What Is Blood Pressure
Blood pressure is the force of blood pushing on the walls of your arteries. Your BP results are written as 2 numbers. The first, or top, number is called systolic BP. This is the pressure caused by your heart pushing blood out to your body. The second, or bottom, number is called diastolic BP. This is the pressure when your heart relaxes and fills back up with blood. Ask your healthcare provider what your BP should be. For most people, a good BP goal is less than 120/80.
What Causes Low Blood Pressure
Some of the causes of low blood pressure include:
- Getting up after you sit or lie down. This can cause a quick drop in blood pressure called orthostatic hypotension.
- Standing for a long time.
- Not drinking enough fluids .
- Medicines, such as high blood pressure medicine or other heart medicines.
- Health problems such as thyroid disease, severe infection, bleeding in the intestines, or heart problems.
- Trauma, such as major bleeding or severe burns.
How To Check Your Blood Pressure Manually
To manually take your blood pressure, youll need a blood pressure cuff with a squeezable balloon and an aneroid monitor, also known as a sphygmomanometer, and a stethoscope. An aneroid monitor is a number dial. If possible, enlist the help of a friend or family member, because it can be difficult to use this method on your own.
Here are the steps to taking your blood pressure at home:
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Digital Blood Pressure Monitors
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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Home Blood Pressure Monitoring
Blood pressure tests can also be carried out at home using your own digital blood pressure monitor.
This can give a better reflection of your blood pressure, as being tested in somewhere like a GP surgery can make you feel anxious and can affect the result. It can also allow you to monitor your condition more easily in the long term.
You can buy a variety of low-cost monitors so you can test your blood pressure at home or while you’re out and about.
It’s important to make sure you use equipment that has been properly tested. The British Hypertension Society has information about validated blood pressure monitors you can buy.
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How Do I Receive The Responses From The Practice
On some services, such as Ask the Practice a question and Ask the Doctor a question once the Practice has processed your request they will send you a response. This response will be sent to the email address that you have given in the form.
For security purposes the email will ask that you verify your identification. Once you have completed this the message from the surgery will be shown for you to read.
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Manual Blood Pressure Readings
Blood can only be heard through a stethoscope if it is turbulent. As the cuff is inflated, the artery is compressed, making the blood flow through the artery turbulent. When the artery is completely closed, there is no blood flow and no sound. As pressure in the cuff is reduced, the point at which the artery is open just enough to let the blood pass, is the systolic blood pressure.
This is detected by turbulent blood flow heard through the stethoscope. As pressure in the cuff is further reduced, the vessel will once again be completely open and non-turbulent. At this point, no more sound is heard and diastolic blood pressure has been reached.
Ambulatory Blood Pressure Monitoring
In some cases, your doctor may recommend 24-hour or ambulatory blood pressure monitoring .
This is where your blood pressure is tested automatically around every 30 minutes over a 24-hour period using a cuff attached to a portable device worn on your waist.
ABPM can help to give a clear picture of how your blood pressure changes over the course of a day.
You should continue with your normal daily activities during the test, although you must avoid getting the equipment wet.
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How Is Blood Pressure Measured
It’s 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 doesn’t necessarily mean that it’s 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.
Automated Blood Pressure Machines
The easiest and most accurate way to measure the blood pressure at home is to buy an automated blood pressure monitor with an upper arm cuff.
The instructions for use may vary with each machine, and a person should follow them carefully to ensure proper operation. If the instructions are difficult to understand, a local pharmacy or doctors office will be able to show a person how to operate the machine correctly.
Doctors may ask a person to bring their at-home machine to the office during their next visit to test the accuracy compared to the doctors reading.
Using a high-quality machine is important, as inaccurate readings may cause unnecessary or harmful changes in medications or treatments.
A variety of blood pressure monitors are available for purchase online and in most drug stores. A person may wish to speak to a doctor about which brand they recommend.
There are apps and wrist devices that claim to measure the blood pressure, but these results are frequently inaccurate and are not a reliable way to monitor a persons health.
Apps that log blood pressure results may be helpful for people who need to take regular blood pressure tests, however.
Recording a set of readings into these apps may help doctors identify trends in blood pressure and recommend treatments.
Blood pressure readings fall into the following categories:
| Blood pressure status |
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What Is Blood Pressure And How Is It Measured
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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Your Readings Exhibit Prejudice
Prejudice for normal readings significantly contributes to inaccuracies in blood pressure measurement. No doubt, youd be suspicious if a fellow EMT reported blood pressures of 120/80 on three patients in a row. As creatures of habit, human beings expect to hear sounds at certain times and when extraneous interference makes a blood pressure difficult to obtain, there is considerable tendency to hear a normal blood pressure.
Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or more, or diastolic blood pressure decrease of 10 mm Hg or more measured after three minutes of standing quietly.
There are circumstances when BP measurement is simply not possible. For many years, trauma resuscitation guidelines taught that rough estimates of systolic BP could be made by assessing pulses. Presence of a radial pulse was thought to correlate with an SBP of at least 80 mm Hg, a femoral pulse with an SBP of at least 70, and a palpable carotid pulse with an SBP over 60. In recent years, vascular surgery and trauma studies have shown this method to be poorly predictive of actual blood pressure .
Noise is a factor that can also interfere with BP measurement. Many ALS units carry doppler units that measure blood flow with ultrasound waves. Doppler units amplify sound and are useful in high noise environments.
Choosing A Home Blood Pressure Monitor
The American Heart Association recommends an automatic, cuff-style, bicep monitor.
- Wrist and finger monitors are not recommended because they yield less reliable readings.
- Choose a monitor that has been validated. If you are unsure, ask your doctor or pharmacist for advice or find options at validatebp.org.
- When selecting a blood pressure monitor for a senior, pregnant woman or child, make sure it is validated for these conditions.
- Make sure the cuff fits measure around your upper arm and choose a monitor that comes with the correct size cuff.
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Welcome To Our Home Monitoring Resource Hub
Here you can find resources for home monitoring, see our simple steps to get an accurate reading and make the most out of home monitoring.
Plus, read more about .
The first step to managing your blood pressure is to Know Your Numbers! Watch our video to see how to measure your blood pressure at home and use our tips and resources below to check your own blood pressure at home.
How Do I Take My Blood Pressure
Before taking your blood pressure:
- Find a quiet place.
- Roll up the sleeve on your left arm or remove any tight-sleeved clothing, if needed.
- Rest in a chair next to a table for five to 10 minutes.
- 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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Questions To Ask Your Doctor
- Why do I need to monitor my blood pressure at home?
- How often do I need to measure my blood pressure?
- What type of monitor should I use?
- What do my blood pressure readings mean?
- What is considered a normal blood pressure for me?
- What should I do if my readings are abnormal?
- Are there any lifestyle changes I can make to help manage my blood pressure?
- Do I need to take medicine to manage my blood pressure?
- What other things can affect a blood pressure reading?
A Step By Step Guide On How To Take A Blood Pressure Measurement
Step 1
- Introduce yourself and verify patient identity using your clinical setting protocol.
- Obtain consent from the patient for the assessment and explain the procedure.
- Ensure that the patient has not had caffeine or tobacco in the last 30 minutes.
- The patient should be allowed to rest for 5 minutes following activity.
- Prepare the environment by making the room quiet, ensure patient privacy and equipment is intact and clean. Blood pressure is measured indirectly with a stethoscope or doppler and a sphygmomanometer. A sphygmomanometer includes the blood pressure cuff, connection tubes, air pump and manometer.
- Perform hand hygiene.
Step 2
Choose a measurement site:
- The preferred site is the brachial pulse site where the brachial artery runs across the antecubital fossa.
- Another site is the posterior thigh, where the popliteal artery runs behind the knee joint.
- A site should be free from pain, injury, surgical incisions, intravenous cannulas, central venous or arterial lines, areas with poor perfusion, arteriovenous fistulas or AV shunts. This reduces the risk of patient harm and helps to ensure result accuracy.
Step 3
Position the patient either sitting, standing, supine or prone depending on your choice of measurement site.
Step 4
Palpate the artery to determine the systolic BP:
Step 5
Position the stethoscope over the brachial artery and use the bell side.
Step 6
Advise the patient of the result.
Step 11
Clean and return the equipment.
Step 12
Document.
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What Else Do I Need To Know
- Do not take a BP reading in an arm that is injured or has an IV or shunt.
- Take your BP medicines as directed. Do not stop taking your medicines if your BP is at your goal. A BP at your goal means your medicine is working correctly.
- Bring the BP machine to your follow-up visit. Your healthcare provider can check that you are using it correctly.
Common Blood Pressure Measurement Errors:
- Bladder cuff too narrow or wide
- Limb being assessed is unsupported
- Insufficient rest before the assessment
- Repeating the assessment too quickly
- Cuff not wrapped tightly and evenly
- Deflating the cuff to quickly
- Deflating the cuff too slowly
- Failure to use the same site for consistency
- Limb being assessed is measured while above their heart level.
References
- Berman, A et al. 2015, Kozier and Erb’s fundamentals of nursing. Pearson Australia Melbourne, Victoria.
- Estes, MEZ., Calleja, P., Theobald, K. & Harvey, T. 2013, Health assessment and physical examination: Australian & New Zealand ed. Cengage Learning Australia South Melbourne, Victoria.
- Tollefson, J. & Hillman, E. 2018. Clinical Psychomotor Skills. 7th ed. Cengage Learning Australia South Melbourne, Victoria.
- Wake, D. 2017, ‘How to Take Blood Pressure’, Ausmed.
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Measuring Your Blood Pressure