Understanding your Blood pressure

Source: Your Guide To Lowering Blood Pressure, www.nhlbi.nih.govc

UNDERSTANDING YOURUNDERSTANDING YOURBLOOD PRESSUREBLOOD PRESSURE

MR. SHIVARAJKUMAR.R.DANDAGIMR. SHIVARAJKUMAR.R.DANDAGIM.Sc (N)M.Sc (N)

LECTURERLECTURERDEPT. OF COMMUNITY HEALTH NURSINGDEPT. OF COMMUNITY HEALTH NURSING


NEW RESEARCH STATES…NEW RESEARCH STATES…

So…high blood pressure is a condition that most people So…high blood pressure is a condition that most people will have at some point in their lives.will have at some point in their lives.

that at age 55 or older, those who do not have that at age 55 or older, those who do not have high blood pressure have a 90% chance of high blood pressure have a 90% chance of developing it during their lifetimes.developing it during their lifetimes.

1 in 3 American adults have high blood pressure1 in 3 American adults have high blood pressure

““Silent Killer”Silent Killer”65 million adults have high blood pressure in this country.65 million adults have high blood pressure in this country.

SHIVARAJKUMARSHIVARAJKUMAR


The first to measure The first to measure BPBP

1733 - Reverend Stephen 1733 - Reverend Stephen Hales first to measure BPHales first to measure BP

Measured the height of a Measured the height of a column of blood after column of blood after cannulating the carotid artery cannulating the carotid artery in a horse with a brass pipe. in a horse with a brass pipe.

I’m that I’m that good!!!good!!!


The first measurement The first measurement of BPof BP

The brass pipe was The brass pipe was attached to a 12 inch attached to a 12 inch glass tubeglass tube

Tube was connected to Tube was connected to the pipe via a trachea of a the pipe via a trachea of a goosegoose


A second try…A second try… 100 years later: a mercury manometer connected to the artery was used 100 years later: a mercury manometer connected to the artery was used

to measure the BPto measure the BP

However:However:

Both of these methods are invasiveBoth of these methods are invasive

… … And maybe… a And maybe… a bit uncomfortable bit uncomfortable

for the patient! for the patient!


Eureka!Eureka! In late 1890s, an Italian physician – Scipione In late 1890s, an Italian physician – Scipione

Riva Rocci invented the SphygmomanometerRiva Rocci invented the Sphygmomanometer

ShygmoShygmo (from the Greek) => pulse (from the Greek) => pulse

Manometer => pressure meterManometer => pressure meter

- Consisted of a mercury column - Consisted of a mercury column Manometer, a rubber sleeve whichManometer, a rubber sleeve whichis filled with air, and a squeeze bagis filled with air, and a squeeze bagto inflate the rubber sleeveto inflate the rubber sleeve I had an I had an

idea!idea!

What Is Blood Pressure?What Is Blood Pressure?

Blood pressureBlood pressure is is the force of blood the force of blood pushing against pushing against

the arteries.the arteries.

Blood is carried to Blood is carried to all parts of your all parts of your body in vessels body in vessels called arteries.called arteries.


Each time the heart beats Each time the heart beats (about 60-70 times a (about 60-70 times a

minute at rest), it pumps minute at rest), it pumps out blood into the arteries. out blood into the arteries.

What Is Blood Pressure?What Is Blood Pressure?

Your blood pressure is at Your blood pressure is at its highest when the heart its highest when the heart beats, pumping the blood.beats, pumping the blood.

When the heart is When the heart is at rest, between at rest, between

beats, your blood beats, your blood pressure falls.pressure falls.

Your blood pressure is always given as these two numbers Your blood pressure is always given as these two numbers with one above or before the other.with one above or before the other.

This is called This is called SYSTOLICSYSTOLIC pressure. pressure.120/120/To

p

num

ber

8080This is calledThis is called DIASTOLIC DIASTOLIC pressure.pressure.

Bottom number



CategoryCategorySystolicSystolic

(Top Number)(Top Number)

DiastolicDiastolic

(Bottom Number)(Bottom Number)

NormalNormal Less than 120Less than 120 Less than 80Less than 80

What Is Normal Blood Pressure?What Is Normal Blood Pressure?

““Normal” blood pressure is when both Normal” blood pressure is when both numbers arenumbers are lower lower than 120/80. than 120/80.


Preparation for Preparation for measurementmeasurement



• Patient should Patient should abstain from abstain from eating, drinking, eating, drinking, smoking and smoking and taking drugs that taking drugs that affect the blood affect the blood pressure one hour pressure one hour before before measurement. measurement.


Remember the followingRemember the following for for accuracy of your readingsaccuracy of your readings

• Instruct your Instruct your patients to avoid patients to avoid coffeecoffee, , smokingsmoking or or any other any other unprescribed drug unprescribed drug with with sympathomimetic sympathomimetic activity on the day activity on the day of the of the measurement measurement



• Because a Because a full full bladderbladder affects the affects the blood pressure it blood pressure it should have been should have been emptied. emptied.



• Painful proceduresPainful procedures and exercise and exercise should not have should not have occurred within occurred within one hour. one hour.

• Patient should Patient should have been sitting have been sitting quietly for about 5 quietly for about 5 minutes. minutes.

Position of the PatientPosition of the Patient


Position of the PatientPosition of the Patient

• Sitting position Sitting position • Arm and back are Arm and back are

supported. supported. • Feet should be Feet should be

resting firmly on resting firmly on the floorthe floor

• Feet not dangling. Feet not dangling.


Position of the armPosition of the arm

• Patient Patient arm should be resting on the deskarm should be resting on the desk and and raised raised


Position of the armPosition of the arm

• Palm is Palm is facing upfacing up. . • The arm should remain The arm should remain somewhat bentsomewhat bent

and completely relaxedand completely relaxed

EquipmentEquipment


In order to measure the In order to measure the Blood Pressure (equipment)Blood Pressure (equipment)• Pediatric Cuff size Pediatric Cuff size

• Minimum Cuff Minimum Cuff Width: Width: 2/3 length of 2/3 length of upper armupper arm

• Minimum Cuff Minimum Cuff length: length: Bladder Bladder nearly encircles armnearly encircles arm


In order to measure the In order to measure the Blood Pressure (equipment)Blood Pressure (equipment)

• Adult Cuff size Adult Cuff size • Cuff Width: Cuff Width: 40% of 40% of

limb'slimb's circumference circumference


Blood Pressure Blood Pressure

• If it is tooIf it is too small small, the , the readings will be readings will be artificially artificially elevatedelevated. . The opposite occurs The opposite occurs if the cuff is tooif the cuff is too largelarge. Clinics should . Clinics should have at least have at least 2 cuff 2 cuff sizessizes available, available, normal and large. normal and large.

Cuff PositionCuff Position


In order to measure the In order to measure the Blood Pressure (Cuff Blood Pressure (Cuff

Position)Position)• Patient's arm Patient's arm

slightly slightly flexed at flexed at elbow elbow

• Push the Push the sleeve sleeve upup, wrap the cuff , wrap the cuff around the bare around the bare armarm


In order to measure the In order to measure the Blood Pressure (Cuff Blood Pressure (Cuff

Position)Position)• Cuff applied Cuff applied directly directly over skinover skin (Clothes (Clothes artificially raises artificially raises blood pressure )blood pressure )

• Position lower cuff Position lower cuff border border 2.5 cm 2.5 cm above antecubitalabove antecubital

• Center inflatable Center inflatable bladder over bladder over brachial artery brachial artery

Technique of BP Technique of BP measurementmeasurement


In order to measure the In order to measure the BPBP

• Wrap the cuffWrap the cuff around the around the patient's upper patient's upper armarm

• Close the thumb-Close the thumb-screw.screw.



• With your left hand With your left hand place theplace the stethoscopestethoscope head head directly over the directly over the braquial braquial artery .artery . Press in firmly but Press in firmly but not so hard that not so hard that you block the you block the artery. artery.



• Use your right Use your right hand to hand to pump the pump the squeeze bulbsqueeze bulb several times and several times and Inflate the cuff until Inflate the cuff until you can no longer you can no longer feel the pulse to feel the pulse to level above level above suspected SBPsuspected SBP



• If you immediately If you immediately hear sound, pump hear sound, pump up an additionalup an additional 20 20 mmHg and repeat mmHg and repeat



• Listen for auditory Listen for auditory vibrations from vibrations from artery artery "bump, "bump, bump, bump"bump, bump" (Korotkoff) (Korotkoff)



• Systolic blood Systolic blood pressurepressure is the is the pressure at which pressure at which you can first hear you can first hear the the pulse. pulse.



• Diastolic blood pressureDiastolic blood pressure is the last pressure is the last pressure at which you can still hear the pulseat which you can still hear the pulse



• Avoid moving Avoid moving your your handshands or the or the head head of the stethescopeof the stethescope while you are while you are taking readings as taking readings as this may produce this may produce noise that can noise that can obscure the obscure the Sounds of Sounds of Koratkoff. Koratkoff.



• If you wish to If you wish to repeatrepeat the BP the BP measurement you measurement you should should allow the allow the cuff to completely cuff to completely deflatedeflate, permit any , permit any venous congestion venous congestion in the arm to in the arm to resolve and then resolve and then repeat a minute or repeat a minute or so laterso later. .


Remember the followingRemember the following for for accuracy of your readingsaccuracy of your readings

• If the BP is If the BP is surprisingly high or surprisingly high or low, low, repeat the repeat the measurementmeasurement towards thetowards the end end of of your exam your exam ((RepeatedRepeated blood blood pressure pressure measurement measurement can be can be uncomfortable)uncomfortable). .


““Prehypertension”Prehypertension”

This category was created to alert people to their risk of developing This category was created to alert people to their risk of developing high blood pressure so they could make lifestyle changes that may high blood pressure so they could make lifestyle changes that may

help to avoid developing this condition.help to avoid developing this condition.

Which of the Which of the following blood following blood

pressure readings are pressure readings are considered considered

“prehypertensive”?“prehypertensive”?

80-8980-89120-139120-139PrehypertensionPrehypertension

138/82138/82 128/89128/89118/78118/78

Top NumberTop Number Bottom NumberBottom Number

NEW!!!

NEW!!!



If your blood pressure is in the prehypertensive range:If your blood pressure is in the prehypertensive range:

It means that you don’t have high blood pressure now, but you are It means that you don’t have high blood pressure now, but you are likely to develop it in the future.likely to develop it in the future.

Unless you take Unless you take ACTIONACTION to prevent it! to prevent it!

““Prehypertension”Prehypertension”

PrehypertensionPrehypertension 120-139120-139 80-8980-89



What Is High Blood Pressure?What Is High Blood Pressure?When blood pressure stays elevated over a long period of When blood pressure stays elevated over a long period of time it is called time it is called high bloodhigh blood pressure or “ pressure or “hypertensionhypertension”.”.

High blood pressure is dangerous because it High blood pressure is dangerous because it makes the heart work too hard and contributes makes the heart work too hard and contributes to hardening of the arteries (atherosclerosis). to hardening of the arteries (atherosclerosis).

http://diseases-explained.com/



What Is High Blood Pressure?What Is High Blood Pressure?

A blood pressure of A blood pressure of 140/90140/90 is considered high blood pressure. is considered high blood pressure.

High Blood PressureHigh Blood Pressure SystolicSystolic DiastolicDiastolic

Stage 1Stage 1 140-159140-159 90-9990-99

Stage 2Stage 2 160 or higher160 or higher 100 or higher100 or higher

““Hypertension”Hypertension”



Why Is High Blood Pressure Important?Why Is High Blood Pressure Important?

Increases your risk for :Increases your risk for :

Heart disease & StrokeHeart disease & Stroke – –Heart disease & StrokeHeart disease & Stroke – – the the 1st1st and and 3rd3rd leading causes of leading causes of death for Americans.death for Americans.

the the 1st1st and and 3rd3rd leading causes of leading causes of death for Americans.death for Americans.

If left uncontrolled, high blood pressure can also cause:If left uncontrolled, high blood pressure can also cause:

Heart failureHeart failure

Heart AttackHeart Attack

Kidney diseaseKidney disease

BlindnessBlindness



What can high blood pressure do to your body?What can high blood pressure do to your body?

Heart AttackHeart Attack

High blood pressure is a High blood pressure is a major risk factor for major risk factor for

heart attack. The heart attack. The arteries bring oxygen-arteries bring oxygen-carrying blood to the carrying blood to the heart muscle. If the heart muscle. If the

heart cannot get enough heart cannot get enough oxygen, chest pain, can oxygen, chest pain, can

occur. If the flow of occur. If the flow of blood is blocked, a heart blood is blocked, a heart

attack results.attack results.

BlindnessBlindnessHigh blood pressure can High blood pressure can eventually cause blood eventually cause blood

vessels in the eye to burst or vessels in the eye to burst or bleed. Vision may become bleed. Vision may become

blurred or otherwise impaired blurred or otherwise impaired and can result in blindness.and can result in blindness.

Kidney diseaseKidney diseaseKidneys act as filters to Kidneys act as filters to rid the body of waste. rid the body of waste.

High blood pressure can High blood pressure can narrow and thicken the narrow and thicken the

blood vessels of the blood vessels of the kidneys. The kidneys kidneys. The kidneys

filter less fluid and waste filter less fluid and waste builds up in the blood. builds up in the blood. The kidneys may fail The kidneys may fail

altogether.altogether.

High blood pressure is the most High blood pressure is the most important risk factor for stroke. Very important risk factor for stroke. Very high pressure can cause a break in a high pressure can cause a break in a weakened blood vessel, which then weakened blood vessel, which then bleeds in the brain. This can cause a bleeds in the brain. This can cause a stroke. If a blood clot blocks one of stroke. If a blood clot blocks one of

the narrowed arteries, it can also the narrowed arteries, it can also cause a stroke. cause a stroke.

StrokeStroke

As people get older, As people get older, arteries throughout the arteries throughout the

body "harden," body "harden," especially those in the especially those in the

heart, brain, and heart, brain, and kidneys. High blood kidneys. High blood

pressure is associated pressure is associated with these "stiffer" with these "stiffer"

arteries. This, in turn, arteries. This, in turn, causes the heart and causes the heart and

kidneys to work harder.kidneys to work harder.

ArteriesArteries

Heart failureHeart failure

The heart is unable to pump enough blood to supply the body's

needs.



The Good News is…The Good News is…You can take action to prevent getting high blood pressure You can take action to prevent getting high blood pressure

or take steps to control it!or take steps to control it!

See your doctor for regular blood pressure check upsSee your doctor for regular blood pressure check ups

Maintaining a healthy weightMaintaining a healthy weight

Get physically activeGet physically active

Eat a healthy diet rich in Eat a healthy diet rich in vegetables and fruits, and low vegetables and fruits, and low fat dairy foodsfat dairy foodsChoose and prepare foods with less saltChoose and prepare foods with less salt

If you drink alcoholic beverages, drink If you drink alcoholic beverages, drink in moderationin moderation

If you smoke, think about quittingIf you smoke, think about quitting



1. GET YOUR BLOOD PRESSURE CHECKED.1. GET YOUR BLOOD PRESSURE CHECKED.

2. EAT HEALTHY FOODS.2. EAT HEALTHY FOODS.

3. GET PLENTY OF EXERCISE.3. GET PLENTY OF EXERCISE.

Our heart health depends on it! Our heart health depends on it!

Understanding Your Blood PressureUnderstanding Your Blood Pressure


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Understanding your Blood pressure