How To Read Manual Blood Pressure

Learn And Practice Taking Blood Pressure

Learn how to take blood pressure with our illustrated lessons and interactive patient simulations. In this section we provide a review of taking blood pressure techniques assessment guides for adults and children practice drills for the assessment of hypertension in children and a series of case studies on hypertension and hypotension blood pressure.

How To Interpret The Blood Pressure Reading

Here are the blood pressure guidelines published by the American College of Cardiology, last updated in 2017 :

• A normal blood pressure is a systolic pressure of less than 120 mmHg and a diastolic pressure of less than 80 mmHg.
• An elevated blood pressure occurs when the systolic pressure is between 120-129 mmHg, and the diastolic pressure is less than 80 mmHg.
• Hypertension Stage 1 occurs when the systolic pressure is between 130-139 mmHg, or the diastolic pressure is between 80-89 mmHg.
• Hypertension Stage 2 occurs when the systolic pressure is greater or equal to 140, or the diastolic pressure is greater or equal to 90 mmHg.

For a patient to be diagnosed as having hypertension, they need an average reading based on 2 readings or more that are obtained on 2 or more occasions .

References:

What Is A Blood Pressure Measurement

Each time your heart beats, it pumps blood into your arteries. A blood pressure measurement is a test that measures the force in your arteries as your heart pumps. Blood pressure is measured as two numbers:

• Systolic blood pressure measures pressure inside your arteries when the heart beats.
• Diastolic blood pressure measures the pressure inside the artery when the heart rests between beats.

High blood pressure, also known as hypertension, affects tens of millions of adults in the United States. It increases the risk of life-threatening conditions including heart attack and stroke. But high blood pressure rarely causes symptoms. A blood pressure measurement helps diagnose high blood pressure early, so it may be treated before it leads to serious complications.

Other names: blood pressure reading, blood pressure test, blood pressure screening, sphygmomanometry

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How Is Blood Pressure Measured

Its important to measure blood pressure more than once because it fluctuates over the course of the day. It can also change due to things like physical exertion, stress, pain, or extreme heat or cold. But this kind of increase in blood pressure is only temporary and it soon returns to normal.

So, if blood pressure is measured just once and found to be high, it doesnt necessarily mean that its always too high. A blood pressure reading taken at the doctors office can also be misleading: Going to the doctor makes some people so nervous that their blood pressure goes up.

So to get reliable readings, blood pressure is measured on several different days and while you are resting. This means sitting down and relaxing on a chair, and waiting about three minutes before taking a measurement so that your circulatory system comes to rest. The upper arm that is being used for the measurement should rest on a table, at about the same height as the heart, while the reading is being done.

You can measure your blood pressure on your own using a digital blood pressure monitor for automated readings or an instrument called a sphygmomanometer for manual readings.

How Do Blood Pressure Monitors Work

As Livongo expands its services beyond diabetes, its a good time to look at the technology that makes blood pressure monitoring possible.

A proper scientific name for a blood pressure monitoring device is sphygmomanometer, which I personally find hard to pronounce, so for the rest of this post Ill use more common, albeit unscientific name blood pressure monitor or BP monitor for short.

For many decades, physicians used a manually inflated air-bladder cuff and a listening device called stethoscope to listen to arterial wall sounds. This is known as auscultatory method of measuring blood pressure. Using this method required some practice and it was typically performed by trained medical practitioners.

Recent advances in medical technology paved way for inexpensive, easy-to-use, digital BP monitors that anyone could use in the comfort of their homes without specialized knowledge or training.

A digital BP monitor uses an inflatable air-bladder cuff, a battery-powered air pump and a pressure sensor for sensing arterial wall vibrations to measure blood pressure in an artery. This is known as oscillometric method.

There are two types of digital BP monitors: the upper-arm and the wrist models . The upper-arm model has a cuff that is placed on the upper arm and is connected by a tube to the monitor that rests on a surface near the arm. The wrist model is smaller and the entire unit wraps around the wrist. Regardless of the BP monitor type, the measurement method is the same.

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Positioning The Blood Pressure Cuff

1Locate your pulse.XTrustworthy SourceCleveland ClinicEducational website from one of the world’s leading hospitalsGo to source Place your index and middle fingers over the inside center of your inner elbow. When you press lightly you should be able to feel the pulse of your brachial artery from this position.

If you have difficultly locating your pulse, place the head of the stethoscope in the same general area and listen until you can hear your heartbeat.

2Wrap the cuff around your arm. Tuck the cuff end through the metal loop and slide it onto your upper arm. The cuff should be roughly 1 inch above the bend of your elbow and should be evenly tight around your arm.

Make sure that your skin is not pinched by the cuff as you wrap it securely. The cuff should have heavy duty velcro on it, which will hold the cuff closed.

3Check the tightness of the cuff by slipping two fingertips underneath. If you can wiggle the two fingertips under the top edge but cannot wedge your full fingers beneath the cuff, the cuff is tight enough. If you can wedge your full fingers under the cuff then you need to open up the cuff and pull it tighter before closing it again.XTrustworthy SourceMayo ClinicEducational website from one of the world’s leading hospitalsGo to source

Also place the stethoscope earpieces in your ears. The earpieces should face forward and point toward the tip of your nose.

Turn the screw on the pump bulb clockwise to close the airflow valve, if necessary.

Preparing To Check Your Blood Pressure

1Verify that you have the right cuff size.XResearch source A standard size blood pressure cuff purchased from a drugstore will fit around the arm of most adults. However, if you have an especially narrow or wide arm, or if you plan to take the blood pressure of a child, you may need a different size.

Check the size of a cuff before buying it. Look at the “index” line. This is the range line on the cuff that tells you if it fits.XResearch source Once it is on the patient’s arm it will tell you whether or not the circumference of your arm fits within the “range” area of the cuff.

If you do not use the proper cuff size, you may end up with an inaccurate measurement.

2Avoid factors that can increase blood pressure. Certain conditions can cause blood pressure to spike temporarily. In order to get an accurate measurement, you or your patient should avoid these conditions before taking your blood pressure.

Factors that can affect blood pressure include: stress, smoking, exercise, cold temperatures, a full stomach, a full bladder, caffeine, and some medications. XTrustworthy SourceAmerican Heart AssociationLeading nonprofit that funds medical research and public educationGo to source

Blood pressure can change throughout the course of the day. If you need to check the patient’s blood pressure regularly, try to do so at the same approximate time each day.XTrustworthy SourceAmerican Heart AssociationLeading nonprofit that funds medical research and public educationGo to source

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What Affects A Blood Pressure Reading

Many things can affect a blood pressure reading, including:

• Nervousness about having your blood pressure taken. This is called white coat syndrome. As many as 1 in 3 people who have a high blood pressure reading at the doctors office may have normal blood pressure readings outside of it.1
• What you ate, drank, or did before your reading. If you smoked, drank alcohol or caffeine, or exercised within 30 minutes of having your blood pressure measured, your reading might be higher.2
• How you are sitting. Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.2

Its important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke.

A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. A reading that says your blood pressure is higher than it actually is may lead to treatment you dont need.

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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.

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What If I Dont Have Equipment

You dont need a blood pressure cuff to take your resting heart rate, which is another measurement that helps indicate heart health. Digital monitors usually display both blood pressure and heart rate, but you can determine the former on your own by checking your pulse by hand. Your pulse is how many times your heart pumps per minute.

First, locate the artery below the thumb on the inside of your wrist and place two fingers there. Count how many times you feel your heartbeat over a 15-second period, and then multiply your count by four to get your resting heart rate.

When youre checking pulse by hand, youre looking for more than just a number. Youre also checking for a regular rhythm, which indicates a strong pulse.

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How Should I Prepare My Child

Use simple words to explain why the procedure is needed. For example, “We need to check your blood pressure to see if your medicine is working.”

Tell your child what is expected ahead of time, such as, “Your job is to hold still while I measure your blood pressure, so I get a good reading.” This will help make it easier for both of you. Praise your child when you are done.

Have your child wear a loose-sleeved shirt and rest in a sitting position for 3 to 5 minutes before measuring the blood pressure. Rest the arm on a table so that it is supported at heart level. A quiet activity such as reading a book may help your child rest before the procedure. Make sure your child’s legs are uncrossed.

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When To Check Blood Pressure

If youre using a blood pressure monitor on your doctors advice, he or she should tell you when to take readings. As a rule, though, you should take them at the same time of day on each occasion, so youre comparing like with like.

Take a few readings each time, a couple of minutes apart, and calculate the average to make the figures more representative. And if your blood pressure monitor doesnt store your readings for you, jot them down in a notebook to get an idea of long-term trends.

References:

Bupa . High blood pressure. Retrieved from www.bupa.co.uk/health-information/heart-blood-circulation/high-blood-pressure-hypertension

American Heart Association . Monitoring your blood pressure at home. Retrieved from www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/monitoring-your-blood-pressure-at-home

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Apps To Track Your Blood Pressure

Although there are apps that promise to check your blood pressure without using equipment, this isnt an accurate or reliable method.

However, there are apps that can help you track your blood pressure results. This can be helpful in identifying patterns in your blood pressure. Your doctor may use this information to determine if you require blood pressure medications.

Some examples of free apps to monitor blood pressure include:

• Blood Pressure Monitor Family Lite for iOS. With this app, you can enter your blood pressure, weight, and height, as well as track the medications you take.
• Blood Pressure for Android. This app tracks your blood pressure and features several statistical and graphical analysis tools.
• Blood Pressure Companion for iOS and macOS. This app allows you to track your blood pressure as well as view graphs and trends on your blood pressure readings across several days or weeks.

These apps can help you quickly and easily track your blood pressure readings. Measuring your blood pressure regularly on the same arm can help you most accurately track your blood pressure readings.

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Understanding Your Blood Pressure Reading

Blood pressure is measured in millimetres of mercury and is given as 2 figures:

• systolic pressure the pressure when your heart pushes blood out
• diastolic pressure the pressure when your heart rests between beats

For example, if your blood pressure is â140 over 90â or 140/90mmHg, it means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg.

As a general guide:

• normal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
• high blood pressure is considered to be 140/90mmHg or higher
• low blood pressure is considered to be 90/60mmHg or lower

A blood pressure reading between 120/80mmHg and 140/90mmHg could mean youâre at risk of developing high blood pressure if you donât take steps to keep your blood pressure under control.

What Do Blood Pressure Readings Tell You

Blood pressure is measured using two different readings. Heres what they mean:

• Systolic pressure. The first reading is called your systolic pressure. Its the first or top number in a reading. Systolic pressure measures the pressure inside your arteries when your heart is contracting to pump blood.
• Diastolic pressure. The second reading is your diastolic number. Its the second or bottom number. Diastolic pressure measures the pressure inside your arteries when your heart relaxes between beats.

For example, you may see blood pressure written as 117/80 mm Hg . In that case, the systolic pressure is 117 and the diastolic pressure is 80.

Normal blood pressure is considered less than 120/80 mm Hg. This number can vary for many reasons.

Higher numbers in either measurement can be a sign that your heart is working extra hard to pump blood through your arteries. This may be the result of an external trigger, like if youre feeling stressed or scared. When this happens, it can cause your blood vessels to get narrower.

Higher blood pressure measurements could also be caused by an internal force, such as the buildup of plaque or fatty deposits in your arteries. This can also cause your blood vessels to become narrower, which, in turn, can increase your blood pressure.

• before or after you take a certain medication
• at certain times of the day
• when youre stressed or feeling dizzy

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Get The Most Out Of Your Monitor

The AHA recommends the following: Sit quietly while taking your blood pressure. Rest for 5 to 10 minutes beforehand. Keep your legs uncrossed and feet flat. Sit with your back straight. Rest your arm on a table so cuff is at heart level.

Over 40 Years of Proven Accuracy When you see a “Clinically Validated for Accuracy” symbol on an A& D Medical product, it means that the product has been rigorously tested and validated by an independent party to meet global clinical standards and protocols. Plus, all of A& Dâs blood pressure monitors have 510 clearance. See our website to find the clinical validation studies that have been published in medical journals.

It’s Important to Know Your Numbers Your blood pressure can vary throughout the day by as much as 30 to 50mmHg. Things like stress, exercise, and even when you eat, drink or smoke can impact your numbers. That’s why it’s important to consistently take your blood pressure at the same time every day so you know what’s normal for you. Speak to your doctor about what your target range should be and what to do if your readings are outside of that range. Don’t forget to log your measurements! You can use a paper logbook or save them electronically in an app, like the A& D Connect app, where you can enter your measurements manually or automatically with a bluetooth connected device.

How To Tell If Your Blood Pressure Cuff Isnt Calibrated

Aneroid sphygmomanometers are the most commonly used type of blood pressure cuff by healthcare professionals and the general public alike.

They work by using a spring mechanism, gears, and a metal diaphragm to measure the pressure changes against the air bladder in the arm cuff. Thats a lot of moving parts and are prone to get knocked out of calibration or being worn out.

But there is an easy way to check to see if its out of whack looking to see if its zeroed. At the bottom of the dial, the gauge is an oval marking. That represents zero.

When the air bladder is fully deflated, the needle should point directly through the middle of this oval. If its outside of the oval, either higher or lower it means you arent zeroed and are getting incorrect readings.

HOWEVER: While this is a quick way to see if your aneroid blood pressure cuff is off, it isnt 100% percent accurate. Even if the needle is in the oval, it could still be off.

Thats why you need to test your aneroid sphygmomanometer against a reference standard a manometer of known accuracy, usually a mercury sphygmomanometer.

Digital blood pressure cuffs are a bit different in that they have internal diagnostic programs to calibrate themselves. Most models have an alert or alarm to let you know that you need to run the calibration program.

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