Blood Pressure

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Clinical-significance 4 Procedure 5 Additional Terms 6 References

More Specific Terms

• arthrogryposis-renal dysfunction-cholestasis syndrome
• diastolic blood pressure (DBP)
• early morning blood pressure surge (EMBPS)
• systemic arterial pressure (SAP)
• systolic blood pressure (SBP)
• toe blood pressure

Introduction

• The driving force that moves blood through the circulatory system. Systolic blood pressure is the blood pressure when the ventricular muscle contracts. Diastolic blood pressure is blood pressure when the ventricular muscle is relaxed between beats.
  

• Ambulatory blood pressure monitoring reveals a significant circadian variation in blood pressure. An early morning blood pressure surge occurs, that begins before awakening. A small post-prandial decline occurs & a more significant decline in blood pressure occurs during nocturnal sleep. [3]

Clinical-significance

• a single blood pressure reading is inadequate; multiple measurements are needed (2-5) [5]
• systolic blood pressure > 130 mm Hg & diastolic blood pressure > 90 mm Hg are associated with increased long-term early mortality among male adolescents
• clinic-based blood pressure readings unreliable; ambulatory blood pressure monitoring recommended prior to diagnosis of hypertension & prescription of antihypertensive therapy [6]

Procedure

• (measurement of blood pressure)
• blood pressure monitoring should start at age 3 [2]
• bladder should encircle 80% of arm
• lower edge of cuff 2 cm above antecubital fossa
• arm should be supported & at the level of the heart
• inflate cuff 20-30 mm Hg above palpated pressure
• listen for Korotkoff sounds deflating cuff at rate of 2 mm Hg/ sec
• 1st occurrence of repetitive sounds (phase 1) is the systolic blood pressure
• muffling of sounds is phase IV
• disappearance of sounds is phase V
• diastolic blood pressure is phase V
• when Korotkoff sounds are heard all the way to 0 mm Hg, record phase 1, phase IV & phase V, for example: 140/70/0

Additional Terms

• ambulatory blood pressure monitoring (ABPM)
• arterial pressure
• blood pressure cuff
• blood pressure in the very old
• home blood pressure monitoring
• hypertension (HTN, high blood pressure, HBP)
• hypotension
• venous pressure

References

1. Diagnostic History & Physical Examination in Medicine, Chan & Winkle, Current Clinical Strategies, Laguna Hills, CA 1996
2. Prescriber's Letter 9(11):63 2002
3. Hermida RC Ambulatory blood pressure monitoring in the prediction of cardiovascular events and effects of chronotherapy: rationale & design of the MAPEC study. Chronobiol Int 2007, 23:749 PMID: [1]
4. Sundstrom J et al. Association of blood pressure in late adolescence with subsequent mortality: Cohort study of Swedish male conscripts. BMJ 2011 Feb 22; 342:d643. PMID: [2]
5. Powers BJ et al Measuring Blood Pressure for Decision Making and Quality Reporting: Where and How Many Measures? Annals of Internal Medicine: June 20, 2011 154(12):781-788 <PubMed> PMID: [3] <Internet> [4]
   - Appel LJ et al Improving the Measurement of Blood Pressure: Is It Time for Regulated Standards? Annals of Internal Medicine: June 20, 2011 154(12):838-39 <PubMed> PMID: [5] <Internet> [6]
6. Hodgkinson J et al. Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension: Systematic review. BMJ 2011 Jun 24; 342:d3621. PMID: [7]
7. National Guideline Clearinghouse Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. ngc-guideline: [8]
   - Best evidence statement (BESt). Blood pressure measurement in children. Cincinnati Children's Hospital Medical Center ngc-guideline: [9]

blood pressure (BP)