As hypertension becomes more and more visible and recognizable in people’s lives, going to the pharmacy to have your blood pressure measured has become a part of some people’s daily lives. But how to measure blood pressure is accurate, how to properly measure to help us diagnose hypertension? These points should be mastered, or you should keep in mind.
Before understanding the measurement of blood pressure, we must first figure out what is blood pressure and what is the normal value of blood pressure.
Clinically, blood pressure can be divided into systolic and diastolic pressure, systolic pressure is also commonly known as “high pressure”, diastolic pressure is commonly known as “low pressure”, if the measured data systolic pressure <120mmHg, diastolic pressure <80mmHg, it can be considered normal blood pressure. As for hypertension, the clinical criteria are generally systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, without the use of antihypertensive drugs, can be diagnosed as hypertension.
In-office blood pressure measurement, the “gold standard” of diagnosis
Measuring blood pressure can be a “technical task”, and improper operation may lead to inaccurate values, which may affect clinical diagnosis. Therefore, in-office blood pressure measurement is often regarded as the “gold standard” for the diagnosis of hypertension, which in fact, in layman’s terms, is the blood pressure measured by medical and nursing staff under standard conditions and according to uniform specifications.
In-office blood pressure measurement
The procedure is as follows.
① Ask the subject to rest quietly for at least 5 minutes before starting to measure the blood pressure in the sitting upper arm, which should be placed at the level of the heart.
②The use of a validated upper-arm medical electronic sphygmomanometer is recommended, and the mercury column sphygmomanometer will be phased out.
③Use a standard size cuff with a balloon length of 22-26 cm and a width of 12 cm. Obese individuals or those with large arm circumference should use a large size balloon cuff.
④The blood pressure of both upper arms should be measured at the first consultation, and the side with the higher blood pressure reading should be used as the upper arm for measurement.
⑤ When measuring blood pressure, the measurements should be repeated 1-2 minutes apart and the average of the 2 readings should be taken and recorded. If the difference between the two readings of systolic or diastolic blood pressure is more than 5 mmHg, the measurement should be repeated and the average of the three readings should be recorded.
(6) In the elderly, diabetic patients and those with postural hypotension, standing blood pressure should be measured additionally, and standing blood pressure should be measured 1 minute and 3 minutes after changing from the prone position to the standing position.
(7) The pulse rate should be measured at the same time as the blood pressure.
However, there are times when blood pressure measurement in the office is not “accurate”, mainly because there are many factors that can affect blood pressure, including mental and emotional stress, which leads to “white coat hypertension” in many people, i.e., blood pressure under other circumstances is This leads to “white coat hypertension” in many people, which means that blood pressure is otherwise normal. Therefore, in addition to in-office blood pressure measurement, there are other clinical methods of blood pressure monitoring, including ambulatory blood pressure monitoring and home blood pressure monitoring.
Ambulatory Blood Pressure Monitoring
Ambulatory blood pressure monitoring requires the use of an ambulatory blood pressure monitoring device to measure blood pressure several times during a 24-hour period, usually at intervals of 15-30 minutes, and then calculate the average systolic blood pressure, average diastolic blood pressure, average pulse pressure, and basal blood pressure over a 24-hour period, which is called ambulatory blood pressure monitoring.
Ambulatory blood pressure monitoring
The results can be used for early diagnosis of hypertension and to assist in identifying primary, secondary and complicated hypertension, and also allow physicians to better guide the rational use of medication, prevent cardiovascular complications, and predict the occurrence and development of complications and death from hypertension.
Home blood pressure monitoring
Home blood pressure monitoring, which may be better known in life than ambulatory blood pressure monitoring, refers to self-measurement by the person being measured using an electronic sphygmomanometer or mercury column sphygmomanometer.
Home blood pressure measurement
It is generally recommended that seated blood pressure be measured 2 to 3 times each day in the morning after waking up before taking medication and at night before going to bed. Avoid strenuous exercise, strong tea or coffee before each measurement, and take two measurements 1 minute apart.
For patients with hypertension who are already taking regular antihypertensive medication and whose blood pressure is under stable control, the number of weekly measurements can be reduced appropriately, and blood pressure measurements can be taken 1 to 2 days a week.
Hypertension is a common chronic disease that often endangers health without a sound, and active prevention is the most important thing. Regardless of your age, learning to judge and measure your blood pressure is a “must-have tip” in life.
References
[1]Chinese guidelines for the prevention and treatment of hypertension (2018 revised edition) [J]. Chinese Journal of Cardiovascular,2019,24(01):24-56.
[2]Bureau of Disease Prevention and Control, National Health Care Commission, Editorial Board of the Chinese Journal of Cardiovascular Diseases, National Cardiovascular Center, et al. Chinese health management norms for hypertension (2019)[J]. Chinese Journal of Cardiovascular Diseases,2020,048(001):10-46.