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What is Blood Pressure
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[picture. circulation of blood]
Blood Pressure is pressure of blood vessel when blood is flowing into the blood vessel.
The blood pressure play a circulation of blood role in order to supply oxygen and nutritious in each part of
body so if don¡¯t circulate the blood, the body is functionally disordered.?
The heart send the blood into an artery as contracting and receive the blood that return after circulate whole body as atonying. The systolic(contraction blood pressure) is pressure that receive on a side wall of artery?when the heart contract and the diastolic (atony blood pressure) is pressure that receive on a side wall of artery when the heart atony. It displays Systolic/Diastolic.
National High Blood Pressure Education Program,
National Heart, Lung and Blood Institute, NIH(JNC7)
1) New Classification of BP levels by WHO, 1999 (unit : mmHg)
Category
Systolic B.P.
Diastolic B.P.
Other condition
¡¡Optimal
~119
~79
¡¡satisfied both of Systolic and Diastolic
¡¡Normal
120~129
80~84
¡¨
¡¡High-Normal
130~139
85~89
¡¡satisfied Systolic or Diastolic
¡¡Grade I Hypertension
140~159
90~99
¡¨
¡¡Subgroup: Boderline
140~149
90~94
¡¨
¡¡Grade II Hypertension
160~179
100~109
¡¨
¡¡Grade 3 Hypertension
180~
110~
¡¨
¡¡Isolated Systolic HPN
140~
~89
¡¡satisfied both of Systolic and Diastolic
¡¡Subgroup : Borderline
140~149
~89
¡¡satisfied both of Systolic and Diastolic
* If it is different category of Systolic and Diastolic, should apply higher part.
2) Classification of a joint committee in USA
If classify the blood pressure in priority of cure, regard the Diastolic as important.
Because the systolic is pressure to the blood vessel during a heart cycle
(from pulsation of heart to next pulsation) but in the blood vessel, always pressure over hypotension.
Category
Systolic
BP
Diastolic
BP
Normal
Prehypertension
Stage 1 Hypertension
Stage 2 Hypertension
below 120
121 ~ 139
140 ~ 159
160 ~
below 80
81 ~ 89
90 ~ 99
100 ~
The blood pressure monitor can measured each blood vessel such as inner heart, large artery, middle&small artery, capillary, and vein but the value is different. Usually the blood pressure is a artery pressure of middle size which is closed heart so it is measure an artery of arm after rest 5 minutes. It called casual or clinical blood pressure.
¡Ø It would classify according to age as following
Age
Blood Pressure Standard
16~39
over 140/90mmHg
40~59
over 150/95mmHg
over 60
over 160/100mmHg
The blood pressure is changed several times in a day, and also change according to life schedule like external changing or body condition. According to food, salt, drinking, pain, stress, feeling, or measuring position especially it is changed hardly that contraction blood pressure so it is very important to measure of condition and position.
1) External factor which is effected in Blood Pressure
¨ç exchanging for a day
The blood pressure is different about 10~30mmHg in morning and evening.
morning (low) - lunch time (highest) - afternoon (decline)
- evening (ascend again) bed time (lowest)
Fig : Variation Blood Pressure for a day
¨è Temperature, Humidity
It increase by winter, low temperature, air pressure, and cold bathtub and a gap of systolic is bigger.
After bath in winter, some people increase around 50mmHg and after bath if relax the blood vessel, the blood pressure fall down for a while.
It presents that increase atony air pressure around 15mmHg in cold room (15¡É) compare with warm room (24¡É)
and also it is increased due to get nervous of muscle with poor posture.
¨é Exercise
Blood pressure is increased in hard working or exercise but maintain stability, it is decreased.
¨ê Stress in moral
It cause to increase blood pressure monitor that awakening, stress, especially fear, uneasiness, and anger, etc.
In case of sleeping quietly, blood pressure fall down around 20mmHg.?
¨ë Food
Include caffeine like alcohol, cigarette, and coffee as well as taking salt, it is increased blood pressure monitor.
Right after drink, it can fall down due to atony of blood vessel. During have food, systolic increase but diastolic decrease a little. ?
¨ì Pain
If have pain, the blood pressure increase but keep in the pain, it falls down.
¨í Age
After middle age, blood pressure increase rapidly because fall down the elasticity of blood vessel.
After 60's age, systolic increase rapidly but diastolic decrease a little.
(mmHg)
Age
around 6
elementary
around 20
30~50
50~60
70
BP
80~100
approx.100
~120
increase gradually
unchangability
fall down
¨î Sex
20~40 age : BP of male > BP of female?
50~60 age : BP of female > BP of male
¨ï Talk during measurement, atony air pressure will be increased around 8~15mmHg
¨ð If fasten the cuff too tight or loose, blood pressure is measured highly.
[Picture 1-4 factor of blood pressure variation]
2) Internal factor which is effected in Blood Pressure
changing of blood vessel system, breathing (asthma), thy-roxin, poise of blood,
trouble the internal organ, and fever. blood pressure = 1 time stroke volume x resistance of blood vessel
¨ç resistance of blood vessel
Become thin the diameter of arteriole, resistance of blood vessel is increased then also increase blood pressure.
¨è Hematocele
Even fixed resistance of blood pressure, if lots of blood going out from heart blood pressure is also increase. In case of uneasiness, exercise, and aortic insufficiency
(caused by rheumatism, syphilis, and arteriosclerosis etc, aortic of heart is not closed perfectly.) the systolic increase but diastolic is normal or decreased so pulse pressure is getting high.
¨é
poise of blood (sticky degree)
In order to flow the sticky blood, it needs more length than fine blood so blood pressure increase.
The poise of blood is raised by proportion of ?a red corpuscle, grape sugar in blood or density of cholesterol.
¨ê Elasticity of large artery
If reduce the elasticity of blood vessel, blood pressure is raised. Most old people come under in this case and systolic is raised and diastolic is reduced.
1) Sort of sphygmomanometer
¨ç Mercury sphygmomanometer
The mercury sphygmomanometer is measure blood pressure indirectly.
It injects air by hand through bulb, after press to measuring part then exhaust slowly and perceive the pulse by hand or a stethoscope at the same time.
So it can read to check the bar of mercury It is very simple structure and a few error so it receive recognition as standard sphygmomanometer.
[Picture. Mercury sphygmomanometer]
¨è aneroid sphygmomanometer
It displays pressure from cuff on the a manometer.
It is more convenience than mercury sphygmomanometer but difficult to use the general public it needs to help from other person.
It is necessaries to calibrate periodically for accuracy.
[Picture. Aneroid sphygmomanometer]
¨é Digital sphygmomanometer
Recently digital sphygmonometer is used widely due to convenience and economical efficiency.It can be measured just one button easily without any other help. The result displays with number so read the result easily and even old people can check the result simply.Also blind people can measure with announced device which inform measuring progress and result as voice messages.
Automatic blood pressure monitor for hospital
2) measuring method the mercury & digital sphygmomanometer
The mercury type is measured by Korotkoff sound but the digital type is measured by Oscillometric method.The Oscillometric is measured to perceive a vibration of cuff pressure as contraction and expansion repeatedly in each heartbeat of artery.The mercury sphygmomanometer is possible to change because of individual variation that judge auscultation sound and the automatic sphygmomanometer is decided the blood pressure by pressure size so if operate device correctly, it can get more accuracy and reliable value. But the sound is not united, it is possible to different with mercury sphygmomanometer. In this case, must check the vibration wave of real pressure then we will know which result is correct.
Blood Pressure Monitor for Hospital in Jawon, it measures accuracy blood pressure through clinical test, experience for a long time and advanced technology.
Hypertension is not particular symptoms so it's not always proportionate high blood pressure and symptoms but heavy individual variation. When rise blood pressure and recognize the symptoms such as 'feel heavy in the behind head', 'dizzy', 'bleed at the nose', and 'have a headache and be not seen', in this time can develop a complication already therefore even if doesn't have any symptoms, should measure blood pressure at regular.
If leave the Hypertension for a long time without cure, the blood vessel receive high pressure so the heart ?have to work a lot in order to maintain high pressure. This is a burden on blood vessel and heart so occur cardiac hypertrophy and arteriosclerosis.The arteriosclerosis raise a disease such as acute myocardial infarction, cerebral hemorrhage, cardiac insufficiency, and nephritis so it is important to manage in early stages for prevention and delay.
If measure blood pressure in hospital, it is effective that blood pressure because of strain that have an interview with doctor, and unfamiliar circumstance. In this reason, even if use accuracy device the blood pressure can be higher than real own blood pressure around 20~30mmHg so if can measure correctly, desirable to measure in home. It can get accuracy blood pressure in stable situation of home and provide to a doctor that result of self-blood pressure measurement regularly so it is helpful to cure as well as recognize own changeable blood pressure.
According to NHLBI, an artery injury start from blood pressure 115/75mmHg which consider as normal until now and if increase 20/10mmHg everytime, danger of death is twice by a cardiac disorder. Also blood pressure is increased steadily according to age so if someone have normal blood pressure in 55age, the probability that hypertension is afflicted is around 90%. So as managing the hypertension with downward adjustment, can reduce 35~40% of a stroke, 20~25% of a cardiac disorder and 50% of nephritis also can prevent dementia, awareness disorder, and loss of eyesight.Usually well known the Diastolic so it is divided the Diastolic more details by the hypertension joint committee of USA but they indicate that over 50 years old, the systolic is also important.
1) Attention when measure
<before measuring>
Prohibit caffeine life coffee before 1 hour and cigarette before 15minutes
Environment : stability at least 5 minutes, appropriate indoor temperature
<during measurement>
(clothes)
take a thick coat off and not be tighten the arm
(posture)
sit upright that feet must be reached on the bottom
don't stand with not upright or don¡¯t sit with legs crossed
(cuff)
pay attention not to in cuff the sleeve which roll up
When wind cuff, the hose of cuff should contact with an artery and toward hand and bottom part should be over 2.5Cm (1 inch) from an elbow.
In this time it has space that can into a finger between cuff and arm.
(arm height)
Adjust to same the heart with the center of cuff
(measurement)
-fixed an elbow for not moved arm.
-be comfortable arm without strength
-don't move and speak
-when select pressurization, should set up 30mmHg higher than loosing point of pulse
-if measure again, 1~2 minutes interval and exclude the air in cuff perfectly
2) posture and position of measuring have affect on blood pressure
-Left & Right : it is higher 5~10mmHg that usually used arm if different over 20~30mmHg, should consult a doctor
-thickness of upper arm :according to thick , measured highly
-position of arm : if higher than heart, hypertension is low otherwise lower than heart, hypertension is high
-posture : sitting is principle
-lie down aside : the blood pressure of upper arm is a little lower than lower arm
-in case of injection sap, should measure another arm
3) take notes or consult a doctor the result as following
-smoking before measured
-take caffeine like coffee, drinking, and meal
-take medicine which affect to blood pressure
-medication time & amount
-measured before urination
-pain within 1 hour before measurement
-exercise or not be stable before measurement
-physique in measured, measuring arm (left, right)
Sometimes even measured blood pressure upright, it has different result. In this time worry about health or fault measuring method but following ase can accompany difference result. However if the difference result is continuously without particular reason, should check the device or consult an expert.
1) in case of measuring with difference arm
it is different blood pressure around 5~15mmHg between right and left. When measure for the first time should measure both of arms and realize higher result is own blood pressure so from next time check the higher arm If the difference is over 20~30mmHg, should consult a doctor.
2) posture
Usually sitting posture is higher than lying and standing posture is higher than sitting. If measure with supine position, it is lower 10~15mmHg of systolic and 10mmHg of diastolic than compare with sitting or standing position. Also if measure with lying aside, upper arm blood pressure is a little lower than lower arm.
3) white coat blood pressure
The white coat blood pressure is normal blood pressure in home but it is increased in hospital. it is usually measured higher around 20~39mmHg.
4) variation for a day and year
The blood pressure is changed several times in a day and also different everyday.
During sleep it is lowest but it is highest on 2~3 p.m. then it is decreasing and then it is increased a little in the evening.In summer, the blood pressure is low otherwise in winter, it is high beside if measure in cold room(15¡É) the diastolic is higher about 15mmHg than measured in warm room(24¡É)
5) in case of arterial fibrillation
In old people the arterial fibrillation is most common arrhythmia and it relates with hypertension.An irregular pulse is difficult to measure and especially difficult to analysis by Korotkoff sound.
6) it is different diastolic if check in point 4 or point 5.
In swan point 4 and point 5, it is individual variation. Someone is closed nearly 0 of point 5 so in this case it is different that decide the diastolic as point 4 and point 5.
7) Auscultators gap
An auscultators gap is usually occurred in second level. If miss this sound and decide next sound as systolic then the systolic is measured too low.
8) using not accuracy device
It must use accuracy sphygmomanometer. Aneroid sphygmomanometer is needed to calibrate frequently and also other sphygmomanometers adjust according to regulation.
9) Others
thick of upper arm : measured high getting thicker?position of arm : higher than heart, the systolic measured as low otherwise lower than heart, it measured as high if inject sap in an arm, should measure another arm.
