Updated 4 March 2021
Blood pressure is the force of blood against artery walls as it is pumped through the body. Blood pressure helps blood get to all parts of the body. Sometimes blood pressure is too strong or too high. This means that the heart is working too hard, or that the arteries are too narrow. A heart that has to work harder than normal for a long time gets larger and weaker and has an even harder time doing a good enough job.
Blood pressure is written as two numbers, such as 112/78 mm Hg. The top (systolic) number is the pressure when the heart beats. The bottom (diastolic) number is the pressure when the heart rests between beats.
Normal blood pressure is below 120/80 mm Hg. If you’re an adult and your systolic pressure is 120 to 129, and your diastolic pressure is less than 80, you have elevated blood pressure. High blood pressure is a systolic pressure of 130 or higher, or a diastolic pressure of 80 or higher, that stays high over time.
Another word for high blood pressure is hypertension. High blood pressure or hypertension increases a person’s risk of heart-related problems, including heart attack and stroke, because of the strain on the heart and arteries.
Among African Americans age 20 and older, almost half have high blood pressure. Compared with whites, blacks develop high blood pressure earlier in life and their average blood pressures are much higher. As many as 30% of all deaths in black men and 20% of deaths in black women are due to uncontrolled high blood pressure.
What Causes High Blood Pressure:
A number of conditions and behaviors contribute to high blood pressure. Sometimes high blood pressure is caused by another medical condition, such as kidney disease or lung disease.
• Salt in the diet – Most Americans consume more salt than their bodies need. Too much salt can increase blood pressure. Your daily intake of salt should not be more than 2300 mg or about 1 teaspoon of salt.
• Being overweight or obese – People who are overweight are more likely to have high blood pressure
• Lack of physical activity – At least 30 minutes of moderate to vigorous physical activity on most days is recommended.
• Heavy alcohol consumption – If you drink alcoholic beverages, drink moderately for men that means a maximum of 2 drinks a day, for women, a maximum of 1.
• Race – more African Americans have high blood pressure because they are less likely to be aware of their high blood pressure and are not being treated for it.
• Age – blood pressure tends to increase with age in most populations, so older people are more likely to have high blood pressure.
• Gender – men have a greater risk of high blood pressure than women until age 55, when the risk becomes similar for men and women. At age 75 and older, women are more likely to develop high blood pressure.
• Smoking – Smoking affects the blood vessels.
• Diabetes and kidney disease – people with these conditions have a higher rate of high blood pressure.
• Heredity – people whose parents have high blood pressure are more likely to develop it than those whose parents don’t.
How is high blood pressure prevented, treated, and controlled?
The good news is that high blood pressure can be prevented and controlled. There are things that can be done to reduce the chances of having high blood pressure and the problems that it can cause.
Treating high blood pressure can reduce the chances of having a heart attack by 27%, stroke by 38%, and heart failure by 55%.
• Use less salt and sodium (about 1 teaspoon daily which equals 2300 mg)
• Aim for a healthy weight
• Eat a low-fat diet that includes fruits and vegetables
• Be active for at least 30 minutes most days
• Limit alcohol (no more than 1 drink each day for women and 2 for men)
• Quit smoking
• Keep blood sugar under control if diabetic
• Take prescription medicine as recommended by a doctor
• Have blood pressure taken as often as doctor advises
Diagnosis of High Blood Pressure
The only way to detect high blood pressure is to measure it using a BP apparatus. There are many kinds of BP apparatus. In this section, we will discuss the use of a Digital blood pressure machine.
A blood pressure measurement gives you two readings (numbers). The upper one, which is higher of the two numbers, is called the systolic blood pressure. The lower number, which is also the smaller of the two numbers, is the diastolic blood pressure.
In a screening programme, an individual with a systolic pressure (upper reading) of 140 mm Hg or more and a diastolic pressure (lower reading) of 90 mm Hg requires referral.
Recording Blood Pressure
• Digital blood pressure instrument.
A digital blood pressure instrument measures blood pressure. It shows the readings on a small screen. It can be used by anyone with a little training. However confirmation of high blood pressure can only be made by a medical doctor.
Important points to keep in mind, ensure the patient is sitting comfortably with back supported, with their feet flat on the floor. The legs should not be crossed.
A. How to apply the cuff
• Ask the individual to remove all clothing that covers the location of cuff placement. When necessary, roll up the sleeves of the subject’s clothing.
• Ensure the hand is relaxed. Place one arm of the participant on the table with the palm facing upward. Always use the same arm for blood pressure readings, as each arm will give you a slightly different reading.
• Make sure the arm cuff is properly deflated (air is out) before placing it around the patient’s upper arm.
• Ensure that the cuff is the correct size for the individual. If required use a smaller or larger cuff.
• Wrap the cuff comfortably or snugly around the upper arm, and tie it up properly with the velcro tape.
• Make sure the whole cuff is above the elbow, about 2cm (or 2 finger breadths) from the elbow.
• Keep the level of the cuff at the same level as the heart during measurement. Make sure that the tubing falls over the front centre of the arm, so that the centre is correctly placed.
B. Recording blood pressure by using the digital blood pressure instrument
• Press the START/STOP button to begin taking blood pressure measurement.
• The BP cuff will start bloating up. This will compress the arm a bit and the patient may complain of pain. Reassure the patient that the pain is temporary.
• The cuff will start to inflate and then slowly deflate so that the machine can take the measurement.
• When the reading is complete, the blood pressure giving systolic and diastolic readings and pulse rate will appear on the screen.
• If the monitor/machine does not record the reading, re-position the cuff and try again after 1-2 minutes and repeat the steps as mentioned above.
• Record the reading either in the machine or in family card of the person.
• It is suggested to take a minimum of 2 readings at interval of 1 minute. The average of those readings should be used to represent the patient’s blood pressure.
• Additional readings should be taken if the difference between the first two is greater than 5 mm Hg, and then the average of these multiple readings is used.
• Press the START/STOP button to turn the machine off.