Tag: hypertension

What is the accurate way to measure blood pressure?

After more than hundred years of measuring blood pressure with the use of a stethoscope and sphygmomanometer (yes, that is what your doctor uses in his office to check your blood pressure) you wonder why the question.

An article in the Canadian Medical Association Journal (CMAJ) makes the point that things have changed in the last 20 years as more and more automated blood pressure measuring devices have hit the market. Their reliability and accuracy have increased. You find them in people’s homes, in your local pharmacy and may be in your doctor’s office.

The blood pressure measurement by sphygmomanometer is called auscultatory method because the method uses a stethoscope to listen the pulse. The automated machine measures the blood pressure by oscillometric method; it detects and analyzes pulse waves to determine blood pressure.

Each method is an indirect way to measure the blood pressure. The accuracy and consistency of the measurement and its clinical relevance depends on the skill of the individual taking the pressure and proper functioning of the automated device.

High blood pressure is known to be a silent killer. The CMAJ article says that clinical practice guidelines set uniform standards to take the blood pressure so consistency and accuracy is maintained. This allows the clinician to predict the effect of abnormal blood pressure on the human body. The guidelines are based on the use of auscultation method using a bare arm – “roll up your sleeve so I can take your blood pressure.”

In another article in the CMAJ, the authors challenge the recommendation that blood pressure should be measured on a bare arm. In their study they found that taking a blood pressure reading over the sleeve of a shirt, blouse or light sweater was not statistically different than taking the blood pressure on a person’s bare arm.

The article also challenges the hypertension practice guidelines which require the use of different size blood pressure cuffs for different sized arms – some arms have a bigger circumference than others. The automated devices have cuffs which do not meet the clinical practice guidelines for measuring blood pressure by the traditional way.

The article says the use of automated blood pressure measuring devices in the clinic provides some real benefits. Well-working fully automated devices are:
-free of terminal digit bias,
-deflate at the correct rate,
-operate consistently over time,
– record the results,
-do not require good hearing and
-generally require less training to operate properly.

In spite of all these benefits, the automated device will not provide a correct reading if the patient or the individual is not mentally and physically relaxed. There are various human behaviours – emotional and physical – which affect a person’s blood pressure, albeit temporarily. So the reading taken may not be of much clinical use. Same problem applies when the blood pressure is taken by the traditional way.

So the jury is still out. The article says that in spite of advances in technology the accurate measurement of blood pressure depends on factors related to the patient, the equipment and the method used to take the blood pressure.

Have you had your blood pressure taken recently? If not, then better do so. Don’t forget, high blood pressure is a silent killer. You may not have any symptoms but your blood pressure may be high. See your doctor and roll up your sleeve or may be not.

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The economic boom in Alberta and rest of Canada is probably giving you a headache. But what is it doing to your blood pressure? In the last one year how many times have you checked your bank balance and compare that to when was the last time you had your blood pressure checked?

We know that anxiety does not cause permanent high blood pressure but it can cause dramatic temporary spikes of high blood pressure which can cause damage to our blood vessels and vital organs like heart and kidneys. It can damage the brain and retina. Persistent or recurrent anxiety can make us prone to picking up bad habits like smoking, drinking or eating too much unhealthy food. Combination of these factors can increase our risk of high blood pressure.

The booming economy brings with it a significant amount of stress as well. Most of the time anxiety and stress go hand in hand. To some it may mean one and the same thing. However you look at it anxiety and stress is bad for your blood pressure.

World Health Organization says that hypertension (high blood pressure) causes seven million premature deaths worldwide each year. Hypertension affects 22 percent of Canadians. It is estimated that 25 percent of the 42 million people with high blood pressure in the United States are unaware that they have hypertension. These patients probably have no symptoms. That is dangerous. That is why it is called a silent killer.

The incidence of hypertension increases with age. Most elderly Canadians have high blood pressure – probably due to thickening of blood vessels. No cause is identified in 80 to 95 percent of people with hypertension. This is known as idiopathic or essential hypertension. Others have hypertension due to primary disease of kidneys or due to certain hormonal disorders

We eat too much and we do not exercise enough. Our blood vessels become harder and less compliant with age. When the blood is pumped out of the heart into less compliant blood vessels, the blood pressure goes up. So the heart has to work harder – and eventually it becomes tired, weak and fails. It silently causes damage to our vital organs and eventually results in heart attack, congestive heart failure, stroke, kidney failure and blindness.

Normally, systolic blood pressure should be less than 140 mm Hg (mercury) and diastolic pressure of less than 90 mm Hg. It is written as – systolic over diastolic (for example 120/80 mm Hg). Blood pressure is lowest in the early morning, rises as the day progresses, and then dips down during the night and earliest hours of the morning.

Blood pressure also varies from minute to minute, depending on levels of stress and physical activity. “White-coat hypertension” means a person’s blood pressure is up in the doctor’s office but not elsewhere.

Hypertension can be prevented and treated with lifestyle changes – with or without medication. Eat a healthy diet, lose weight if you are overweight, do not smoke, limit alcohol intake, eat a low salt diet, minimize sugar intake, do regular exercise, relax and learn to manage stress with laughter and meditation.

If your doctor wants you take pills to control your blood pressure then make sure you take it regularly. Research has shown that 50 per cent of the patients with high blood pressure discontinue their antihypertensive medications by the first year. This is no good.

So, when was the last time you had your blood pressure checked?

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Hypertension (high blood pressure) is one of the diseases of mass destruction.

World Health Organization says that hypertension causes 7-million premature deaths worldwide each year.

It is estimated that 25 percent of the 42 million people with high blood pressure in the United States are unaware that they have hypertension.

Hypertension affects 22 percent of Canadians.

If untreated, hypertension is deadly.

Hypertension can damage your heart, brain, kidneys, and retina. You may have high blood pressure but may have no symptoms. It is a silent killer.

For close to 100 years, it is known that hypertension causes premature death. That is why it is important to have blood pressure checked on a regular basis.

Why is hypertension on the rise (pardon the pun!)? Partly because we are eating more and moving less. And we are living longer. Our blood vessels become harder and less compliant with age. When the blood is pumped out of the heart into less compliant blood vessels, the blood pressure goes up. So the heart has to work harder – and eventually it becomes tired, weak and fails.

Normally, systolic blood pressure should be less than 140 mm Hg (mercury) and diastolic pressure of less than 90 mm Hg. It is written as – systolic over diastolic (for example 120/80 mm Hg).

Blood pressure is lowest in the early morning, rises as the day progresses, and then dips down during the night and earliest hours of the morning.

Blood pressure also varies from minute to minute, depending on levels of stress and physical activity.

“White-coat hypertension” means a person’s blood pressure is up in the doctor’s office but not elsewhere.

Hypertension can be prevented and treated with lifestyle changes – with or without medication.

Eat a healthy diet, lose weight if you are overweight, do not smoke, limit alcohol intake, eat a low salt diet, minimize sugar intake, do regular exercise, relax and learn to manage stress with laughter and meditation.

Here is a medical joke to reduce your blood pressure. It was published in Stitches, a humor magazine for doctors.

A motorcycle mechanic was removing the cylinder head from a Harley Davidson’s engine when a well-known heart surgeon came into the shop. The doctor was waiting for the service manager to have a look at his bike.

“Hey Doc, can I ask you a question?” the mechanic called out. The surgeon was bit surprised but walked over to the mechanic.

The mechanic straightened up, wiped his hands and said, “So, Doc, my job is just like yours. Look at this motor, I open it up and take out the valves, fix them or put in new parts, and when I’m done it will run like a new one. So how come I work for almost nothing and you get the really big bucks when you and I are doing basically the same work?”

The surgeon thought for a moment, then smiled, leaned over and said, “Try doing it while the engine is running.”

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

“Hypertension is a growing concern in our society. The increase in the prevalence of this condition is in part related to changes in levels of physical activity and diet and increases in obesity and the average age of the Canadian population,” says an article in the Canadian Medical Association Journal (CMAJ).

Why should we worry about hypertension?

Hypertension (high blood pressure) is a silent killer. One may have high blood pressure but have no symptoms. It silently causes damage to our vital organs and eventually results in heart attack, congestive heart failure, stroke, kidney failure and blindness.

It is estimated that 25 percent of the 42 million people with high blood pressure in the United States are unaware that they have high blood pressure and approximately three fourths of those with known hypertension have blood pressure that exceeds the recommended level! This is dangerous!

What is the normal blood pressure?

Normal blood pressure is defined as systolic blood pressure of less than 140 mm Hg (mercury) and diastolic blood pressure of less than 90 mm Hg. It is written as – systolic over diastolic (for example 120/80 mm Hg).

Blood pressure is lowest in the early morning, rises as the day progresses, then dips down during the night and earliest hours of the morning, says another CMAJ article.

Blood pressure also varies from minute to minute, depending on levels of stress and physical activity, as well as other determinants of cardiovascular activity.

“White-coat hypertension” means a person’s blood pressure is up in the doctor’s office but not elsewhere.

Why do people have hypertension?

Hypertension affects 22 percent of Canadians. The incidence of hypertension increases with age. Most elderly Canadians have high blood pressure – probably due to thickening of blood vessels. No cause is identified in 80 to 95 percent of people with hypertension.
This is known as idiopathic or essential hypertension. Others have hypertension due to primary disease of kidneys or due to certain hormonal disorders.

What can we do to prevent and control hypertension?

Hypertension can be prevented and/or treated with lifestyle changes – with or without medication.

Here are some suggestions: eat a healthy diet, lose weight if you are overweight, do not smoke, limit alcohol intake, eat a low salt diet, do regular exercise – three to five times a week, relax and learn to manage stress with laughter and meditation.

An article in the New England Journal of Medicine states that in general there is poor control of hypertension as 50 per cent of the patients with high blood pressure discontinue their antihypertensive medications by the first year. There are many reasons why this happens. But this is not good. It is dangerous.

Now, here is something for your Thursday morning smile – written by an unknown author:

It’s sad for a girl to reach the age
Where men consider her charmless,
But it’s worse for a man to attain the age
Where the girls consider him harmless.

So, let us be careful about our blood pressure before it makes us charmless, harmless and worthless!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!