, 2 cm above the elbow bend.
- Determined the pulse at the radial artery at the wrist.
- Air is rapidly pumped into the cuff. After the disappearance of the pulse, the cuff is pumped for another 30–40 mm Hg. Art.
- Along the lower edge of the cuff in the ulnar fold, slightly inward from the center of the ulnar fossa, the head of the phonendoscope is placed.
- Air is slowly released from the cuff – at a speed of 2-3 mm Hg.Art. in 1 p. In this case, the scale of the device is constantly monitored. The scale value at which the first sound appears is considered the value of the systolic pressure, and the value at which it disappears is the diastolic value.
- When the beat of the pulse wave is no longer audible, air is rapidly released from the cuff.
Measuring blood pressure with an electronic tonometer for a specific device may have its own subtleties and is described in detail in the instruction manual.
Blood pressure norm, blood pressure measurement
Blood pressure norm
Blood pressure is the pressure of the blood in a person’s large arteries.There are two indicators of blood pressure:
– Systolic (upper) blood pressure – at the time of maximum contraction of the heart;
– Diastolic (lower) blood pressure at the time of maximum relaxation of the heart.
The level of blood pressure is not a constant value – it fluctuates continuously depending on the impact of various factors. Blood pressure is measured in millimeters of mercury (mmHg). The normal systolic blood pressure range is 115-130 mmHg.Art. The normal diastolic blood pressure range is 60 – 89 mm Hg.
Blood pressure measurement
Measurement of blood pressure can be carried out both at rest and during the action of physical or psycho-emotional stress, as well as in the intervals between different types of activity.
Blood pressure is most often measured while sitting (the back must be supported, since any form of isometric exercise causes an immediate increase in blood pressure) or lying down.
Measurement of blood pressure requires rest (you cannot talk or make sudden movements).
Do I need to measure blood pressure on two hands?
Increased blood pressure
Hypertension (arterial hypertension) – persistent increase in blood pressure in large arteries over 140/90 mm Hg. Increased blood pressure is the main risk factor for the development of vascular diseases of the brain, coronary heart disease, heart and kidney failure, and eye damage.
The main goal of treating hypertension is not to knock down, but to gradually reduce blood pressure, striving to achieve a level of 120-130 / 80 mm Hg. Art. For elderly patients, it is advisable to lower blood pressure to higher values (140-145 / 85-90 mm Hg). An excessive decrease in blood pressure is dangerous for patients with arterial hypertension with left ventricular hypertrophy, coronary artery disease and cerebrovascular disease, as this impairs the blood supply to the vessels of the heart and brain.
Can arterial hypertension be cured?
Is it necessary to lower systolic pressure in old age?
Lowering blood pressure without medication?
Low blood pressure
Hypotension (arterial hypotension) – a persistent decrease in blood pressure below normal, low blood pressure.
The magnitude of such a decrease is individual, but usually below 100/60 mm Hg.Art. for men and 95/60 mm Hg. Art. for women.
The causes of low blood pressure can be various: dehydration, blood loss, heart failure, heart defects, poisoning, chronic infections (tuberculosis), tumors, hypovitaminosis, but the most common cause of hypotension is vegetative vascular dystonia.
Low blood pressure is associated with impaired vascular tone. Normally, the vessels, if necessary, must quickly narrow and expand, but in hypotonic patients this reaction is slowed down, which leads to insufficient blood supply to the organs and tissues.As a result, the body’s systems and organs experience oxygen starvation and are unable to work optimally.
If blood pressure has a tendency to a persistent deviation from the norm, both upward and downward, it is necessary to observe and examine a general practitioner in order to select an adequate complex treatment using drug and non-drug methods of therapy.
Consultation of a physician-therapist
Make an appointment with a therapist
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Rules and technique for measuring blood pressure
Rules and technique for measuring blood pressure. Tonometers for home use.
It should be remembered that at present, special attention is paid to the measurement of blood pressure (BP) at home. It has been proven that self-monitoring of blood pressure and keeping a diary of hypertensive patients increase the patient’s motivation to treat hypertension, increase the effectiveness of treatment by 15-20%.When visiting your attending physician, specialist consultant, you must bring your diary entries with you.
When measuring blood pressure with any tonometer in order to improve the accuracy of the results, a number of conditions must be observed.
- Measurement of blood pressure must be carried out in a sitting position.
- It is necessary to provide support on the back of the chair, relax the legs
- Measurement is carried out after 5 minutes rest
- The hand on which the measurement is taken must lie on the table and be at the level of the heart.
- the measurement is carried out on the arm on which the pressure is higher than
- during blood pressure measurement you should not talk,
- for 1-1.5 hours it is necessary to exclude food intake and smoking.
- it is necessary to have a cuff of the required size, which must be applied to the exposed shoulder;
- The lower edge of the cuff is 1–2 cm above the elbow bend.
- It is recommended to measure blood pressure twice with an interval of 3-5 minutes
Measurement of blood pressure by the auscultatory method (Korotkov’s method) using a phonendoscope and listening to pulsation tones requires compliance with additional rules:
- Install the stethophonendoscope head in the center of the cubital fossa
- quickly enough to pump air into the cuff; at the same time, the inflation level should be 20-30 mm Hg higher than the “normal” blood pressure
- after opening the tap, the air should be vented at a speed of 2-3 mm Hg per second
- to fix the appearance of the first Korotkoff tone, which indicates systolic blood pressure
- to fix the disappearance of Korotkov’s tones, which indicates diastolic blood pressure
Which tonometer is recommended to measure blood pressure at home?
European guidelines for the treatment of hypertension and the Recommendations of the Russian Society of Physicians “Prevention of Chronic Non-Communicable Diseases” (2013) recommend “… to measure blood pressure to patients with an automatic method using various models of tonometers.” Firstly, it is these instruments that provide high measurement accuracy. Secondly, due to the convenience and simplicity of the procedure for measuring blood pressure, only automatic blood pressure monitors contribute to high motivation and patient commitment to constant blood pressure measurement and keeping a hypertensive diary.
So, in particular, measuring blood pressure by the auscultatory method (Korotkov’s method) using a phonendoscope and listening to pulsation tones requires good hearing, experience and coordination of the “hand-eye-ears” system.In addition, the observance of the technique of pumping air into the cuff and releasing it, which is required for high accuracy of the results, makes the procedure difficult for a person who does not have the skills to do this. Failure to comply with these rules leads to errors in the results when using mechanical blood pressure monitors of 10-15 mm Hg. Such an error is significant and can affect the treatment and prognosis of the disease. The use of a pear for self-pumping of air is undoubtedly associated with muscle tension in the arm, which also leads to an overestimation of blood pressure values.Therefore, the use of semi-automatic tonometers with an oscillometric sensor, but retaining the bulb for self-inflating air, is unjustified.
Over the past decades, the accuracy of automatic blood pressure monitors has been repeatedly evaluated in accordance with stringent international criteria for the standardization of medical devices. This served as the basis for recommending the use of automatic blood pressure monitors at home.
Tonometer OMRON – tonometer No. 1 for measuring blood pressure at home.
Tonometers OMRON have all the necessary characteristics that make them the number 1 device for measuring blood pressure at home. The fan-shaped cuff of the universal size of 22-42 cm, following the natural contour of the hand, evenly distributes air, making the measurement painless and accurate. The intelligent Intellisense system inflates air immediately, adapting to the patient – 20-30 mm above systolic blood pressure, making measurement convenient, fast and accurate.
It should be emphasized that many models of automatic OMRON blood pressure monitors have sensors for cuff position, hand movement, and arrhythmia indicators.At the same time, only the OMRON tonometer model M6 is able to most accurately measure blood pressure in atrial fibrillation, which is a significant difference between this model and other tonometers, including other manufacturers.
OMRON, which produces high-sensitivity sensors used in a wide variety of equipment, has been producing blood pressure monitors for 40 years, which are used in medicine in different countries. These characteristics make OMRON blood pressure monitors the leader in sales in Russia over the past few years.
Based on the studies carried out by American and European experts, OMRON automatic blood pressure monitors have been assigned a high accuracy class (A) (European Society of Hypertension, 2013).
OMRON wrist tonometers are also recommended for use. These devices are primarily indicated for people with a large shoulder volume, as well as for those who often take a tonometer on the road. Currently, there is no age limit for the use of wrist blood pressure monitors. Important! For accurate BP measurement, the cuff sensor must be positioned as accurately as possible at the level of the patient’s heart.
Important to know!
When measuring blood pressure with any tonometer, sequential blood pressure measurement with an interval of 2-3 minutes will give different values. The value of blood pressure, like all other parameters of the body, are not constant and are within the range of physiological fluctuations. Differences in the readings of tonometers should not be regarded as manifestations of inaccuracies or malfunctions of instruments.
Blood pressure measurement
Blood pressure – one of the main indicators of the cardiovascular system. Blood pressure can change in many diseases, and it is very important to maintain it at the most optimal level.
Distinguish between systolic, or upper, arterial pressure – blood pressure during the period of contraction of the ventricles of the heart (systole). The volume of blood pushed out by the heart cannot immediately pass through the small blood vessels.Therefore, the aorta and other large vessels are stretched, and the pressure in them rises, reaching normal 100-130 mm Hg. Art. During relaxation of the ventricles (diastole), the blood pressure in the aorta gradually drops to normal to 90 mm Hg. Art., and in large arteries – up to 70 mm Hg. Art. The difference in the values of systolic and diastolic pressure is perceived as a pulse wave, which is called a pulse.
In healthy people, the level of blood pressure is relatively stable, although in everyday life it often fluctuates.This also happens with negative emotions, nervous or physical stress, with excessive fluid intake and in many other cases.
In patients with arterial hypertension, blood pressure levels can significantly exceed normal values - the cardiovascular system is simply not designed for such loads, and therefore, over time, irreversible changes in blood vessels and heart muscle increase in the body of a person suffering from arterial hypertension, which in the future can lead to serious complications.
In polyclinic # 32, of course, you will be prescribed adequate treatment to lower blood pressure and improve the functioning of the heart and blood vessels, but your personal participation is an integral part of such treatment. Surely the doctor will ask you to keep a blood pressure diary – that is, measure it yourself at different times of the day. It is very important to measure your blood pressure correctly, otherwise it will be difficult to assess the effectiveness of your treatment.
So how can you measure your blood pressure?
There are some simple rules:
- The most commonly used device for measuring blood pressure is a device with an arm cuff, an air pump, and a pressure gauge.Such a device can be either manual or automatic. It is very important that the cuff is adequate for the volume of the arm and is neither too tight nor too loose.
- Measure blood pressure in a calm, comfortable environment. Refrain from physical activity, smoking, coffee and eating for at least half an hour before the measurement.
- Sit in a comfortable position and just sit quietly for 2-3 minutes (writing can also increase blood pressure).
- If you are using a tonometer with a wrist cuff, place your arm so that the cuff is at the same level as your heart. If you are using a tonometer with a shoulder cuff, no special adjustments are required.
- Do not speak or move during measurement – normal conversation may affect the final result.
- There should be a pause of 5 minutes between two measurements (this is necessary to relax the vessels).
- Try to measure your blood pressure at the same time of day.
Physician
I therapy. branches
Deev Dmitry Mikhailovich
Tags: general practitioner, blood pressure
Measure blood pressure correctly | Science and Life
Again and again we have to return to the topic of hypertension and high blood pressure. The eyelids are too short for men (and recently for women) in Russia. Very often, the cause of strokes and heart attacks is indifference to their health.And here it is important that we do not monitor blood pressure. A bathhouse with a beer or many hours of effort over the beds under the scorching sun for hypertensive patients can turn into a disaster. Only very often people do not even realize that they have high blood pressure. However, you also need to be able to measure it, even with the smartest devices.
What is blood pressure?
1. Indicators of daily monitoring of blood pressure within normal limits.
2.Indicators of daily monitoring of blood pressure in a patient with essential hypertension (increased blood pressure during the day and night).
3. The same indicators after five years of non-systematic treatment.
Determination and classification of blood pressure levels (in mm Hg) in persons over 18 years of age.
Blood pressure is considered normal in the range from 139 (systolic) to 60 mm Hg. Art. (diastolic).
Correct position of the cuff and tonometer when measured with aneroid manometer.
Correct pressure measurement with a display device.
German physiologist Johann Dogil used this apparatus in 1880 to study the effect of music on blood pressure.
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Blood pressure (BP) – blood pressure in the arteries – one of the main indicators of the cardiovascular system.It can change with many diseases, and keeping it at an optimal level is vital. It is not for nothing that the doctor accompanies any examination of an unwelling person by measuring blood pressure.
In healthy people, blood pressure levels are relatively stable, although they often fluctuate in everyday life. This also happens with negative emotions, nervous or physical stress, with excessive fluid intake and in many other cases.
Distinguish between systolic, or upper, blood pressure – blood pressure during the period of contraction of the ventricles of the heart (systole).In this case, about 70 ml of blood is pushed out of them. This amount cannot immediately pass through the small blood vessels. Therefore, the aorta and other large vessels are stretched, and the pressure in them rises, reaching normal 100-130 mm Hg. Art. During diastole, blood pressure in the aorta gradually drops to normal to 90 mm Hg. Art., and in large arteries – up to 70 mm Hg. Art. We perceive the difference in the values of systolic and diastolic pressure in the form of a pulse wave, which is called a pulse.
Arterial hypertension
Increased blood pressure (140/90 mm Hg.Art. and above) is observed in hypertension, or, as it is commonly called abroad, essential hypertension (95% of all cases), when the cause of the disease cannot be established, and with so-called symptomatic hypertension (only 5%), developing as a result of pathological changes in a number organs and tissues: for kidney diseases, endocrine diseases, congenital narrowing or atherosclerosis of the aorta and other large vessels. Arterial hypertension is called a silent and mysterious killer for a reason.In half of the cases, the disease is asymptomatic for a long time, that is, a person feels completely healthy and does not suspect that an insidious disease is already eroding his body. And suddenly, like a bolt from the blue, serious complications develop: for example, stroke, myocardial infarction, retinal detachment. Many of those who survived after a vascular catastrophe remain disabled, for whom life is immediately divided into two parts: “before” and “after”.
Recently I had to hear from a patient a striking phrase: “Hypertension is not a disease, blood pressure is increased in 90% of people.”The figure is, of course, greatly exaggerated and based on rumors. As for the opinion that hypertension is not a disease, this is a harmful and dangerous delusion. It is these patients who, what is especially depressing, the overwhelming majority do not take antihypertensive drugs or are not treated systematically and do not control blood pressure, frivolously risking their health and even their lives.
In Russia, 42.5 million people currently have elevated blood pressure, that is, 40% of the population.Moreover, at the same time, according to a representative national sample of the Russian population aged 15 years and older, 37.1% of men and 58.9% of women knew about the presence of arterial hypertension, and only 5.7% of patients received adequate antihypertensive therapy. men and 17.5% women.
So in our country there is a lot of work to be done to prevent cardiovascular catastrophes – to achieve control over arterial hypertension. The target program “Prevention and treatment of arterial hypertension in the Russian Federation,” which is currently being carried out, is aimed at solving this problem.
How blood pressure is measured
The diagnosis of “hypertension” is made by a doctor, and he chooses the necessary treatment, but regular monitoring of blood pressure is already a task not only for medical workers, but for every person.
Today, the most common method for measuring blood pressure is based on the method proposed back in 1905 by the Russian physician N. S. Korotkov (see Science and Life No. 8, 1990.). It is associated with listening to sound tones. In addition, the palpation method (probing the pulse) and the method of daily monitoring (continuous pressure control) are used. The latter is very indicative and gives the most accurate picture of how blood pressure changes during the day and how it depends on different loads.
To measure blood pressure by the Korotkov method, mercury and aneroid manometers are used. The latter, as well as modern automatic and semi-automatic devices with displays, are calibrated on a mercury scale before use and periodically checked.By the way, on some of them the upper (systolic) blood pressure is indicated by the letter “S”, and the lower (diastolic) blood pressure is indicated by the letter “D”. There are also automatic devices adapted to measure blood pressure at certain, set intervals (for example, this is how you can observe patients in the clinic). Portable devices have been created for daily monitoring (tracking) of blood pressure in a polyclinic.
Blood pressure fluctuates during the day: it is usually lowest during sleep and rises in the morning, reaching a maximum during the hours of daytime activity.It is important to know that in patients with arterial hypertension, nighttime blood pressure values are often higher than daytime ones. Therefore, for the examination of such patients, daily monitoring of blood pressure is of great importance, the results of which make it possible to clarify the time of the most rational drug intake and ensure full control of the effectiveness of treatment.
The difference between the highest and lowest blood pressure values during the day in healthy people, as a rule, does not exceed: for systolic – 30 mm Hg.Art., and for diastolic – 10 mm Hg. Art. With arterial hypertension, these fluctuations are more pronounced.
What is the norm?
The question of what blood pressure should be considered normal is rather complicated. The outstanding domestic therapist AL Myasnikov wrote: “In essence, there is no clear boundary between the values of blood pressure, which should be considered physiological for a given age, and the values of blood pressure, which should be considered pathological for a given age.”However, in practice, of course, it is impossible to do without certain standards.
The criteria for determining the level of blood pressure, adopted in 2004 by the All-Russian Society of Cardiology, are based on the recommendations of the 2003 European Society of Hypertension, experts of the US Joint National Committee for the Prevention, Diagnosis, Evaluation and Treatment of High Blood Pressure. If systolic and diastolic blood pressure are in different categories, then the assessment is made at a higher rate.In case of deviation from the norm, we are talking about arterial hypotension (blood pressure below 100/60 mm Hg) or arterial hypertension (see table).
How to measure blood pressure correctly?
Blood pressure is most often measured in a sitting position, but sometimes it is necessary to do this while lying down, for example, in seriously ill patients or when the patient is standing (with functional tests). However, regardless of the position of the subject, the forearm of his hand, on which blood pressure is measured, and the apparatus should be at the level of the heart.The lower edge of the cuff is positioned approximately 2 cm above the elbow bend. The cuff that is not filled with air should not squeeze the underlying tissue.
Air is rapidly pumped into the cuff to a level of 40 mm Hg. Art. higher than that at which the pulse on the radial artery disappears due to vascular compression. The phonendoscope is applied to the ulnar fossa at the point of arterial pulsation just below the lower edge of the cuff. The air must be released from it slowly, at a speed of 2 mm Hg. Art. one beat of the pulse.This is necessary in order to more accurately determine the level of blood pressure. The point on the pressure gauge scale at which distinguishable pulse beats (tones) appear is noted as systolic pressure, and the point at which they disappear as diastolic. Changing the volume of tones, their attenuation are not taken into account. The cuff pressure is reduced to zero. The accuracy of fixing and registering the moments of appearance and disappearance of tones is essential. Unfortunately, when measuring blood pressure, they often prefer to round the results to zero or five, which makes it difficult to evaluate the data obtained.Blood pressure must be recorded with an accuracy of 2 mm Hg. Art.
It is impossible to count the level of systolic blood pressure at the beginning of the fluctuations of the mercury column visible to the eye, the main thing is the appearance of characteristic sounds; during the measurement of blood pressure, tones are heard, which are divided into separate phases.
Phases of tones N. S. Korotkov
1st phase – HELL, at which constant tones are heard. The sound intensity gradually increases as the cuff deflates.The first of at least two consecutive tones is defined as systolic blood pressure.
2nd phase – the appearance of noise and “rustling” sound with further deflation of the cuff.
3rd phase – the period during which the sound resembles a crunch and increases in intensity.
4th phase corresponds to a sharp ducking, the appearance of a soft “blowing” sound. This phase can be used to determine diastolic blood pressure when tones are heard before the zero division.
The 5th phase is characterized by the disappearance of the last tone and corresponds to the level of diastolic blood pressure.
But remember: between the 1st and 2nd phases of Korotkoff tones, the sound is temporarily absent. This happens with high systolic blood pressure and continues during the deflation of air from the cuff up to 40 mm Hg. Art.
It happens that the blood pressure level is forgotten during the time between the moment of measurement and the registration of the result. That is why you should record the received data immediately – before removing the cuff.
In cases when it becomes necessary to measure blood pressure on the leg, the cuff is applied to the middle third of the thigh, the phonendoscope is brought to the popliteal fossa at the site of arterial pulsation. The level of diastolic pressure on the popliteal artery is about the same as on the brachial artery, and the systolic pressure is about 10-40 mm Hg. Art. above.
The blood pressure level can fluctuate even in short periods of time, for example, during measurement, which is associated with a number of factors. Therefore, when measuring it, certain rules must be followed.The room temperature should be comfortable. One hour before measuring blood pressure, the patient should not eat, physically strain, smoke, or be exposed to cold. For 5 minutes before measuring blood pressure, he needs to sit in a warm room, relaxed and without changing the accepted comfortable posture. The sleeves of clothing should be loose enough, it is advisable to bare your hand by removing the sleeve. Blood pressure should be measured twice with an interval of at least 5 minutes; the average value of two indicators is recorded.
In addition, one should remember about the shortcomings in determining blood pressure due to the error of the Korotkov method itself, which, under ideal conditions, with a normal blood pressure level is ± 8 mm Hg.Art. An additional source of errors can be cardiac arrhythmias in the patient, incorrect position of his arm during measurement, poor cuff placement, non-standard or faulty cuff. For adults, the latter should have a length of 30-35 cm in order to wrap around the patient’s shoulder at least once, and a width of 13-15 cm. A small cuff is a common reason for erroneous determination of high blood pressure. However, obese people may require a larger cuff and a smaller one for children.Inaccuracy in measuring blood pressure can also be associated with excessive squeezing of the underlying tissues by the cuff. Overestimation of blood pressure values also occurs when a weakly applied cuff is inflated.
Recently I had to talk to a patient, to whom a nurse in a polyclinic said, having measured blood pressure, that it was elevated. Arriving home, the patient measured blood pressure with his own apparatus and was surprised to note significantly lower values. The typical manifestation of white coat hypertension is explained by emotional reactions (our fear of a doctor’s verdict) and is taken into account when diagnosing arterial hypertension and determining the optimal level of blood pressure during treatment.White coat hypertension occurs quite often – in 10% of patients. It is necessary to create an appropriate environment in the room: it should be quiet and cool. It is unacceptable to conduct extraneous conversations. It is necessary to talk with the examinee calmly, kindly.
And finally … We are far from powerless in the face of an insidious disease. It responds well enough to treatment, as is convincingly evidenced by the large-scale preventive programs to combat arterial hypertension, carried out both in our country and abroad, and which made it possible to reduce the incidence of stroke by 45-50% within five years.All patients received adequate treatment and strictly followed the doctor’s instructions.
If you are over 40, measure your blood pressure systematically. I would like to emphasize once again that arterial hypertension is often asymptomatic, but this makes the disease even more dangerous, causing a “blow from behind”. A device for measuring blood pressure should be in every family, and every adult should learn how to measure it, especially since this does not present significant difficulties.
“The knowledge that is most necessary for human life is the knowledge of oneself.” The famous French writer and philosopher Bernard Fontenelle (1657-1757), who lived for exactly 100 years, came to the same conclusion that is still relevant today.
The author thanks A. Kadykova and M. Prokopovich, the staff of the State Institution of Neurology of the Russian Academy of Medical Sciences for their help in illustrating the article.
How to measure blood pressure correctly at home
Self-monitoring of blood pressure at home is widely used.Home blood pressure measurements are very useful – they allow the doctor to more accurately assess the true blood pressure level and correctly prescribe antihypertensive drugs for long-term treatment of patients with hypertension.
These measurements are important because they provide information about the blood pressure level over long periods of time during which the patient does not visit the doctor and is in his usual environment.
Measurement conditions
– Rest for at least 5 minutes before taking blood pressure measurements.
– At least 30 minutes before measuring blood pressure, you must refrain from smoking and drinking caffeine (coffee, cola, tea).
During the measurement, one should sit, leaning against the back of a chair, and the motionless arm should lie comfortably on the table.
– Do not talk while measuring.
– The cuff should be wrapped around the forearm with the center of the inflatable bag just above the brachial artery, and the bottom edge of the cuff should be about 2-3 cm above the elbow bend.
– The cuff inflatable bag must be at the level of the heart during the measurement.
– Legs should not be crossed when measuring.
– Feet should be on the floor.
– The bladder must be emptied before measuring blood pressure.
– The shoulder should not be squeezed by clothing (all the more, measurement through clothing is unacceptable).
Failure to comply with these conditions may lead to high blood pressure:
after taking coffee – by 11/5 mm Hg.Art.
alcohol per – 8/8 mm Hg. Art.
smokers at – 6/5 mm Hg. Art.
with an overflowing bladder – by 15/10 mm Hg. Art.
in the absence of back support – systolic at 6-10 mm Hg. Art.
in the absence of a hand support – by 7/11 mm Hg. Art.
Which tonometers are better to use
For home blood pressure measurement, there are several types of devices available on the market:
– Auscultatory method: mercury devices, aneroid (“dial”) and electronic (“hybrid”) devices for measuring blood pressure are used simultaneously with a stethoscope.
– Electronic automated devices for measuring blood pressure at shoulder, wrist and fingers.
Electronic shoulder-level blood pressure monitors, whether semi-automatic (manual cuffs inflate by squeezing a bulb) or automatic (battery-operated or mains-powered) are preferred for self-measurement of blood pressure at home. These devices are easy to use, require minimal training, and many are affordable.
Preferred are tonometers with memory, which automatically store each measurement (with date and time) and the average of all measurements prior to the doctor’s visit.
Wrist devices are less accurate and not recommended unless shoulder blood pressure measurement is impossible or very difficult.
Finger devices not recommended.
Mercury blood pressure monitors require extensive training and have been banned in some countries for environmental reasons.Aneroid devices also require preparation and regular calibration. The use of these devices should be limited to patients in whom automatic measurements are impossible or inaccurate.
Not all home blood pressure monitors available on the market have been adequately tested. Up-to-date information on device testing should be provided by a physician.
Selecting the correct cuff and the size of the patient’s arm is essential for accurate measurement.The cuff inflatable bag should cover 80-100% of the shoulder circumference. The use of small cuffs can lead to an overestimation of blood pressure, while the use of large cuffs can lead to an underestimation of blood pressure. Therefore, if your arm has a circumference of <24 cm or> 32 cm, make sure that the device is equipped with a small or large cuff, respectively.
How often should blood pressure be measured at home?
For an initial assessment of hypertension and the assessment of the effects of taking antihypertensive drugs, blood pressure at home should be measured for at least 3, and preferably 7 days.
Daily blood pressure measurements should be carried out both in the morning (immediately after waking up and before taking the drug during treatment) and in the evening. In each case, re-measurement should be carried out 1 minute later.
The average of all measurements shall be calculated after discarding the measurements of the first day.
This 7-day schedule should be followed before each subsequent visit to the doctor.
For long-term observation, it is advisable to take home measurements less frequently.
Measurement under stress can be misleading and should be avoided
Excessive use of home blood pressure measurement should be avoided to change the treatment yourself (take additional pills or change the dose).
The results should be recorded in the log immediately after each measurement, unless the device stores in memory the blood pressure values with the date and time of each measurement or has a built-in data transmission system.
What are the norms of blood pressure when measuring at home?
As mentioned above, repeated measurements over several days should be averaged to obtain a reliable picture of blood pressure levels at home.
Mean systolic blood pressure below 130 mm Hg. and diastolic below 80 mm Hg. is considered normal home blood pressure, and systolic pressure is 135 mmHg. and above and / or diastolic 85 mm Hg.Art. and higher – high home blood pressure.
Interpretation of blood pressure measurements
The average of several blood pressure measurements at home over several days complements the measurements in the doctor’s office and helps the doctor to make an accurate diagnosis.
Home blood pressure measurements can vary significantly from measurement to measurement. Blood pressure can be very high, especially during stressful situations, panic, severe pain, etc.or rather low, for example, after a long rest or after intense exercise. “One-off” measurements are of little value and cannot provide an indication of the “normal” home blood pressure level. High blood pressure in a single measurement should not be alarming unless very high values persist after a sufficient period of rest or are accompanied by severe symptoms (eg, shortness of breath, chest pain, weakness in an arm or leg, difficulty speaking).
Increasing self-control of blood pressure at home is not in itself an indication for treatment. Your doctor will advise you when and what treatment is indicated.
In some cases, self-measured blood pressure at home may be significantly lower than the measurements obtained at the doctor’s appointment. This phenomenon is not uncommon and is known as white coat hypertension. On the other hand, in some cases, blood pressure may be low in the doctor’s office, while self-measured blood pressure at home is high (latent hypertension).These situations require careful medical evaluation. Additional tests and repeated monitoring of blood pressure at home or on an outpatient basis for 24 hours may be required in order to decide if treatment is necessary.
How to measure blood pressure? | Federal Center for Risk Management
Blood pressure (BP) is the pressure of blood in the large arteries of a person. There are two indicators of blood pressure:
Systolic (upper) blood pressure is the level of blood pressure at the time of maximum contraction of the heart.
Diastolic (lower) blood pressure is the level of blood pressure at the time of maximum relaxation of the heart.
1. What methods are used to measure blood pressure?
- Using a mechanical tonometer.
- Oscillometric method (this is a method that uses electronic blood pressure monitors).
2. When to measure?
The measurement can be taken at any time, depending on the state in which the heart needs to be monitored (at rest, after exercise, after taking medication, etc.)etc.).
3. On which hand is it better to measure pressure?
The difference in pressure on the arms can be quite significant, therefore it is recommended to measure on the arm with higher blood pressure values.
4. Preparation for measurements
Before measuring blood pressure, you must:
- Do not drink tea, coffee or smoke for 30 min.
- Empty the bladder.
- Remain at rest for 10-15 minutes.
- Expose the arm on which the tonometer cuff will be put on.
During blood pressure measurement it is necessary:
- Sit still, do not move.
- Sit in silence, do not talk.
- Sit upright, do not bend over so as not to squeeze the abdominal cavity.
HELL can be increased at:
- Lack of sleep and constipation.
- Full bladder.
- Drinking caffeinated beverages such as coffee, tea, cola.