New Acc/aha Blood Pressure Guidelines: Check
Its been over a year since the new blood pressure guidelines were released and 103 million Americans were recategorized with high blood pressure. Thats nearly 1 in 2 of us. How are YOU doing?
|AND/OR||HIGHER THAN 120|
Out-of-office BP measurements are recommended to confirm the diagnosis of hypertension and for titration of BP-lowering medication, in conjunction with telehealth counseling or clinical intervention Self monitoring of BP refers to the regular measurement of BP by an individual at home or elsewhere outside the clinic setting .
2013 ESH/ESC Guidelines for the Management of Arterial Hypertension defines high blood pressure readings obtained by self-measurement at home as:Systolic Blood Pressure 135Diastolic Blood Pressure 85
In terms of taking action based on your blood pressure readings, this should always be discussed and decided on between you and your doctor. You should never self-diagnose or adjust your medication if not prescribed by your doctor.
To learn more about blood pressure, click on the following links:
Blood Pressure Cuff Size
When it comes to blood pressure cuffs, size does matter. The wrong size cuff can cause your readings to be either too high or low. Most home monitors and cuffs have an arm size range on the cuff.
Some home monitors come with one size range cuff and others may give you a choice of cuffs. If your arm size changes, some monitor cuffs can be changed to a different size .
Before you purchase a home monitor, make sure you know what cuff size youre getting. The home monitor I use and recommend comes with a standard cuff size that fits most people. It measures between 8.75 and 16.5.
The best way to measure your upper arm is with a cloth measuring tape. Keep your arm relaxed, supported or hanging straight down. Wrap the measuring tape around the middle of your upper arm and make sure it is even all the way around.
Make a note of your measurement and make sure it falls within the range of the cuff youre buying.
Blood pressure cuff placement is one of 14 sections in my article about blood pressure cuffs. Learn more about BP cuffs, including how to apply them, errors made and sizes, here in the article, Blood Pressure Cuffs.
For Accurate Readings The Angle Matters
How you position your arm during a blood pressure check could potentially determine whether your doctor properly diagnoses and treats your hypertension.
That conclusion comes from a study in which researchers at UC San Diego placed patients arms in slightly exaggerated positions. With the arm straight and parallel to the body, blood pressure readings can be up to 10% higher than when the elbow is bent at a right angle to the body at the level of the heart, researchers found. The ideal position falls between those extremes, with the arm at heart level and the elbow slightly flexed.
Dr. David Guss, director of emergency room services at UC San Diego, oversaw the study of 100 emergency room patients with signs of cardiovascular problems. Two medical students took readings from the left arm when the patients were standing, sitting or lying down, first with the arm perpendicular to the body, then with the arm parallel to the body.
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What Is A Healthy Blood Pressure Reading
Your blood pressure measures the force of the blood being pushed through your body as your heart beats.
The first number is called your systolic pressure. It measures the pressure in your blood vessels when your heart pumps. The second number is called your diastolic pressure, which measures the pressure in your blood vessels in between heartbeats.
A blood pressure reading is considered healthy if it is 120/80 millimeters of mercury or below. Any blood pressure above this is considered elevated or abnormal.
A single blood pressure reading in the higher range isnt cause for concern, but if youre regularly getting higher readings, a medical professional will make a plan to help you lower your numbers.
Elevated blood pressure categories include:
The Wrong Diagnosis Of Low Or High Blood Pressure
There is a checklist in the new blood pressure guidelines for medical professions to follow when taking BP. Failure to do any of them can lead to a wrong diagnosis of low or high blood pressure. One of the things on the checklist is taking blood pressure in both arms during the initial visit or if the pressure is not normal in one arm.
Lets say you go for a doctor visit one day, and the nurse takes your BP in only one arm and the measurement indicates high blood pressure. Your doctor will be under the impression your blood pressure is high. In addition, the reverse can happen if the BP is low in one arm. The doctor will think your pressure is low or normal when it might actually be high because they never checked the other arm. Or even worse, like the 69 year old woman, they may miss that you have a serious narrowing of an artery on one side of your body.
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Check The Arm Size Range On The Cuff
Every home blood pressure cuff is made for a particular size range. The home monitor I use, came with a range of 8.75 to 16.5. All you have to do is check the size of the cuff to your arm circumference prior to ordering.
If youre looking for a new, affordable machine thats high quality, you can read about it in my blog post, Home Blood Pressure Monitors. It has cuff options up to 21.25. If the monitor doesnt come with the correct size cuff for you, try these options:
- Find out if the cuff can be changed.
- Shop for an appropriate size for your arm that will attach to your monitor. Here are some extra large size cuffs you can check out.
- Find a monitor with the correct size for you. Here are some monitors with extra large cuffs.
- Consider using a wrist cuff monitor instead. Heres the wrist monitor I recommend.
How Did Bfr Training Begin
Congratulations! If youve made it this far you are really dedicated to learning about BFR training. So Ill give you a little bonus info about how it got started.
BFR was invented by a Japanese therapist, Yoshiaki Sato, around 1994. After sitting in a traditional kneeling position for a long time at a funeral, Sato realized that his calves felt just as if hed done a vigorous workout.
From there he wondered if sitting on his calves had slowed blood return, trapping CO2, lactic acid, and other waste products. This, he thought might trick the muscles into growing because they felt like they had done a heavy bout of exercise.
Further research proved his hypothesis, and he started KAATSU training the origin of BFR. He tried it out on himself as one of the first test subjects. After breaking his ankle, he decided to use BFR on the injured leg while he was in a cast for 8 weeks. He found that hed prevented almost all of the atrophy that usually comes from being in a cast for that long. And the rest is history.
Looking to recover faster? Check out our guide to choosing the best turmeric supplements for your needs.
This does not constitute specific medical advice and does not indicate a physician-patient relationship between Dr. Larson and readers of this website. Please consult your own physician regarding any of these recommendations before starting them.
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Selection Of Participants And Study Design
This was a prospective study enrolling a convenience sample of subjects. Inclusion criteria included age 18 years and a chief complaint and presumptive diagnosis unlikely to be associated with cardiovascular instability. Exclusion criteria included complaints of lightheadedness, chest pain, abdominal pain, vomiting, diarrhea, gastrointestinal bleeding, and any injury or complaint that would preclude repeated
Youve Placed The Cuff Incorrectly
The standard for blood pressure cuff placement is the upper arm using a cuff on bare skin with a stethoscope placed at the elbow fold over the brachial artery.
The patient should be sitting, with the arm supported at mid heart level, legs uncrossed, and not talking. Measurements can be made at other locations such as the wrist, fingers, feet, and calves but will produce varied readings depending on distance from the heart.
The mean pressure, interestingly, varies little between the aorta and peripheral arteries, while the systolic pressure increases and the diastolic decreases in the more distal vessels.
Crossing the legs increases systolic blood pressure by 2 to 8 mm Hg. About 20 percent of the population has differences of more than 10 mmHg pressure between the right and left arms. In cases where significant differences are observed, treatment decisions should be based on the higher of the two pressures.
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Why Can’t I Get A Reading From My Omron Wrist Blood Pressure Monitor With Aps
The most common cause of this situation is due to the user not having the unit at heart level. For an Omron wrist blood pressure monitor with A.P.S. technology, please follow the below instructions.
To turn the unit on and take a measurement, press START/STOP button once. The monitor will start beeping. Holding left elbow and arm against body, elevate cuffed wrist to heart level . The monitor will beep faster as you get closer to the Heart Zone. Four slow beeps will sound when in the correct position.
Please note: cuff will not begin inflating until correct position is reached. This is to ensure that you get an accurate reading.
Hold still until cuff deflates and results are displayed. Press START/STOP to turn off the monitor.
Are The Readings Different Between An Upper Arm Blood Pressure Monitor And A Wrist Blood Pressure Monitor
It is quite possible that your readings may be different from your upper arm to your wrist as blood pressure varies throughout the human body. All Omron blood pressure monitors, whether upper arm or wrist, are validated in the same manner and have the same accuracy specifications. In terms of which type of blood pressure monitor is best for you, we recommend that you discuss this with your doctor, based on your individual needs.
For more information on Omrons line of upper arm and wrist home blood pressure monitors, click below:
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Blood Pressure Cuff Over Clothing
A cuff should never be placed around clothing because your measurement wont be accurate. If youre at home, wear a loose, shirt sleeve shirt. Do the same prior to going to your doctor appointment.
In addition, if you happen to have a long sleeve shirt on, take it off instead of rolling up your sleeve. Often rolling up your sleeve causes the sleeve to tighten up around your arm.
Two reasons why this is incorrect. One, the tight sleeve acts as a tourniquet and can affect blood flow . Two, it frequently results in less room and may cause the cuff placement to be too low.
What Is The Advantage Of Having Wireless Bluetooth Convenience
Wireless Bluetooth Convenience allows you to sync your blood pressure monitor to the free OMRON Connect app where you can store, track and share your heart health information on your smartphone, and even share it with your loved ones or doctor. The app is available for download on a variety of iOSÂ® or AndroidÂ® devices. To learn if your mobile device is compatible, visit OmronHealthcare.com/connect). And if you have AmazonÂ® AlexaÂ®-enabled devices, youll also want to try the Omron Health skill to help manage your heart health. Once connected, simply ask Alexa!
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Accurate Blood Pressure Measurements And The Other Arm
When duty calls, some people are never at home.
The examiner, a nationally prominent cardiologist, began my ordeal with a simple question: What is the blood pressure in both arms of your patient?
The scene was Charity Hospital in New Orleans, where I took my oral examination for board certification in internal medicine 51 years ago. Fortunately, I answered his question easily, because in those days, doctors routinely took their patientsâ blood pressure in both arms and checked the pulses in all 4 extremities at the initial examination. It was a standard of practice.
Some doctors tell me that they donât have time to take their patientsâ BP. Others claim that checking a patientâs BP is elementary and that practically anybody can do it. Still others, especially house officers and young private practitioners, say that questions regarding who took the patientâs BP and how it was taken virtually never came up during their training.
I believe that our current training programs lack sufficient emphasis on basic clinical skills, including emphasis on accurate BP measurements. I also believe that a responsible doctor is never too busy to take a patientâs BP. And measuring the BP accurately is, in fact, vitally important and cannot be done by just anybody. Consider the following.
Failure to compare the BP and pulses in both arms can have serious consequences, as the following case summary illustrates.
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Proper Technique For Blood Pressure Measurement
Is your blood pressure being measured correctly? Accurate blood pressure measurements are essential for diagnosing and treating high blood pressure. A specific set of techniques and procedures have been developed for obtaining the most accurate blood pressure readings possible.
But research has shown that medical professionals often do not completely follow these guidelines. It is important for you as a patient to be able to identify when proper protocol is being followed, or not.
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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 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 to help you manage your blood pressure.
Arm Position And Abpm
In total, 15 subjects participated: 10 were on antihypertensive medications and 5 were untreated while being evaluated following clinic diagnosis of hypertension. They were randomly allocated to usual or horizontal arm position during the first of two monitoring periods. Both monitoring periods were performed on days of similar activity. During the horizontal ABPM period, patients were asked to hold the arm in the horizontal position during each BP measurement when not in bed. They were allowed to rest the arm on nearby furniture or hold it without support. They were not advised on the possible effects of arm position on BP. Successful completion of greater than 90% of BP readings was required for each ABPM period using a spacelabs 90207 oscillometric device , with the cuff on the nondominant arm. Volunteers in both studies were in sinus rhythm, did not have cardiac failure, autonomic neuropathy or a recent history of postural hypotension, and were not taking tricyclic antidepressants or -adrenoceptor blockers.
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Variability Of Blood Pressure
The observer must be aware of the considerable variability that may occur in blood pressure from moment to moment with respiration, emotion, exercise, meals, tobacco, alcohol, temperature, bladder distension, and pain, and that blood pressure is also influenced by age, race, and circadian variation. It is usually at its lowest during sleep. It is not always possible to modify these many factors but we can minimise their effect by taking them into account in reaching a decision as to the relevance or otherwise of a particular blood pressure measurement.
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When Its Time To See A Health Care Provider
If you have a significant blood pressure difference between arms , you should see your health care provider. If they also measure a blood pressure difference of more than 10 points between arms, they may order another test referred to as the ankle-brachial index test to rule out peripheral artery disease.
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Why Does A Blood Pressure Cuff Have An Artery Marker
When the artery marker is lined up with the brachial artery at the elbow, the cuff bladder is centered on the brachial artery 4. This helps to ensure when the cuff is inflated the bladder inside compresses the artery 5.
If it took longer for the artery to get compressed, the cuff would have to keep inflating more than it should. This can result in an inaccurate reading and discomfort on your arm.
How Often Should You Measure Your Blood Pressure
When and how often you take your readings will depend on your blood pressure. Speak to your doctor or nurse about whats suitable for you.
It can be useful to monitor your blood pressure closely to begin with, then less often but at regular intervals.
When you first start using your home monitor
When you first start using a home monitor, measure your blood pressure in the morning and evening, every day for a week.
Take three readings in the morning, one to two minutes apart, and the same again in the evening, and record all the readings. Take an average of the readings, but discard the first one if its much higher than the others. To take an average simply add the two readings together and divide by two. Divide by three if you use all three readings.
Ignore the first days readings altogether, because they might not be accurate as youre not familiar with your monitor yet.
At the end of the week you will have a useful picture of what your blood pressure is normally like.
Your doctor might ask you to keep a record like this when they first think you might have high blood pressure and would like to know more before making a .
After the first week
Once you have a record of your blood pressure over a week, you can take readings less often once every one to two weeks perhaps. Your doctor or nurse can talk to you about this, theres no need to measure it too often.
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