How is blood pressure measured

Blood pressure: long-term measurement can save lives

Status: 05/15/2018 09:29 a.m. | archive

Many premature deaths could be avoided if people with blood pressure had a 24-hour blood pressure measurement. According to a current study, individual measurements at the doctor's or at home are not sufficient to confirm the diagnosis and to find the best individual therapy. But so far, long-term measurement is not absolutely necessary. For every person with high blood pressure, experts recommend a 24-hour measurement at the beginning and regularly as a check-up.

Blood pressure: symptoms and consequences

High blood pressure does not hurt, does not make you tired and does not otherwise interfere with daily life. Still, he's very dangerous. If the blood constantly rushes through vessels and organs with too much pressure, this damages the vessel walls and can have life-threatening consequences such as cardiac arrhythmias, heart attacks, heart failure, strokes and kidney damage.

Almost every second adult in Germany has high blood pressure, often without realizing it. Because it does not cause any symptoms, high blood pressure (arterial hypertension) develops in secret for a long time. It is therefore important to have your blood pressure checked regularly by your doctor. Anyone suffering from high blood pressure should also check their blood pressure at home.

What the blood pressure readings mean

As a rule, blood pressure is only measured on one arm - even if the treatment guidelines state otherwise.

When measuring blood pressure, two values ​​are always given, for example 120 to 80. The unit is millimeters of mercury (mmHg). The higher value mentioned first is the so-called systolic blood pressure. It is measured while the heart is pushing blood into the arteries. The lower value is diastolic blood pressure as the heart chambers relax and fill.

These blood pressure values ​​are considered normal

The German Hypertension League recommends a blood pressure of less than 140 to 90 mmHg for the vast majority of high blood pressure patients. Lowering the systolic blood pressure to less than 130 mmHg could only be considered if there was a high risk of cardiovascular disease. According to the current European guideline for the treatment of high blood pressure, no drugs should be used at values ​​between 130 and 139 mmHg. In this case, a change in lifestyle is sufficient:

  • Exercise regularly, for half an hour, at least five days a week
  • give up cigarettes
  • Eat a maximum of six grams of salt per day

Measure blood pressure on both arms

Even with routine examinations in the doctor's office, some hypertension remains undetected for a long time because the blood pressure is often only measured on one arm - although the treatment guidelines require measurement on both arms. Ideally, the pressure should even be measured on both arms at the same time in order to compensate for any fluctuations. If you only measure the arm with the lower pressure, you may not notice that your blood pressure is too high.

Measure blood pressure correctly

In the case of side differences in blood pressure, the higher values ​​are generally decisive for diagnosis and therapy of hypertension. Side differences of more than ten mmHg indicate an increased risk of cardiovascular disease. Differences of more than 25 to 30 mmHg indicate vascular calcification or a malformation of the artery under the clavicle. It obstructs the flow of blood into the arm and causes the blood pressure in the arm to drop on the same side. The arm then receives the blood it needs primarily from the vessel that supplies the head - this can result in frequent attacks of dizziness. Doctors speak of a "subclavian steal syndrome".

This can be remedied by widening the constriction with a balloon catheter, in which a tiny stent is inserted. Then the arm is better supplied with blood, the dizziness attacks disappear and the blood pressure can be better controlled and adjusted.

Recognize hidden high blood pressure

High blood pressure that only occurs in certain situations ("masked hypertension") is insidious:

  • Blood pressure rises, for example, during stress, possibly at work, while at home it tends to remain in the normal range. Therefore, this high blood pressure is not detected in routine measurements.
  • When measuring blood pressure in the doctor's office, many people are excited, the measured blood pressure values ​​are often too high. If the doctor uses the values ​​as a basis for therapy, it can happen that he overdoses medication.

Measure blood pressure for 24 hours

A long-term measurement detects the hidden blood pressure. An automatic measuring device measures the current blood pressure over 24 hours under everyday conditions - every 15 minutes during the day and every 30 minutes at night. On the day of the measurement, those affected should not take it easy, but behave as they would in normal everyday life. In this way, the doctor can see when and how the blood pressure changes. He then decides whether and which medication is necessary to keep blood pressure at a good level over the long term.

Treat high blood pressure

If there is indeed hypertension, there are a number of treatment approaches. This includes exercise, a low-salt diet, a wide range of medications or the use of special pacemakers (baroreceptor stimulation). In addition, alternative treatment methods have proven themselves, for example relaxation techniques, regular blood donation and classic bloodletting. The doctor and patient have to try out which measures promise success in individual cases and check them again and again as the process progresses.

Exercise can lower blood pressure

Research shows that regular exercise can lower blood pressure levels by up to 20 mmHg. Endurance sports such as running, cycling and swimming are suitable. However, caution should be exercised in sports such as weightlifting, weight training or climbing: the static load can lead to dangerous blood pressure peaks.

Nocturnal high blood pressure can be dangerous

Sufferers often take many medications at the same time, for example one tablet for the heart, one for drainage, one for blood thinning and one for blood pressure. Usually the medication is taken in the morning. However, current studies show that the effect of antihypertensive drugs depends heavily on the time of day and the body's own rhythm. If the long-term blood pressure measurement over 24 hours shows that the blood pressure is increased at night, targeted treatment is required - for example, by taking the tablets in the evening instead of in the morning. Because high blood pressure at night is particularly dangerous for the heart and blood vessels.

Use measuring devices with a test seal

The German Hypertension League awards seals of approval.

Automatic measuring devices attached to the upper arm or wrist are suitable for monitoring blood pressure at home. Important: If the blood pressure is measured on the wrist, the wrist must be at the level of the heart so that correct values ​​are determined. A valuable help when choosing a blood pressure monitor is the seal of approval of the high pressure league, which is only awarded to devices that provide sufficiently accurate values.

Since the automatic measurement does not work reliably for all people despite the sophisticated technology due to anatomical deviations, a new device should first be brought to the practice. The doctor can then check whether the values ​​measured by him and the device match.

Blood pressure measurement - the most important rules:

  • Relax for five minutes before taking a measurement.

  • The blood pressure cuff must be at heart level. This is especially important with handheld devices.

  • Always sit down and lean against the table, with your arm resting on the table.

  • Do not move or talk while measuring.

  • Measure morning and evening, always at the same time. Measure in the morning before taking antihypertensive drugs so that blood pressure is also recorded in the early hours of the morning.

  • Document the results (if there is no data memory in the device). The doctor can then see whether the previous treatment is optimal or should be changed.

Blood pressure monitors in a practical test

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Visit | 05/15/2018 | 8:15 pm