Blood Pressure Check
Blood pressure is the pressure created when blood is forced out of the heart and comes into contact with the walls of the arteries which transport blood around the body. The pressure of blood flowing in the arteries changes according to the different phases of the heartbeat cycle. The pressure in the arteries will be at its highest when the heart is ‘contracting’ and pumping blood out, and at its lowest as the heart relaxes before it pumps again.
Blood pressure is recorded as two numbers: the systolic pressure (as the heart beats) and the diastolic (as the heart relaxes between beats). The numbers are written one above or before the other, the systolic number on top and the diastolic on the bottom.
Your target blood pressure depends on your age and your medical conditions. For most people the targets are <140/90 (if under 80 years old) or <150/90 (if 80 years or older). If you have any coronary heart disease such as angina or have had a heart attack or stroke, or have diabetes or kidney disease, it is better for your target blood pressure to be less than 130/80. These targets are lower if being checked at home – see below – Home blood pressure monitoring.
High blood pressure – hypertension – means that your blood pressure is constantly higher than the recommended target blood pressure. Over time if this is not treated, you become more at risk of heart disease or having a stroke. You may be asked to come to see a nurse for a blood pressure check and if it is found to be above the recommended target, you may also be asked to have a number of tests – blood tests, an electrocardiogram (ECG), a painless procedure which records the electrical activity of the heart, ambulatory blood pressure (ABP) which records your blood pressure over a 12 hour period during the day – to help your doctor decide if treatment is necessary.
Home Blood Pressure Monitoring
Surgery blood pressure measurements do not always give a true picture of what your blood pressure is doing over your normal day. Some people are found to have a higher blood pressure when at the surgery or when they are not relaxed.
It is now recommended that a better way to check your blood pressure is to measure it yourself three times each morning and evening for five days, when you are at home, relaxed and comfortable. Record the lowest reading each time so you have 10 readings by the end. This will then give us an idea as to what your blood pressure really is, and whether the measurements we take in the surgery are similar to those you record at home.
Simple steps to an accurate reading
- Many things can make your blood pressure rise for a short time. Make sure you do not need to use the toilet, and that you have not just eaten a big meal. Do not measure your blood pressure within 30 minutes of drinking caffeine or smoking.
- Wear loose-fitting clothes like a short-sleeved t-shirt so that you can push your sleeve up comfortably.
- Always use the same arm for blood pressure readings, as each arm will give you a slightly different reading. If one arm has a higher BP (ie systolic/highest number) then use that arm for all recordings.
- Before you take your readings, rest for five minutes. You should be sitting down in a quiet place, preferably at a desk or table, with your arm resting on a firm surface and your feet flat on the floor.
- Make sure your arm is supported and that the cuff around your arm is at the same level as your heart. You may need to support your arm with a cushion to be sure it is at the correct height. Your arm should be relaxed, not tensed.
How to take your blood pressure using a home blood pressure monitor
- Put the cuff on following the instructions that came with your monitor.
- Make sure you are relaxed and comfortable. If you are anxious or uncomfortable, this will make your blood pressure rise temporarily.
- When you are taking your reading, keep still and silent. Moving and talking can affect your reading.
- Take three readings, each about two minutes apart, in the morning and evening. Record the lowest of the 3 readings. Some people find that their first reading is much higher than the next readings. If this is true for you, keep taking readings until they level out and stop falling, then use this as your reading.
- Continue BP recordings for 5 consecutive days.
- The average of the above readings should be calculated (ignoring the first day) and the data (raw data and average BP) along with the BP monitor (if loaned from the practice) should be handed back to reception for review.
Tips on taking blood pressure readings
- Do not round your measurements up or down – if you don’t keep accurate records of your blood pressure it may affect the treatment you receive.
- Do not be alarmed if you get an unexpected high reading – a one-off reading may be nothing to worry about. Measure your blood pressure again at another time, but if you find that it continues to be high after a period of time, see your doctor or nurse.
- Do not check your blood pressure too often – you may become worried or stressed about small changes in your reading. This can raise your blood pressure in the short-term. Worrying about your blood-pressure reading may actually make it higher.
If you have your own blood pressure monitor, you may be asked to record a series of readings over a week to be averaged and recorded in your notes. If you do not have your own machine, you may be loaned a machine from the surgery which a nurse will demonstrate how to use. (Please check with reception regarding the availability of blood pressure monitoring equipment).
Blood pressure targets for home readings are 5mmg Hg lower than readings taken at the practice. For example for those with heart disease the home blood pressure target is 125/75.
Stopping smoking is one of the best things you can do for your overall health and your blood pressure.