Hypertension has become extremely common in the general population, with approximately 3 out of 10 people in China suffering from hypertension and more than half of the elderly suffering from hypertension, most of whom are unaware of it.
Hypertension is a chronic disease that endangers life and quality of life in the long term. The literature shows that for every 20 mmHg increase in SBP or 10 mmHg increase in DBP from 115/75 mmHg to 185/115 mmHg, the risk of cardiovascular and cerebrovascular complications multiplies, and this is even more pronounced in the Asia-Pacific population, where every 10 mmHg increase in SBP increases the risk of stroke by The risk of stroke increases by 125% and fatal heart attack increases by 47.6% for every 10 mmHg increase in SBP.
In many cases, we need to measure blood pressure not only in the hospital, but also at home.
Let’s talk about self-monitoring at home.
Who needs to monitor blood pressure at home?
1. People who suspect abnormal blood pressure
This mainly refers to those whose blood pressure is found to be high during a physical examination. Very often, a single measurement does not always reflect the true situation. Also, the definition of hypertension emphasizes that the diagnosis is made only when the blood pressure exceeds 140/90 mmHg three times on non-same days. Therefore, when your initial physical examination reveals an increase in blood pressure, there is no need to be nervous, and unless the blood pressure is particularly high, there is no need for immediate medication, and you should monitor your blood pressure continuously over the next few days to see if you already have hypertension. Of course, there are conditions to do a dynamic blood pressure is also OK.
2, white coat effect or masked hypertension
Blood pressure is a very magical thing, in addition to the most common cases of hypertension, there are some special cases, such as the white coat effect and masked hypertension. White coat hypertension” means that the patient’s blood pressure is high when measured at the doctor’s office, but normal when measured at home. The masked hypertension refers to the kind of condition where the blood pressure is high at home, but normal when measured at the hospital. Isn’t that amazing! That how to identify it, home self-measurement blood pressure is essential information.
3, people who already have high blood pressure
Most people who already have high blood pressure need to take long-term medication to control their blood pressure, and the medication needs to be adjusted according to the blood pressure, but if you only adjust the medication according to your blood pressure measured at the hospital, there will obviously be a big deviation, so how to do? The best way is to insist on taking your blood pressure at home, and make a good record of it, and bring it to the doctor when you visit him/her, so that he/she can speed up the consultation and also let the doctor have a more comprehensive grasp of your blood pressure.
4. Patients with high blood pressure but not receiving medication for the time being
There are many patients who are clearly hypertensive, but their blood pressure is not very high, and they are not receiving antihypertensive medication for the time being but using non-pharmacological treatment, such as lifestyle improvement, etc. For such patients, it is definitely necessary to insist on home self-monitoring of blood pressure at home.
What kind of blood pressure monitor do I need to monitor my blood pressure at home?
Although doctors use traditional mercury sphygmomanometers to measure blood pressure, mercury sphygmomanometers are difficult for a single person to operate and require long-term training to measure accurately. Therefore, electronic sphygmomanometers are usually recommended for self-monitoring at home.
1. What kind of specifications?
In China, there is no clinical accuracy testing standard for blood pressure monitors, so if you have enough budget, you should choose a monitor that is marked with the words ESH, AAMI or BHS certified by Europe and the United States, such as most of Omron’s models.
Sphygmomanometers are available in different cuff sizes and should be selected according to the thickness of your arm/wrist, so please ask for details when purchasing.
In addition, electronic sphygmomanometers need to be calibrated once a year, and the manufacturer must provide calibration services, otherwise it is not worth buying.
2. Which blood pressure monitor is better, wrist or upper arm?
Most people use a wrist blood pressure monitor because they cannot hold the monitor flush with their heart, increasing the error. Moreover, studies have shown that even with standard use, the reliability of the upper-arm sphygmomanometer is better than that of the wrist type. Therefore, the upper arm type electronic blood pressure monitor should be preferred.
Of course, the wrist blood pressure monitor is more compact and portable, and it can be measured without taking off the sleeves when wearing more clothes, so it is also an option for people who travel frequently or in cold areas.
How to use the electronic blood pressure monitor to measure blood pressure?
1. Preparation before measurement
Avoid strenuous exercise, smoking, alcohol, coffee, tea, etc. 30 minutes before the measurement, and go to the bathroom in advance, find a chair or sofa with a backrest, and sit for 5 minutes to rest calmly.
For hypertensive patients, the blood pressure measurement is to assess the effect of control, so the medication must be taken on time, do not delay because of the measurement.
2. Measurement movements
When measuring, relax your arms, place them on the table at the same height as your heart, lean your back against a chair or sofa cushion, relax your legs and measure calmly. The wrong position of the arm, arm force, etc. will make the measurement results appear large errors.
Regarding which arm is used to measure blood pressure, there is no such thing as male left or female right. In principle, both arms are fine, as long as it is convenient, but the same side should be measured each time so that it is comparable.
There is often a small difference in blood pressure between the two arms, but it is considered normal as long as it is within 20 mmHg. If the difference is too large, you should consult your doctor.
3. What data should I record after taking the blood pressure?
Immediately after the measurement, you should record the blood pressure and pulse in a notebook, and record the date and time of the measurement, left or right arm, and whether or not you are taking medication and the dose of medication, so that you can use it for medical consultation.
What time period to measure
Whether you are a normal person or a person with hypertension, you should understand one common sense – even if you exclude the interference of lifestyle and medication, blood pressure itself has its own daytime and nighttime fluctuations throughout the day.
Through 24-hour ambulatory blood pressure monitoring of normal people and hypertensive patients in China, it was found that 70% of people have two blood pressure peaks and two valleys, namely, 6-8 am for the first blood pressure peak; 8 am after the start of the decline, to 12 noon to 1 pm for the first trough; then blood pressure began to rise, to 4-6 pm The second peak is at 4-6 p.m., which is the highest blood pressure time of the day; thereafter, the blood pressure drops to 1-2 a.m., which is the lowest point of the day and the second trough; finally, the blood pressure gradually rises and then enters the first peak of the next day.
The above time points are not consistent for everyone, and a few people even have the exact opposite – their blood pressure is higher during sleep than during the day.
Therefore, if you take the test only once, you may just miss the diagnosis of hypertension by not capturing the moment when the person’s blood pressure is over the limit.
Therefore, some suggestions are given.
1. Before going to the clinic, take measurements for at least 5-7 consecutive days, once a day after waking up (before meals) and once a day before going to bed.
2. If you have just started treatment for hypertension or have just adjusted the dosage of your medication, you should also measure once a day after waking up (before meals) and once before going to bed, until your blood pressure has been stable for at least one week, and then reduce the frequency.
3. Patients with well-controlled blood pressure should have their blood pressure measured once or twice a week, usually in the morning, when their daily blood pressure is high.
4. Patients who do not meet the diagnostic criteria for hypertension, but whose blood pressure is high (e.g., greater than 130/80 mmHg but not 140/90 mmHg, depending on the specialist’s on-site findings), should have their blood pressure measured once a month, both day and night, and improve their lifestyle.
How do I understand the results of self-measured blood pressure?
The criteria for monitoring blood pressure at home are different from the usual diagnostic criteria for hypertension (140/90 mmHg), which are generally considered to be met when the self-measured blood pressure at home is higher than 135/85 mmHg.
Can I adjust my blood pressure medication on my own?
It is best not to do so. It is recommended that you consult a specialist for medication adjustments.
If you really want to make adjustments on your own, it is not advisable to do so too often. Some patients increase their medication as soon as their blood pressure is measured high, and decrease it as soon as it is measured low, which is most undesirable and will only lead to drastic fluctuations in your blood pressure. Generally speaking, if your blood pressure is high (low) for 3 consecutive days, you can consider adjusting your dose. However, if your blood pressure suddenly rises significantly, for example, above 180 mmHg, and remains high after rest, you are advised not to make any adjustments on your own, but to consult a medical professional as soon as possible and adjust your medication.
For the health of you and your family, learn how to measure your blood pressure, and don’t forget to follow your doctor’s instructions!