Is Your Blood Pressure Measured Correctly?

Introduction

Blood pressure is one of the important indicators of human health. Blood pressure measurement is the main means to understand blood pressure levels, diagnose hypertension, guide treatment, evaluate antihypertensive efficacy, and observe changes in disease conditions.

At present, there are three main methods of blood pressure measurement: office blood pressure measurement, ambulatory blood pressure monitoring and home blood pressure monitoring. Self-measurement of blood pressure at home can enhance patients' awareness of self-management of blood pressure, standardize treatment, improve control rate, and prevent complications such as myocardial infarction, cerebral hemorrhage, coronary heart disease, and cerebral infarction. Therefore, self-measurement of blood pressure at home is very important. So, how to measure your blood pressure at home? Is your blood pressure measured correctly?

Choice of sphygmomanometer: electronic sphygmomanometer or mercury column sphygmomanometer?

There are three types of commonly used blood pressure monitors: mercury column sphygmomanometer, wrist electronic sphygmomanometer, and upper arm electronic sphygmomanometer.

The advantage of the mercury column sphygmomanometer is that the measured blood pressure value is accurate and stable, but it is troublesome to use and the user must be trained. If the user cannot master the technical essentials well, it will easily cause measurement errors.

Wrist electronic sphygmomanometers are easy to carry and can measure simply and quickly, but they are not suitable for elderly people suffering from blood pressure circulation disorders and vascular diseases. Diseases such as diabetes, hyperlipidemia, and hypertension will accelerate arteriosclerosis, thereby causing peripheral circulation disorders and leading to The measurement results are inaccurate.

The upper arm electronic blood pressure monitor is relatively easy to operate, has good stability and is accurate.

Therefore, it is first recommended to use an upper-arm electronic sphygmomanometer certified by international standards (ESH, BHS or AAMI) for home measurement. The "China Blood Pressure Measurement Guidelines" recommends that home self-measurement of blood pressure use an upper-arm electronic sphygmomanometer certified by international standards. For those who are extremely obese and have thick and short upper arms, when using a thigh cuff is not suitable, you may consider using a certified wrist blood pressure monitor.

How to choose a cuff?

The cuff bladder should cover at least 80% of the upper arm circumference. If the cuff is too small, the blood pressure measurement value will be high; if the cuff is too large, the blood pressure measurement value will be low.

Recommended cuff size

1.Thin adults or teenagers: extra small size (size 12cm*18cm) upper arm circumference 22cm~26cm;

2.Adult small size (size 12cm*22cm) upper arm circumference 27cm~34cm;

3.Adult standard size (size 16cm*30cm) upper arm circumference 35cm~44cm;

4.Adult large size (size 16cm*36cm) upper arm circumference 45cm~52cm;

5.Adult extra large or thigh cuff (size 16cm*42cm).

How to measure correctly?

For newly diagnosed hypertensive patients or patients with unstable blood pressure, it is recommended to measure once every morning (6:00-9:00) and once in the evening (18:00-21:00), and take the average of 2 to 3 measurements each time. ; Continuous self-test for 7 days, and take the average blood pressure in the last 6 days as a reference for evaluating treatment. For individual patients who are unable to complete 7 consecutive days of blood pressure measurement, it is recommended to measure at least 3 consecutive days, and the average blood pressure of the next 2 days will be used as the reference value.

Those whose blood pressure is controlled stably and up to standard can self-test their blood pressure 1 to 2 days a week, once in the morning and once in the evening. It is best to self-measure sitting blood pressure at a fixed time after getting up in the morning, before taking antihypertensive drugs, before breakfast, and after urinating. In the evening, it is recommended to measure blood pressure after dinner, after bathing, and before going to bed after taking medicine.

Left hand or right hand?

When measuring the blood pressure of a patient, the blood pressure should be measured on both sides at the first visit and on the higher side later; or after excluding the influence of other factors (such as an injury to one arm of the patient), for the same individual, one arm should be fixed for outpatient follow-up. Measurement to achieve the purpose of comparison of before and after data. It should be noted that when diseases such as aortic coarctation are suspected, the blood pressure of both arms should be measured. If the difference in blood pressure (systolic blood pressure) between the two arms is >20 mmHg, it is recommended to measure the blood pressure of the limbs.

Sitting or lying position?

Both are acceptable, but you cannot cross your legs. The most commonly used position for blood pressure measurement is sitting or supine, but it should be noted that the blood pressure measured in these two positions is different. It has been reported that diastolic blood pressure measured in the sitting position is 5 mmHg higher than in the supine position, and the systolic blood pressure is not much different. Crossing your legs can increase systolic blood pressure by 2 to 8mmHg. Some patients need to measure their blood pressure in the upright position. Generally, the systolic blood pressure in the supine position is 5 to 8 mmHg higher than that in the upright position, and the diastolic blood pressure is 4 to 6 mmHg higher.

Need to take off your clothes?

Clothes will affect the results of blood pressure measurement. Therefore, the upper arm clothes required for blood pressure measurement should be removed as much as possible or the thickness should be less than 0.5cm. Pay attention to taking off the clothes and not lifting them up. When the clothes are too thick, the blood pressure measured through the clothes will be higher than that of the bare upper arm, while the blood pressure measured after the sleeves are rolled up will be lower than that of the bare upper arm. At the same time, the lower edge of the cuff should be 2 to 3cm above the cubital fossa, and should be tight enough to fit two fingers into it. If the cuff is tied too tightly, the measured blood pressure value will be low; if it is tied too loosely, the measured blood pressure value will be high.

Precautions

1.The blood pressure monitor should be monitored regularly to maintain accuracy;

2.Not all hypertensive patients can use self-measurement for blood pressure monitoring. Self-measurement of blood pressure is not recommended for patients who are depressed or anxious and who modify their treatment plan without authorization. Atrial fibrillation, frequent arrhythmias, and severe atrioventricular conduction tissue will affect the authenticity of blood pressure measurements. Home self-measurement of blood pressure is not recommended for these patients;

3.Repeat three times each time the blood pressure is measured, with an interval of 1 minute, and take the average of the three measurements as the measurement value;

4.Do not modify the treatment plan based on home self-measurement of blood pressure or stop taking antihypertensive drugs on your own.