Keys to Successful Blood Pressure Monitoring

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Keys to successful Blood Pressure monitoring:

*Measure at least THREE TIMES. Usually the first reading is discarded, and the average of the second two readings is recorded.

 Use the correct cuff size to get an accurate reading (see above).

 Use fresh alkaline batteries.

 Measure at the same time every day.

 Preferably no smoking or caffeine in the hour prior to the test.

 Sit in the same chair/position.

 Do not cross legs and keep your feet flat on the floor.

 Relax for 5 minutes before measurement.

 Arm should be at heart level; rest the arm on a table during the procedure.

 Sit still during measurement – no talking, eating or sudden movements.

 Record your measurement in a logbook.

(Adapted from Life Source One Step Blood Pressure Monitor Manual)

 

BLOOD PRESSURE TARGETS

Home SBP values of ≥135 mm Hg or DBP values ≥85 mm Hg should be considered to be increased and associated with an increasedoverall mortality risk. The threshold above which home/self BP values should be considered elevated is 135/85 mmHg. This is supported by prognostic studies showing an increased risk of cardiovascular events above or near this threshold. (Reference: Canadian Hypertension Education Program- CHEP guidelines 2014)

 

WHAT TO DO IF THE PATIENT’S BLOOD PRESSURE READS “HIGH”

If, while monitoring patient’s blood pressure, you get a:

Systolic reading of 180 mm Hg (top number) or higher

OR a diastolic reading of 110 mm HG or higher (lower number)

wait a couple of minutes and take it again. If the reading is still at or above that level, you should seek immediate emergency medical treatment for a hypertensive crisis. If you can’t access the emergency medical services (EMS), have someone drive patient to the hospital right away.

Hypertensive Urgency is a situation where the blood pressure is severely elevated [180 or higher for your systolic pressure (top number) or 110 or higher for your diastolic pressure (bottom number)], but there is no associated organ damage.

Those experiencing hypertensive urgency may or may not experience one or more of these symptoms:

 Severe headache

 Shortness of breath

 Nosebleeds

 Severe anxiety

(Adapted from Canadian Hypertension Education Program- CHEP guidelines 2014)

 

The consequences of uncontrolled blood pressure in this range can be severe and include:

 Stroke

 Loss of consciousness

 Memory loss

 Heart attack

 Damage to the eyes and kidneys

 Loss of kidney function

 Aortic dissection

 Angina (unstable chest pain)

 Pulmonary edema (fluid backup in the lungs)

**Speak to the patient’s doctor about what constitutes as a HIGH reading for the individual patient, as this may vary in terms of when to seek medical emergency, contact the physician, continue monitoring, adjust medications.

 

WHAT TO DO IF THE PATIENT’S BLOOD PRESSURE READS “LOW”

To know if the patient has high or low blood pressure, you need to know what a healthy blood pressure level is. Optimal blood pressure is less than 120/80 mm Hg (systolic pressure is 120 AND diastolic pressure is less than 80). Within certain limits, the lower your blood pressure reading is the better. There is no specific number at which day-to-day blood pressure is considered too low, as long as no symptoms of trouble are present.

 

If the blood pressure stays around 85/55, do they have a health problem?

As long as the patient is not experiencing symptoms of low blood pressure, there is no need for concern. A single lower-than-normal reading is not cause for alarm if the patient is not experiencing any other symptoms or problems. Most doctors consider chronically low blood pressure dangerous only if it causes noticeable signs and symptoms, such as:

 Dizziness or lightheadedness

 Fainting (called syncope)

 Dehydration and unusual thirst-Dehydration can sometimes cause blood pressure to drop. However, dehydration does not automatically signal low blood pressure. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can all lead to dehydration, a potentially serious condition in which your body loses more water than you take in. Even mild dehydration (a loss of as little as 1 percent to 2 percent of body weight), can cause weakness, dizziness and fatigue.

 Lack of concentration

 Blurred vision

 Nausea

 Cold, clammy, pale skin

 Rapid, shallow breathing

 Fatigue

 Depression

As long as no symptoms are present, low blood pressure is not a problem. However, if the blood pressure is normally higher or if they are experiencing any of the symptoms listed above, low pressure may have an underlying cause. Severely low blood pressure can be life threatening and should be evaluated by a physician immediately.

When to see a healthcare professional

If the patient is experiencing any dizziness or light-headedness or any of the symptoms mentioned above, consult with the healthcare provider. If the patient has gotten dehydrated, have low blood sugar or have spent too much time in the sun or a hot tub, it is more important to recognize how QUICKLY and SUDDEN the blood pressure drops than how low it drops. Keep a record of the symptoms and activities at the time your symptoms occurred.

(Adapted from Canadian Hypertension Education Program- CHEP guidelines 2014)