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How Is Blood Pressure Measured

Which Number Is More Important

How to measure blood pressure?

Typically, more attention is given to systolic blood pressure as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term buildup of plaque and an increased incidence of cardiac and vascular disease.

However, either an elevated systolic or an elevated diastolic blood pressure reading may be used to make a diagnosis of high blood pressure. According to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.

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Blood pressure is always measured on a number of different days and when you are at rest. If several of these measurements are too high, you are said to have high blood pressure, even if only one of the two either the systolic or the diastolic one is high. The medical term for high blood pressure is hypertension. In adults, blood pressure is considered to be normal under a systolic value of 140 mmHg and under a diastolic value of 90 mmHg.

When taking your blood pressure for the first time, it makes sense to measure the blood pressure in both arms, because it’s sometimes high on only one side. The values that are higher are always the ones used for assessing blood pressure. After that it is enough to measure the blood pressure only in the arm that produced the higher reading. A person is considered to have high blood pressure if the systolic value is over 140 mmHg, the diastolic value is over 90 mmHg, or if both are higher than these readings.

Table:

Normal and high blood pressure readings

Normal blood pressure systolic under 140 mmHg and diastolic under 90 mmHg
High blood pressure systolic over 140 mmHg and/or diastolic over 90 mmHg

How Do Mercury Sphygmomanometers Work

Mercury sphygmomanometers work in combination with the ears of the clinician to give accurate blood pressure readings.

A cuff is placed around the patients arm . The cuff is inflated with air, applying increasing pressure until the artery collapses.

The clinician, listening with a stethoscope, can hear that the blood flow has halted.

Pressure in the cuff is slowly released, and the clinician can hear the turbulent flow and capture the moment in which the arterial pressure falls below the pressure of the cuff. The reading on the mercury manometer at that moment is the systolic blood pressure.

The clinician continues to listen and release pressure from the cuff. When laminar blood flow resumes, it can no longer be heard, and the reading at that moment is the diastolic blood pressure.

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Before Checking Your Blood Pressure

  • Find a quiet place to check your blood pressure. You will need to listen for your heartbeat.
  • Make sure that you are comfortable and relaxed with a recently emptied bladder .
  • Roll up the sleeve on your arm or remove any tight-sleeved clothing.
  • Rest in a chair next to a table for 5 to 10 minutes. Your arm should rest comfortably at heart level. Sit up straight with your back against the chair, legs uncrossed. Rest your forearm on the table with the palm of your hand facing up.

What Is Blood Pressure And How Is It Measured

Tips to measure your blood pressure correctly

The heart supplies the organs and tissues of the body with blood. With every beat, it pumps blood into the large blood vessels of the circulatory system. As the blood moves around the body, it puts pressure on the walls of the vessels. Blood pressure readings are made up of two values:

  • Systolic blood pressure is the pressure when the heart beats while the heart muscle is contracting and pumping oxygen-rich blood into the blood vessels.
  • Diastolic blood pressure is the pressure on the blood vessels when the heart muscle relaxes. The diastolic pressure is always lower than the systolic pressure.

Blood pressure is measured in units of millimeters of mercury . The readings are always given in pairs, with the upper value first, followed by the lower value.

So someone who has a reading of 132/88 mmHg has a

  • systolic blood pressure of 132 mmHg, and a
  • diastolic blood pressure of 88 mmHg.

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What Is Normal Blood Pressure And When Is Blood Pressure Considered To Be High

Blood pressure is always measured on a number of different days and when you are at rest. If several of these measurements are too high, you are said to have high blood pressure, even if only one of the two either the systolic or the diastolic one is high. The medical term for high blood pressure is hypertension. In adults, blood pressure is considered to be normal under a systolic value of 140 mmHg and under a diastolic value of 90 mmHg.

When taking your blood pressure for the first time, it makes sense to measure the blood pressure in both arms, because it’s sometimes high on only one side. The values that are higher are always the ones used for assessing blood pressure. After that it is enough to measure the blood pressure only in the arm that produced the higher reading. A person is considered to have high blood pressure if the systolic value is over 140 mmHg, the diastolic value is over 90 mmHg, or if both are higher than these readings.

Table: Normal and high blood pressure readings

systolic over 140 mmHg and/or diastolic over 90 mmHg

When And Where To Get Your Blood Pressure Tested

You should have a blood pressure test if you’re worried about your blood pressure at any time.

If you’re over 40, you can have this test done as part of an NHS Health Check, which is offered to adults in England aged 40 to 74 every 5 years.

If you have been diagnosed with high or low blood pressure, or you have a high risk of developing either, you may need more frequent checks of your blood pressure.

You can get your blood pressure tested at a number of places, including:

  • your local GP surgery
  • some workplaces

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If a doctor recommends ambulatory blood pressure monitoring, you will need to wear a blood pressure cuff for 24 hours. It’s connected to a small, portable measuring device that automatically measures your blood pressure at set times and records the readings.

Ambulatory blood pressure monitoring is used, for example, to see whether blood pressure levels vary greatly over the course of the day and night or whether they are constantly elevated. During those 24 hours, you can do all of the usual things you would otherwise do over the course of the day. If you are especially active at certain times, you can make a note in a diary. Then the doctor has a better idea of how to interpret the recorded values when evaluating them.

Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison’s Principles of Internal Medicine. New York: McGraw-Hill 2015.

Pschyrembel. Klinisches Wörterbuch. Berlin: De Gruyter 2017.

Stierle U . Klinikleitfaden Kardiologie. Munich: Urban und Fischer 2017.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Before You Measure Your Blood Pressure

Blood pressure measurement – OSCE guide
  • Avoid things that can raise your blood pressure in the short term. Dont measure your blood pressure within half an hour of eating, smoking, drinking caffeinated drinks such as coffee, or exercising. These can all raise your blood pressure temporarily. If you need to use the toilet, go before you measure your blood pressure.
  • Wear loose-fitting clothes. Wear a short-sleeved t-shirt or something with sleeves you can push up easily, nothing tight. This is so that you can fit the cuff around your arm.
  • Rest for five minutes before you take your reading. Sit down somewhere quiet, ideally at a desk or table. Have your back supported with your arm resting on a firm surface and your feet flat on the floor. Stay in this position while you take your blood pressure.
  • Make sure your arm is supported and at the same level as your heart. Position yourself so that your arm is resting on a surface and is at the same height as your heart. Keep your arm and hand relaxed, not tensed.
  • Make sure you are relaxed and comfortable. If you are anxious or uncomfortable, your blood pressure will rise temporarily.

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How Blood Pressure Is Tested

Blood pressure machines vary, but they’re all a type of measuring device, which often have an arm cuff attached to it.

The cuff is usually wrapped around your upper arm and filled with air until it feels tight. This can feel uncomfortable but it only lasts a few seconds.

It’s important to relax and not talk during this time, because this is when your blood pressure is measured.

If a healthcare professional is doing this for you, they may also use a stethoscope to record your blood pressure.

An automatic device usually picks up the measurements from sensors in the arm cuff, which are sent to a digital display.

You should get the results straight away.

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In Germany and other countries, people with high blood pressure can attend patient education courses that teach a number of things, including how to measure your blood pressure. As part of specialized disease management programs for people who have narrow coronary arteries , statutory health insurers offer additional healthcare services. These include patient education about high blood pressure. Some doctors practices don’t offer these courses, though.

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Systemic Arterial Pressure And Age

Fetal blood pressure

In pregnancy, it is the fetal heart and not the mother’s heart that builds up the fetal blood pressure to drive blood through the fetal circulation. The blood pressure in the fetal aorta is approximately 30 mmHg at 20 weeks of gestation, and increases to approximately 45 mmHg at 40 weeks of gestation.

The average blood pressure for full-term infants:

  • Systolic 6595 mmHg
95140 6090

In children, the normal ranges for blood pressure are lower than for adults and depend on height. Reference blood pressure values have been developed for children in different countries, based on the distribution of blood pressure in children of these countries.

Aging adults

Salt Intake And High Blood Pressure

Blood Pressure Measurement

Reducing the amount of salt you eat can also help to manage or even avoid high blood pressure. To help reduce your salt intake:

  • Ensure your diet consists of wholefoods including vegetables, fruits, wholegrains, lean meat and poultry, fish and seafood, legumes, unsalted nuts and seeds.
  • Avoid packaged and processed foods that are high in salt. You cant see the salt in these foods, so you dont know how much salt you are having. Get into the habit of checking food labels.
  • Choose low-salt food where possible. If you cant find low-salt products, those with moderate amounts of salt are ok too. Another simple alternative is to look for labels with low salt, salt reduced or no added salt.
  • Avoid adding salt to cooking or at the table flavour meals with herbs and spices instead.

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How To Measure Your Blood Pressure At Home Using A Home Monitor

  • Follow the instructions that came with your monitor. Make sure you place the cuff around your arm as described in the instructions.
  • Place the arm cuff just above your elbow. The cuff should be about 2cm above your elbow to make sure it can detect the artery in your arm, just under the skin.
  • Keep still and quietwhile you take your reading. Moving, chewing, talking and laughing can affect your reading. Make sure you don’t cross your legs, as this will raise your reading too.
  • Take two or three readings, each about one to two minutes apart. If your first reading is much higher than the next, ignore it and take an extra reading. Once you have two to three readings, you can work out the average.
  • Keep a record of your measurements. Record all your readings in the memory of your monitor, on your computer or phone or on paper whichever you prefer. Write them down exactly as they appear on screen.
  • Why Do We Still Use Mercury To Measure Blood Pressure

    Of course, we now know that mercury is a highly toxic material, and it is being phased out of medical devices around the world.

    Unfortunately, mercury sphygmomanometers remain the most accurate way to measure blood pressure. They are also incredibly easy to evaluate to see if they need calibration the unused, inactive meter should read 0, and if it doesnt, it needs servicing.

    Other sphygmomanometers are much more complex to evaluate for accuracy and to calibrate. In fact, aneroid sphygmomanometers are calibrated by measuring them against a mercury sphygmomanometer to determine if they are inaccurate.

    Poorly maintained mercury sphygmomanometers may leak and pose health hazards, and studies show that not all of these devices are maintained or serviced as often as they should be.

    But modern mercury devices are much less prone to leaks or damage, and other blood pressure measuring devices to date remain far less accurate.

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    How Can I Measure My Blood Pressure At Home

    Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure monitoring.

    SMBP means you regularly use a personal blood pressure measurement device away from a doctors office or hospitalusually at home. These blood pressure monitors are easy and safe to use. A health care team member can show you how to use one if you need help.

    Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their health care team than if they dont use SMBP.3

    Use these additional tips for SMBP:4

    • Use a blood pressure log pdf icon to record your blood pressure measurements.
    • Take your blood pressure at the same time every day.
    • Take at least two readings, 1 or 2 minutes apart.

    Is There Anything Else I Need To Know About A Blood Pressure Measurement

    How to Measure Blood Pressure

    If you were diagnosed with high blood pressure, your provider may recommend one or more of the following lifestyle changes.

    • Exercise regularly. Staying active can help lower your blood pressure and also help manage your weight. Most adults should aim for 150 minutes of physical activity per week. Check with your provider before beginning an exercise program.
    • Keep a healthy weight. If you are overweight, losing as little as 5 pounds can lower your blood pressure.
    • Eat a healthy diet that includes fruits, vegetable, and whole grains. Limit foods high in saturated fat and total fat.
    • Reduce salt in your diet. Most adults should have less than 1500 mg of salt per day.
    • Limit alcohol use. If you choose to drink, limit yourself to one drink a day if you are a woman two drinks a day if you’re a man.
    • Don’t smoke.

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    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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    Digital blood pressure monitors are often used on the wrist, but they can also be placed on the finger or upper arm and are activated simply by pressing a button. They read the blood pressure automatically based on variations in the volume of blood in the arteries. When taking blood pressure measurements on the wrist, it’s important to keep the hand level with the heart. Otherwise it can affect the readings.

    Digital meters can sometimes be inaccurate and produce unreliable readings anyway especially in people with certain heart rhythm problems or arteries that have hardened due to arteriosclerosis.

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