On Request from dear readers- All about blood pressure monitoring out need to know

"Blood pressure (BP)" is the resulting force of blood against the arteries. The contractive phase is systole (SIS toh lee), and the relaxation phase is diastole (dye AS toh lee). Blood pressure is recorded in millimeters of mercury (Hg) as a fraction representing the systolic pressure over the diastolic pressure. Optimum blood pressure is a systolic reading less than 120 and a diastolic reading less than 80. This is written as 120/80."

guidelines could be understood briefly as under:

Normal : Under 120 and Under 80
Prehypertension: 120-139 or 80-89
Stage 1 hypertension: 140-159 or 90-99
Stage 2 hypertension: over 160 or over 100

Correct measurement and interpretation of the blood pressure (BP) is essential in the diagnosis and management of hypertension. It is essential that BP machines are properly calibrated, appropriate cuff sizes are selected, and, when BP is measured in an office-based setting, personnel are properly trained and the patient is positioned correctly.

Hypertension can be diagnosed using one of the following three acceptable measurement strategies:

●Ambulatory blood pressure monitoring (ABPM)
●Home blood pressure monitoring
●Office-based blood pressure measurements

Ambulatory blood pressure monitoring (ABPM) is determined using a device (worn by the patient) that takes blood pressure (BP) measurements over a 24- to 48-hour period, usually every 15 to 20 minutes during the daytime and every 30 to 60 minutes during sleep. These blood pressures are recorded on the device, and the average day (diurnal) and night (nocturnal) blood pressures are determined from the data by a computer.
In India usually the instruments are given on rent to the patient to come back after a day to submit the monitoring and coma back later for the report generated to be followed up in OPD.

Home BP monitoring is done through instruments that may be analog (manual) or with semi automatic instruments. the difference is that one uses the stethoscope to listen to the beats and the other does that automatically by inflation of the cuff and then displaying the reading on the monitor.

The proper measurement of office-based BP requires attention to all of the following:

●Time of measurement
●Type of measurement device
●Cuff size
●Patient position
●Cuff placement
●Technique of measurement
●Number of measurements

Some tips on the position:

Patient position — The BP should be taken with the patient in a seated position with the back supported and legs uncrossed. The diastolic pressure (Lower reading ) may be higher by 6 mmHg if the back is unsupported, and the systolic (upper reading) pressure may be raised by 2 to 8 mmHg if the legs are crossed

Supine (lying down) values tend to be slightly different, with the systolic pressure higher by two to three mmHg and the diastolic pressure lower by a similar degree. Supine and standing measurements should always be taken in the elderly and diabetics to detect postural hypotension.

The arm should be supported at the level of the heart. If the arm is allowed to hang down when the patient is sitting or standing, the measured BP will be elevated by 10 to 12 mmHg due to the added hydrostatic pressure induced by gravity. The patient should sit quietly for five minutes before the BP is measured [25]. Bladder distension, talking, and background noise can all affect the measured BP.

we have more data on the myths about the BP and then medications that will come over shortly for each reader. Thanks more  

View all 6 comments Below 6 comments
Great input more  
Thanks for the very good, comprehensive, useful and illustrative information on BP measurement and monitoring and extent of deviations in improper conditions. Many of us really do not know the postures for proper measurement of BP at home and may correct it for future now. Kindly also let us know the extent of higher BP permissible for senior citizens with apparently no heart relative problems and also the extent of lower BP permissible for any age more so again for senior citizens with no apparent heart problems. There are also few cases with both high and low BP on same or on different days. Any reason behind that. Is entire body pain is also related to low or high BP. Request also correlate BP with liver and kidney/brain functioning/problems. more  
thanks for the comments mr walia and mr uppal. Lets keep the fire burning all through the cold weather! more  
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