Blood pressure of children and adolescents, 2016-2019

Release date: March 23, 2021

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The combined results of the 2016-2019^Note  Canadian Health Measures Survey (CHMS) indicate that the average resting blood pressure of children and adolescents aged 6 to 19 was 96/62 mmHg. Among this group, 94.3% had a measured blood pressure that was considered normal and 5.7% had results considered borderline or elevated (data not shown). Reliable estimates of hypertension in children are scarce, however studies have shown that children’s hypertension has increased over the past decade partially due to an increase in childhood obesity. A systematic review estimated that the global prevalence of childhood hypertension in 2015 ranged from 4.3% among children aged 6 years to 3.2% among those aged 19 years and peaked at 7.9% among those aged 14 years.^Note 

The CHMS results indicate that in children aged 6 to 11, average resting blood pressure was 93/61 mmHg, while youth aged 12 to 19 had an average resting blood pressure of 99/62 mmHg.

The proportion of girls aged 12 to 19 with blood pressure in the normal range was significantly higher than that of girls aged 6 to 11 (Chart 1).

Data table for Chart 1


Data table for Chart 1

Table summary

This table displays the results of Data table for Chart 1 Blood pressure classification, Normal and Elevated or Hypertensive, calculated using percent units of measure (appearing as column headers).

	Blood pressure classification
	Normal	Elevated or Hypertensive
	percent
Total
6 to 11 years	91.6	8. 4
12 to 19 years	96.2	3.8Note E: Use with caution
Boys
6 to 11 years	91.5	8.5
12 to 19 years	95.6	4.4Note E: Use with caution
Girls
6 to 11 years	91.8	8. 2
12 to 19 years	96.9	3.1Note E: Use with caution

Blood pressure and body composition

Height and weight were measured for all CHMS respondents. Children and youth who were classified as being overweight (98/62 mmHg) or obese (104/66 mmHg) had a significantly higher average blood pressure than normal weight children (95/61 mmHg). Average systolic blood pressure was significantly higher in overweight and obese children compared with those in the normal weight category (Chart 2). As well, overweight and obese children had significantly higher average diastolic blood pressure when compared with their normal weight counterparts (Chart 3).^{Note Note Note Note} 

Data table for Chart 2


Data table for Chart 2

Table summary

This table displays the results of Data table for Chart 2 Thinness/normal weight, Overweight and Obese, calculated using mmHG units of measure (appearing as column headers).

	Thinness/normal weight	Overweight	Obese
	mmHG
Total
6 to 11 years	92	95	100
12 to 19 years	97	101	108
Boys
6 to 11 years	92	94	100
12 to 19 years	97	103	109
Girls
6 to 11 years	92	95	101
12 to 19 years	97	99	105

Data table for Chart 3


Data table for Chart 3

Table summary

This table displays the results of Data table for Chart 3 Thinness/normal weight, Overweight and Obese, calculated using mmHg units of measure (appearing as column headers).

	Thinness/normal weight	Overweight	Obese
	mmHg
Total
6 to 11 years	61	60	65
12 to 19 years	62	63	66
Boys
6 to 11 years	61	61	66
12 to 19 years	61	62	65
Girls
6 to 11 years	61	60	64
12 to 19 years	63	64	68

Start of text box

About blood pressure

Blood pressure is a measure of the force of blood against the artery walls, and is expressed as systolic pressure/diastolic pressure in millimetres of mercury (e. g., 120/80 mmHg). The systolic pressure (top number) is the pressure when the heart contracts and pushes the blood out, and the diastolic pressure (bottom number) is the lowest pressure when the heart relaxes between beats.

Resting blood pressure was measured in the CHMS using an automated device (BPTru™) following a five-minute rest period. The BPTru™ recorded six measurements, one minute apart. The average systolic and diastolic blood pressure were calculated using the last five out of six measurements.

The criteria for blood pressure classification in children and youth are as follows:



End of text box

Data

The Canadian Health Measures Survey (CHMS) is a two-step survey. The first step is a personal interview at the respondent’s household. The second step is a visit to the CHMS mobile clinic where physical measurements and blood and urine samples are taken.

The 2016-2019 reference period refers to combined results from Cycle 5 (2016 and 2017) and Cycle 6 (2018 and 2019) of the CHMS.

The target population for the CHMS consists of persons 3 to 79 years of age living in the 10 provinces. The observed population excludes: persons living in the three territories; persons living on reserves and other Aboriginal settlements in the provinces; full-time members of the Canadian Forces; the institutionalized population and residents of certain remote regions. Altogether these exclusions represent approximately 3% of the target population.

Survey weight and bootstrap weight files and instructions are available for combining Cycle 6 Canadian Health Measures Survey data (where possible) with equivalent data from Cycles 1 to 5.

Canadian Health Measures Survey data related to this Health Fact Sheet are available in data tables 13-10-0319-01, 13-10-0326-01 and 13-10-0373-01.

ISSN: 1920-9118

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Published by authority of the Minister responsible for Statistics Canada.

© Her Majesty the Queen in Right of Canada as represented by the Minister of Industry, 2021

All rights reserved. Use of this publication is governed by the Statistics Canada Open Licence Agreement.

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2021-03-23

High Blood Pressure (Hypertension): Causes, Diagnosis and Treatment

Blood pressure, measured with a blood pressure cuff around an arm or leg, is the force of the blood pushing against the artery walls.

Two numbers are recorded when measuring blood pressure:

• The higher number, or systolic pressure, refers to the highest pressure inside the artery. It occurs when the heart contracts and pumps blood out to the body.

• The lower number, or diastolic pressure, refers to the lowest pressure inside the artery. It occurs when the heart relaxes and fills with blood.

Each time the heart beats, it pumps blood into the arteries, resulting in the highest blood pressure, the systolic pressure, as the heart contracts, and the lowest blood pressure, the diastolic pressure, as the heart relaxes.

Both the systolic and diastolic pressures are recorded as “mm Hg” (millimeters of mercury).

What Is High Blood Pressure?

High blood pressure means that there is higher than normal pressure inside the arteries either during systole (when the heart contracts and pumps blood through the body), or during diastole (when the heart relaxes and fills with blood).

If the pressure is high during the pumping phase (systole), then the first number recorded with a blood pressure reading (the systolic pressure) will be high.

If the pressure is high during the relaxation phase (diastole), then the second number recorded (the diastolic pressure) will be high. Sometimes both numbers are high and sometimes only one number is high.

High blood pressure is also called hypertension.

Is a Blood Pressure Reading Always the Same?

Blood pressure can be affected by many factors, including, but not limited to, the following:

• The time of day. Blood pressures fluctuate during waking hours, and are lower during sleep.

• Physical activity. Blood pressure is usually higher during and immediately after exercise, and lower at periods of rest.

• Emotional moods and stress. Feelings such as fear, anger, or happiness can affect the blood pressure.

• Age, height, weight, and gender. Each of these can affect blood pressure.

• Other illnesses present or medications you are taking. Other illnesses, including kidney disease or heart disease, affect blood pressure, as can certain medications.

Children and adolescents may be anxious in a doctor’s office, not knowing what may happen. Your doctor is aware that any emotions related to visiting the clinic can affect blood pressure and may give falsely high readings.

Before determining that your child has high blood pressure, a doctor or nurse will take several readings when your child is calm.

When Is the Blood Pressure Too High?

Blood pressures vary depending on the age of your child, as well as according to his or her height, weight, and gender. For example, an infant may have a quite normal blood pressure of 80/45, while that value in an adult is considered low. A teenager may have an acceptable blood pressure of 110/70, but that value would be of concern in a toddler. Generally, blood pressure is low in infancy, and rises slowly as children age. Boys’ blood pressures are slightly higher than girls’, and taller people generally have higher blood pressures than short people.

The National Heart, Lung, and Blood Institute (NHLBI) has prepared a series of age- and gender-specific blood pressure measurement tables for children ages 1 through 17 years, based on percentiles. A range of blood pressure values is given based on how old and how tall your child is. According to the tables, if your adolescent has a blood pressure that is higher than 90 to 95 percent of other males or females his or her age and height, then he or she may have high blood pressure.

Why Is High Blood Pressure a Concern?

High blood pressure, or hypertension, directly increases the future risk of coronary heart disease (heart attack) and stroke.

Heart attack and stroke related to high blood pressure are rare in children and adolescents. Yet, high blood pressure can start without any other signs or symptoms and persist undetected for years if not measured. If undiagnosed high blood pressure exists in childhood, then young adults in their 20s can begin to exhibit harmful effects on their heart and blood vessels that can lead to heart attacks and stroke. 

Who Is at Risk for Developing High Blood Pressure?

Primary hypertension (with an unknown cause) is the most common cause of high blood pressure in adolescents and adults, but is less common in children. Many children with high blood pressure also have adult relatives with hypertension, indicating there may be a hereditary aspect to the disease. There is a higher incidence of high blood pressure in African-American children after the age of 12 and into adulthood. Increased rates of obesity have increased the risk of developing high blood pressure in children. 

Norm of pressure in children aged 10

Caring and attentive mothers always monitor the health of their child. For parents, the most important thing is that their baby is healthy. Important indicators for assessing the work of the cardiovascular system are pulse and blood pressure. These values ​​are different at different ages. Moms should know the distinctive features and regulatory indicators.

Peculiarities of children’s blood pressure

Children’s body grows, blood pressure on the walls of blood vessels changes. In babies, they are very elastic, the lumen is wider, and therefore blood pressure is lower. With age, the vessels lengthen, the child grows, and the blood flow decreases. The lumen of the vessels narrows, and blood pressure rises.

The BP of boys after five years is slightly higher than that of their girlfriends of the same age. The pressure in children of 10 years old (normal) is close to the indications of an adult, as the child is approaching the puberty period of his development.

Blood pressure in a 10-year-old child: normal. Pressure table in children

Factors affecting blood pressure in children

Children at the age of 10 are usually very mobile and emotional. There are many factors that affect a child’s blood pressure. Among them are the following:

1. Weight and height.

2. The work of the heart.

3. Condition of blood vessels and arteries.

4. Physical and mental stress (the child’s fatigue will be very noticeable).

5. Emotional state. We know that children at this age are impressionable and vulnerable.

6. Diseases of a child. The presence of various pathologies.

7. Environment. Children in the northern regions have lower rates than those in the southern part of the country.

8. Hereditary factor.

All these components are interconnected. Food intake and the time of day when the pressure is measured will also affect the indicators.

What is the normal blood pressure for 10 year olds?

There is a formula by which you can calculate the pressure of a particular child. The pressure in children 10 years old (normal) is the maximum systolic up to 120 mm. rt. Art. and up to 70 mm Hg. Art. – diastolic.

What should be the pressure in children? Blood pressure: the norm for …

Systolic is calculated as follows: 90 + age times two. So, for a ten-year-old child, it will be 90 + 10 * 2 = 110. Diastolic: 60 + age, so 60+10=70. The optimal pressure of a child of 10 years old is the norm – 110/70. Deviations from these indicators by 10-20 units are acceptable, taking into account the factors affecting the baby. Of course, you can not ignore the pulse. You need to pay attention to its rhythm, tension. In a 10-year-old child, this is 75-80 beats per minute.

How to measure your child’s blood pressure

To measure these indicators, electronic blood pressure monitors are widely used. They are simple and easy to use at home. When pressure is measured in children 10 years old, the norm should be about 110-120 mm. rt. Art. by 70 mm. rt. Art. These indicators may have upward deviations if the child was actively moving before the measurement.

To measure pressure correctly, you need to follow a few rules:

• It must be measured in a calm state. It is forbidden to move and talk at this moment.
• Use a special cuff for children. Its width should not be more than 2/3 of the length of the shoulder.
• If measurements are taken at intervals, then it must be measured in one position, sitting or lying down.

Blood pressure is recommended to be measured in the morning or after the child has had at least 15 minutes of rest. Place your hand at heart level, palm up. The cuff is put on a bare arm 2-3 cm above the elbow. The hand should not be squeezed by clothing. The cuff does not need to be tightened, there should be space for one finger between it and the arm. The best option for a child is to measure blood pressure 3 times with the same time interval in one position in order to see the full picture of the changes. The lowest readings will be considered more accurate.

What pressure should be at 14? Normal pressure in a teenager

Deviations from the norm

If a child has health problems, then it is necessary to monitor blood pressure. When blood pressure is below normal, metabolism is disturbed, tissues are poorly enriched with oxygen. There may be a malfunction in the work of internal organs: the liver, kidneys, heart, the endocrine system suffers. If the pressure is higher than normal, ruptures of blood vessels and even hemorrhage can occur, but, fortunately, this happens very rarely in children. If the pressure in a 10-year-old child is normal, the pulse also corresponds to age, then everything is in order with health. With deviations from normal values ​​to a smaller or larger side, diseases such as hypertension or hypotension can already be suspected. It is from the age of ten that a doctor can diagnose these diseases.

Hypertension and its symptoms

There are two types of hypertension in childhood: primary and secondary. Primary is a temporary increase in pressure associated with physical or emotional stress. This increase is not permanent. We can observe it in quite healthy children.

Secondary hypertension, or arterial, is a stable increase in pressure over time. It is associated with the presence of certain pathologies in the body:

1. Diseases of the kidneys.
2. Problems in the endocrine system.
3. Most often, hypertension is observed in overweight children prone to obesity.

An increase in pressure in the body, even for a short time, leads to undesirable changes in the functioning of the organs. First of all, it affects the work of the heart and blood vessels. The vessels narrow, their walls thicken, thereby not providing a full flow of blood to the organs. The heart muscle is poorly supplied, it works hard, which means that its density increases. As a result, the walls of the arteries thicken, the nutrition of tissues worsens, which weakens the body as a whole.

Children usually do not feel any symptoms of high blood pressure, which is not the case with low values.

Hypotension and its symptoms

If the pressure in children 10 years old is normal, the pulse is normal, then your child is quite healthy. In the case when the indicators are significantly reduced, then we can already talk about hypotension. This can be observed after a long illness or a lot of emotional stress.

Symptoms indicating low blood pressure:

• General weakness is characteristic.
• Fatigue.
• Headache.
• Difficulty waking up in the morning.
• Increased sweating during physical activity.

First of all, in such a child, the heart and blood vessels should be examined.

Treatment and prevention

How to treat hypertension or hypotension in children? First, you need to conduct a thorough examination to identify diseases that provoked an increase or decrease in pressure. In no case should you self-medicate. All drugs must be prescribed by a specialist.

Proper nutrition and a healthy lifestyle play an important role in the prevention of hypertension. Watch your diet carefully: dishes should not contain a lot of salt and fat. Sitting at the computer, as it is now fashionable, should be minimized, move more and exercise. All this, combined with proper nutrition, will give a positive trend. If blood pressure is measured within a few days, and the indicators are 120 to 70, then we can say that the pressure in children of 10 years old is the norm. So your efforts have not been in vain.

For the prevention of hypotension, in the first place we put physical exercises with gradually increasing loads and, of course, a full and healthy diet. Hardening has a very good effect on such children.

The child should take drugs strictly under the supervision of the parents. Adults themselves should be an example for their child. If necessary, then reconsider eating habits, put an end to a sedentary lifestyle. By doing this, you will help your child cope with his illness. The pressure of a 10-year-old child plays a big role in his subsequent development and the formation of a maturing organism.

Hypertension: degrees, symptoms and causes of high blood pressure

However, if it so happens that you are interested in the topic of health and hypertension in particular, then this publication may be useful to you, from it you will learn:

• What is high blood pressure?
• How can it harm your health?
• How do you know if you have hypertension?
• How do you self-assess your risk of complications?
• What to do next? How can a doctor help you? What can you do yourself?

First of all, this information will be of interest:

• Those who already have high blood pressure
• Those whose loved ones suffer from high blood pressure
• Those who want to know in advance how to take care of their health now in order to prevent disease in the future.

What is blood pressure?

Arterial pressure (BP) is the force with which blood presses against the walls of blood vessels from the inside. BP is systolic and diastolic. Systolic is the pressure of blood in the arteries during the contraction of the heart. This is “upper pressure”. Diastolic is the pressure of blood in the arteries when the heart relaxes. This is the “down” pressure. If you connect the pump to an inflated bicycle chamber and imagine that the pump is the heart, and the chamber is the vessels, then the pressure in the chamber, which will be at the moment the pump pumps air, will be systolic. And diastolic pressure is the pressure with which air presses on the walls of the chamber (blood presses on the walls of the vessels) while the pump is not operating. The level of diastolic pressure will depend on the elasticity of the chamber walls.

Normally, there is a certain corridor, and if the indicators do not go beyond it, we consider that a person’s pressure is normal. The boundaries of this corridor: not higher than 140/90 and not lower than 90/60. High blood pressure is more dangerous than low blood pressure. And if there are serious concomitant diseases, for example, diabetes mellitus, then the upper limit of the corridor goes down – 130/80 pressure should be lower than 140/90. Hypertension is a chronic disease in which there are periodic or persistent rises in blood pressure above 140/90. At the same time, this does not mean that every person who has ever had high blood pressure has hypertension. Short-term and slight fluctuations in blood pressure can be observed in different situations. For example, an increase in blood pressure is noted in the morning after waking up, with excitement, stress, physical activity, and smoking.

A short-term decrease in blood pressure is observed at rest, during sleep. Our body is threatened by a prolonged increase in blood pressure. Many factors influence the level of blood pressure. It depends on the volume of blood pushed out by the heart into the vessels, on the frequency and strength of the contractions of the heart and the elasticity of the vessels. If you draw analogies with a regular water hose for water, then you can increase the pressure in it by pinching a certain section of the hose. But you can also increase the pressure by opening the faucet harder and increasing the flow of water.

Arterial hypertension is a widespread disease, it occurs in 40% of the population. It is dangerous because it increases the load on the heart and causes vascular stiffness. Over time, high pressure injures the vascular wall, causing damage to blood vessels, cholesterol begins to be deposited in the vessel wall, which leads to rapid aging of blood vessels, their narrowing. Vessels lose their elasticity, become fragile and brittle. This increases the risk of heart attack and stroke, the 1st and 3rd leading causes of death. Also, the thickening of the walls of blood vessels causes a slowdown or cessation of the flow of oxygen-rich blood, resulting in damage to vital organs. As a result of these changes, complications of hypertension develop, which are dangerous.

Complications are acute, associated with a sharp jump in pressure: for example, a hypertensive crisis, stroke, heart attack, aortic rupture. Chronic complications develop gradually against the background of a long course of hypertension for decades, they arise as a result of atherosclerosis damage to small vessels that feed vital organs, as a result, these organs are chronically deprived of blood supply, rich in oxygen and nutrients, and eventually begin to function worse.

These organs are called target organs:

• The first signs of kidney damage are the appearance of protein in the urine, then kidney function worsens
• Visual impairment
• The walls of the heart thicken, its relaxation and filling with blood becomes more difficult, angina pectoris appears, the pumping function of the heart worsens, heart failure develops
• Damage to the walls of the aorta
• The work of the brain is disturbed, which is manifested by a decrease in memory, quick wits, attention.

In 95% of cases, the specific cause of the increase in pressure cannot be established – this is the result of the influence of a complex of factors – in this case, hypertension is an independent disease – and is called Hypertension. In 5% of cases, the cause can be identified and (often, but not always) eliminated – in this case, hypertension is a symptom of another disease.

The main organ involved in the regulation of pressure is the kidney. Problems with the vessels of the kidneys, the kidneys themselves or the adrenal glands are the bulk of symptomatic hypertension. Also, symptomatic hypertension can be caused by changes in the thyroid gland, congenital and acquired anomalies of blood vessels and the heart.

If you are over fifty and have just woken up and nothing hurts, then you are already dead. So say the English scientists. We disagree with colleagues. This is what hypertension looks like. Most often, high blood pressure goes unnoticed, without showing itself. You can find out about it by chance at a physical examination. Therefore, it is important to undergo medical examination in a timely manner.

The insidiousness of hypertension lies in the fact that most people, even with very high pressure numbers of 180/100 and above, do not develop any symptoms.

The same people who feel increased pressure are worried:

• Throbbing headaches in the back of the head, heaviness in the head
• Dizziness
• Flashing “flies” before the eyes
• Irritability, fatigue, depressed mood
• Sleep disorders (insomnia, frequent waking up)
• Visual impairments
• Pain in the region of the heart
• First, episodic increases in blood pressure, then a persistent increase.

Uncontrolled hypertension can lead to complications

Let’s take a closer look at the acute complications of hypertension first – these are emergency situations when you must immediately call an ambulance. If there is no way to call an ambulance, ask someone to take you to the hospital.

One of these situations is a Hypertensive crisis – this is a sharp, sudden jump in pressure, accompanied by a deterioration in well-being. Sometimes the state of health can be normal. However, a hypertensive crisis always requires urgent intervention. Provoking factors for a pressure surge can be:

• Psychological and physical stress
• Change of weather
• Heavy smoking
• Abrupt withdrawal of blood pressure lowering drugs, taking short-acting drugs
• Drinking alcohol
• Large meals, especially salty, and at night
• Foods and drinks containing substances that increase blood pressure: coffee – caffeine, chocolate, cheese, caviar – tyramine.

It is very important to know what you can do yourself with high blood pressure before the doctor arrives

• First of all, you need to measure blood pressure
• Before the doctor arrives, try to lower your blood pressure yourself: to do this, take: Kapoten 25 mg – 1-2 tabs under the tongue or Corinfar 10 mg – 1 tab inside.
• For pain in the heart – nitrospray – 1 injection under the tongue
• You can not reduce blood pressure sharply, especially in the elderly and with a stroke, otherwise there may be cerebral ischemia (reduce by 20-25% in 2 hours).
• Call an ambulance doctor.

Against the background of high pressure, it is important to pay attention to the manifestations characteristic of a stroke or a temporary violation of cerebral circulation.

For this you need:

• Ask the person to smile. He can’t do it with both corners of his mouth. The smile will be crooked.
• Ask for a simple sentence, such as “the weather is fine today.” He will not be able to say clearly, “the tongue is tangled.”
• Ask to raise both hands at the same time. He will not be able or will be able only partially
• Ask to stick out the tongue – if it is twisted, turned – then this is a sign of a stroke.
• Visual impairment in one or both eyes, dark spots
• Disorders of gait, coordination, balance, dizziness
• Severe headache without cause

If you find these symptoms, you should immediately consult a cardiologist.

Irreversible changes can be prevented by calling an ambulance in the first 4.5 hours after the onset of these symptoms.

Now a few words about the chronic complications of hypertension. As we said earlier, with a long course of hypertension, small arteries are primarily affected, causing disruption of the work of various organs: the heart, kidneys, eyes, brain, blood vessels. Therefore, these organs are called targets of hypertension. The vulnerability of these organs in different people is different – in someone the heart is first affected, in someone the kidneys, in someone the brain. The presence of hypertension cannot be known without measuring the pressure.

The only way to determine your blood pressure is to measure it at least occasionally. And come to the annual medical examinations to the therapist. To measure pressure at home, there is a special device – a tonometer. Pressure should begin to be measured after 30 years. Today in pharmacies you can find a wide variety of blood pressure monitors from various manufacturers. The main difference between tonometers is in the method of measuring pressure. There are manual mechanical blood pressure monitors, semi-automatic and fully automatic blood pressure monitors.

The main disadvantage of mechanical tonometers and at the same time the advantage of automatic tonometers is that mechanical tonometers do not allow you to measure the pressure yourself, especially when you feel unwell, since to determine the pressure you need to listen to your heart sounds with a stethoscope, so you need another person who will measure your pressure , while automatic blood pressure monitors require only putting on a cuff and pressing a button. Also, mechanical blood pressure monitors work without batteries, while automatic ones can work both from batteries and from the mains. The display of the tonometer has a battery charge indicator, which will allow you to avoid situations when a discharged battery will take you by surprise, just when you urgently need to measure pressure.

Most blood pressure monitors have a cuff that is worn on the shoulder or on the wrist. There are also sports fitness bracelets without a cuff that can measure pressure and pulse, as well as body temperature, blood oxygen saturation, pulse regularity, sleep duration. The most convenient and accurate are blood pressure monitors with a cuff on the shoulder.

Since different people have different arm diameters, cuffs come in different sizes depending on the diameter of the arm circumference. As a rule, a standard cuff (22-32 cm) or a universal cuff (22-42 cm) is included with the tonometer. If the cuff does not fit, then you can additionally purchase a cuff suitable for your tonometer model. They come in the following sizes: 1. Pediatric cuff: 15-22 cm (S) 2. Medium cuff: 22-32 cm (M) 3. Large cuff: 32-42 cm (L) 4. Extra large: 32-52 cm (L-XL) Cuffs are soft and rigid. Here you can focus on your preferences. As a rule, a rigid cuff provides a more comfortable measurement process. However, we recommend that you try the cuff on your arm before buying in order to choose the most suitable one. Rigid cuff Soft cuff Also, to ensure the accuracy of the result and reliability of use, we recommend using blood pressure monitors from well-known manufacturers, such as: Beurer, AND, Microlife, Omron, Littledoctor, CITIZEN, Sanitas, Medisana, Nissei, Panasonic.

Tonometers of different manufacturers and brands are equipped with various other functions that facilitate the process of measuring pressure and make it more convenient, for example, display backlight, sound signals, voice guidance, saving the results of previous measurements in memory, the ability to use one tonometer for two people, while the results of their measurements are saved individually. Here you can focus solely on your preferences. All tonometers show the measurement result as two numbers: systolic pressure (upper) and diastolic pressure (lower). BP is measured in mmHg. The tonometer also shows the pulse rate and the presence of arrhythmias (irregular heartbeats).

In order to obtain accurate results using a tonometer, certain rules must be followed.

Rules for measuring pressure

It is necessary to measure the pressure while sitting, in a calm state for at least 5 minutes. Not earlier than 30 minutes after physical, emotional stress, food, cigarettes or coffee. If there is more pressure on one of the two hands, then for all subsequent measurements we select it. If a person is overweight and the circumference of his shoulder is more than 46 cm, then it is necessary to use a cuff with a width of 14 cm, otherwise the data will be overestimated.

1. Sitting with support on the back of a chair, relax your legs. The arm is relaxed and rests on a flat horizontal surface, not on weight
2. The hand is at the level of the heart
3. The arm is stationary during the measurement
4. Cuff 2.5 fingers above the elbow
5. Do not cuff clothing, do not roll up sleeves to form a roll of fabric
6. Repeated measurement on the same arm is possible after 1-2 minutes.
7. Measurement of blood pressure – in the morning after waking up and in the evening before bedtime.

Further, the obtained measurement results are used to diagnose the presence of arterial hypertension, as well as to assess the risk of developing vascular complications, such as strokes and heart attacks, in the next 10 years specifically in your situation. This is called prognosis. This prognosis is influenced by your medical history, blood pressure levels, and test results. The examination is prescribed by a cardiologist or therapist to determine the state of your target organs at the moment. The examination allows you to get a holistic view of your health and understand which target organs will be vulnerable in the first place.

The minimum examination looks like this:

• Monitoring of blood pressure and ECG per day. False-positive results occur in white-coat hypertension. When you see a doctor, your subconscious remembers how, as a child, a person dressed like this gave you a very painful injection in the ass, which, as you thought, was completely unfair. This is stressful for you and the pressure naturally rises. “Hypertension,” the doctor tells you. You come home, your wife measures your blood pressure – it is completely normal. In our case, the output is the daily monitoring of blood pressure. When a special wearable device measures the pressure every 20-40 minutes during the day. This is the “gold standard” for diagnosing hypertension
• ECG,
• ultrasound of the heart;
• Ultrasound of the kidneys;
• urinalysis;
• Doppler ultrasound of neck vessels;
• Blood tests: cholesterol, sugar, clinical blood count;
• Examination by an ophthalmologist – evaluation of the fundus vessels.

Knowing the test results, you and your doctor can assess your risk of vascular complications by answering questions. At the same time, if you have at least 1 item from the left column, then the risk of complications is already high and drug treatment should be started immediately.

Check if you moved:

• Stroke;
• Heart attack;

Please list your risk factors:

• Age >55 for men and >65 for women
• Smoking
• Elevated cholesterol (>6.5 mmol/l)
• Cardiovascular diseases in relatives
• Obesity
• Lack of physical activity
• Excessive alcohol consumption

Please note if you have:

• Angina pectoris
• Diabetes mellitus
• Vascular disease of the legs (“intermittent claudication”)
• Aortic aneurysm
• Renal dysfunction

Ask your cardiologist if you have:

• Left ventricular hypertrophy
• Fundus changes
• Protein in urine and/or increased blood creatinine
• Systolic BP >180/110 Each yes answer to the questions in this table corresponds to one risk factor.

The total number of “yes” answers tells you how many risk factors you have in total.

Then, compare the number of risk factors you have with your blood pressure levels and use the table below to estimate your risk of developing vascular complications over the next 10 years.

• Low risk <15%,
• Medium risk 15-20%,
• High risk 20-30%,
• Very high risk >30%

Now you know your risk of vascular complications. What to do next?

The choice of further medical tactics for arterial hypertension depends on your level of risk. Each level of risk has its own tactics.

Low Risk: No immediate treatment needed, monitor blood pressure regularly for 6-12 mo. If after 12 months BP>150/95 – then you need to start drug therapy.

At Moderate risk: Regularly measure blood pressure for 3-6 months, non-drug correction of risk factors for 3-6 months. If, after 6 months, blood pressure > 140/90, then it is necessary to start drug therapy.

If you are at high risk: Immediate medical treatment. You need to see a doctor. To reduce the risk of vascular complications – heart attack and stroke, it is necessary to normalize blood pressure.

To do this, you need to understand what underlies high blood pressure. Pressure is based on both genetics and environmental influences. Therefore, all risk factors for the development of hypertension are divided into 2 large groups – these are:

• Immutable factors. We cannot influence these factors, since they are determined by genes and are innate. These include: gender, age, heredity (the presence of cardiovascular diseases in close relatives at a young age up to 40 years). But in itself, a hereditary predisposition to arterial hypertension does not mean that a person will definitely get sick.

But when other negative factors join heredity:

• Changeable factors. Most of them are our life habits. We can change them. These include: smoking, nutrition, obesity, excessive salt intake, inactivity, stress, nervous tension, cholesterol levels, alcohol abuse, coffee, blood pressure levels. One of these factors is the general abuse of salt, and specifically, sodium, which is part of it. Few people know that even without salting food on purpose, we nevertheless consume sodium three times more than the amount that we need. Sodium is found not only in table salt, but also in the mass of food additives in food products, such as preservatives, dyes, stabilizers, sweeteners, additives to improve the taste and color of foods, flavorings (for example, monosodium glutamate, sodium nitrite, sodium benzoate , sodium citrate, sodium cyclamate and others). Excess intake of sodium in the body is one of the most powerful risk factors for arterial hypertension. We will talk about this separately.

As for stress… Undoubtedly, stress often works like a detonator, it starts the process of arterial hypertension. But if a person who quarrels with his superiors, drives through city traffic jams, overcomes snowdrifts and puddles, etc., is provided with ideal living conditions, then arterial hypertension will not disappear from him.

The treatment of arterial hypertension is always a partnership between a doctor and a patient.

We would like you to have an understanding of what you can do for yourself and how important it is to understand the purpose for which the doctor gives certain recommendations. This gives you the opportunity to prevent or slow down the course of the disease and reduce the risk of its complications.

Hypertension treatment includes both non-drug treatments and medications.

Non-drug methods relate to changing habits and lifestyle and are recommended for all patients, regardless of pressure numbers and risk levels. Non-drug treatments for high blood pressure include:

• Power Features
• Dietary sodium reduction
• Maintaining the intake of potassium, calcium, magnesium in the body
• Reduce dietary intake of saturated fat, cholesterol, increase vegetables and fruits
• Increased physical activity
• Restriction of alcohol consumption, coffee
• Smoking cessation
• Weight loss in obesity
• Normalization of the regime of work and rest We will discuss all these factors separately later.