How to check your blood pressure
Yes!! We now understand what this menace “High Blood Pressure” Is all about. I feel it would be very useful to enlighten everyone on how to detect high blood pressure. What does it entail you might ask? Well the first step in detecting high blood pressure is measuring blood pressure correctly for accurate diagnosis.
A lot goes into measuring blood pressure accurately as the proper working instrument must be used. The instrument used to measure blood pressure is known as a sphygmomanometer. I know the name sounds pretty long and bogus, but you can simply call it the blood pressure gauge. The parts of this instrument would be properly explained for easy understanding.
There are four types of sphygmomanometers namely:
- Manual Sphygmomanometer
- Mercury Sphygmomanometer
- Aneroid Sphygmomanometer
- Digital Sphygmomanometer
Manual Sphygmomanometers: usually makes use of a stethoscope for auscultation (listening for sounds made by the heart) and in some cases palpation (using one’s hands to examine) alone is used to obtain a basic reading although with palpation we can only get the systolic pressure.
Mercury Sphygmomanometer: It usually shows blood pressure by affecting the height of a column of mercury. It is actually considered the gold standard for clinical evaluation of high risk patients including pregnant women.
Aneroid Sphygmomanometer: are mechanical types of Sphygmomanometers with a dial. They are not as accurate as the mercury Sphygmomanometer and may require calibration checks although they are quite safer. They are in common use and are not so expensive.
Digital Sphygmomanometer: are electronic and very easy to use without training. “Is this not great”? There is no need for a trained personnel to operate the digital Sphygmomanometer and it can be used in noisy environments. They use electronic calculations rather than auscultation. They have monitors and a cuff placed around the upper arm. These monitors are also useful in detecting irregular heartbeats.
So How Then Do We Check The Blood Pressure?
Now that we know the various types of Sphygmomanometer it is safe to say that checking the blood pressure depends on the type of instrument being used. As earlier stated the manual Sphygmomanometer makes use of a stethoscope to listen to the sounds made by the heart. The digital thermometer on the other hand does not need so much technical training to using it.
We would therefore be focusing on how to check he blood pressure using the mercury and aneroid Sphygmomanometer. But of course before we go into details about the steps o accurately measuring the blood pressure there are some important things to note in order to avoid getting a false reading.
The length of the bladder should be about 80% of the upper arm circumference as too small or too big cuffs can alter blood pressure readings and give false values.
It is important to be well rested before taking the blood pressure. Also, do not smoke or take alcohol within 20 minutes of a blood pressure measurement.
Finally, when taking blood pressure the patient should sit with his / her back supported elbow should be at about the level of the heart.
Eight Steps to high blood pressure measurement using a mercury / Aneroid Sphygmomanometer
- Place the cuff over the upper arm making sure it covers leaving the cuff’s lower edge about an inch above the bend of the elbow and then wrap the cuffs around the upper arm properly and stick with the ends of the cuff together to close it. It should be not be too tight to prevent false readings.
- The next step is to locate the brachial artery (located halfway between the shoulder and elbow in the middle of the inner arm) then place the bell of the stethoscope over the brachial artery. It is important to note that the stethoscope helps to listen for sounds at various body sites. The two ear pieces on the stethoscope enables the person taking the blood pressure measurement to hear the steady thump in the brachial artery.
- So the digital / aneroid Sphygmomanometer have a screw at the side of the gauge’s rubber bulb. The next step in the measurement is to tighten the screw and then squeeze the bulb so as to allow air into the bulb. As this is done, the cuff expands until the blood flow through the brachial artery stops. The pressure in the cuff increases fast to about 30mm of mercury at this point and no sound can be heard in the stethoscope likewise no pulse is felt in the radial artery (located in the wrist).
- Please note that we cannot leave the cuff expanded for long as we already said that it cuts off blood flow through the brachial artery. We therefore have to turn the screw that was previously tightened and this lessens the air pressure which decreases at the rate of 2mm per second. “Blood flow through the brachial artery has been restored”.
- The first sound heard in the stethoscope as the air pressure decreases is the systolic blood pressure the systolic blood pressure. The number beside the top of the mercury column when this sound is heard should be noted.
- Also, it is important to take note of when the sound ceases and note the number beside the top of the mercury column as this is the diastolic blood pressure.
- At this point the cuff would have decompressed as it can be removed from the arm. It is however important to record the blood pressure reading gotten so as not to forget.
- If the first measurement gotten is above 14 / 90 it is advisable to take another measurement in the same arm after the 60 second and then measure the other arm.
NM: Both the mercury and aneroid sphygmomanometer should be checked periodically as they require a certain level of maintenance. The top of the column should always be at zero before pressure is added. This reminds me, I would like to mention that faulty instruments can alter blood pressure readings therefore it is important to avoid equipment problems and inaccurate blood pressure reading.
The following safety precautions should be adhered to pertaining the stethoscope:
- Check that the earpieces are not plugged and sound can be heard clearly. Any broken earpiece should be replaced.
- The bell of the stethoscope should also be checked to note any cracks and should be subsequently replaced.
- The stethoscope should have s proper tube length of about 22 – 8 inches between the earpieces and the bell as tubing that is too long may reduce sound causing it not to be heard properly.
Pertaining the Sphygmomanometer
- Ensure the mercury column is vertical and that the top of the mercury column is at zero (0) when the blood pressure guage has no air pressure.
- The size of the bladder should not be too narrow or wide so as not to give high or low readings respectively.
Five Step Guide to high blood pressure measurement using the Digital Sphygmomanometer
- Relax while sitting in a stable chair with your back supported.
- Support your hand to be used for measurement on a table top at an even level with your heart.
- Wrap the cuff around your arm, 2cm above your elbow and tighten it by pulling the end of the cuff until the cuff is wrapped evenly and firmly around your arm.
- Take a deep breath before starting and relax for a few minutes, then when ready to proceed, hit the start button.
There would be an inflation of the cuff at first followed by a slow deflation of the cuff which indicates that the digital shypmomanometer is attempting to determine your blood pressure values. Immediately the measurement is completed, readings of your systolic, diastolic blood pressures and your pulse rate will be displayed on the digital pane.
Some people experience high blood pressure only with visit to the doctor’s office. This condition is known as “White Coat Hypertension”. On noticing this, the doctor usually requests that the patient monitors his or her blood pressure at home or may also be asked to wear an ambulatory blood pressure monitor. The ambulatory blood pressure monitor is usually worn for 24 hours and can take blood pressure of 30 minutes.
Finally before we round up on the subject matter for today, the following tips would be very helpful anytime you intend to take your blood pressure reading.
- Go to the bathroom to empty your bowels prior to reading. This is because a full bladder can change your blood pressure reading.
- Wear short sleeves so that your arm would be exposed and there would no difficulties in putting the cuffs over the arm.
- Last but not least it is important and advisable to take two readings at least two minutes apart. The average of the two results can then be taken as the blood pressure readings and of course always make sure the readings are recorded so as to avoid forgetting the numbers or mixing them up.
- Yaay We now know how to successfully take our blood pressure, next we would like to educate you on who exactly is at risk of a high blood pressure and ways to avoid the risk factors. But before we delve into that in the next series, lets take a quick look at symptoms of hypertension.
Symptoms of Hypertension
Hypertension generally is often associated with few or no symptoms hence it is called the “silent killer”. If symptoms occur it is usually as a result of sudden increase in blood pressure. It is often very serious and even considered an emergency. Most times the blood pressure in this emergency cases are usually about 180 / 110 mmHg and above. Rare high blood pressure symptoms include dull headaches, frequent nose bleeds and dizziness.