The very first pressure measuring devices were the “bloody” devices of Stephen Gales, in which a needle was attached to a vessel attached to a tube with a scale. The Italian Riva-Rocci put an end to the bloodshed by proposing to attach a mercury monometer to the cuff placed on the shoulder.
Nikolai Sergeevich Korotkov in 1905 proposed to attach a mercury monometer to the cuff placed on the shoulder and listen to pressure with the ear. Air was pumped out from the cuff of the pear, the vessels were compressed. Then the air slowly returned to the cuff, and the pressure on the vessels weakened. Using a stethoscope on the vessels of the elbow, tones of the pulse were heard. The first strokes indicated the level of systolic blood pressure, the last – diastolic.
Modern monometers are electronic devices that can do without a stethoscope and record the pressure and heart rate.
Pressure and heart rate
By arterial pressure is understood a value that determines the intensity of the effect of blood flowing through the arteries from the inside to the vascular wall. Indications in millimeters of mercury, or mercury, are recorded. The international designation is mm Hg (mmHg).
Blood pressure is not an isolated indicator. Its ratio to the pulse rate is determined. Under normal conditions, when internal regulation is adequately carried out, with an increase in blood pressure, the heart rate decreases. And vice versa – at low pressure, in order to maintain adequate blood supply to all organs and tissues, the heart begins to work more actively, and the heart rate (HR) increases.
If regulatory mechanisms break down, blood pressure pathologically decreases or rises. In the first case, hypo- develops, and in the second, hypertension.
Indicators of blood pressure and pulse allow you to assess the overall health of a person already at the first examination. Their fluctuations, arrhythmia speak of dysfunction of the cardiovascular system, make it possible to assess the severity of disorders, the nutritional level of each cell in the body.
Pulse and pressure are markers of myocardial contractility. It is no coincidence that the difference between the arterial pressure and the arterial pressure is called the pulse pressure (normally it is 30-50 units). It is by the pulse that the first symptoms of cardiovascular problems are recorded. Allowed fluctuations of not more than 15 units, otherwise there is a headache, fainting, anemia develops. This may indicate the presence of a person:
The indicators of pressure and heart rate by age in men and women are presented in the table.
|Men age||Norm GARDEN / DARTERIAL PRESSURE in mmHg Art.||Heart rate|
|From 20 30 up||123/75||51 – 91|
|Until 40||127/78||61 – 91|
|Until 50||130/80||62 – 82|
|Until 60||134/83||64 – 84|
|Until 65||137/84||72 – 91|
|Older than 65||135/89||75 – 90|
|Women age||Norm GARDEN / DARTERIAL PRESSURE in mmHg||Heart rate|
|From 20 30 up||125/75||60 – 70|
|Until 40||128/79||70 – 75|
|Until 50||131/81||74 – 82|
|Until 60||135/82||79 – 83|
|Until 65||137/85||81 – 85|
|Older than 65||135/87||82 – 86|
How to measure blood pressure
Normal blood pressure is a parameter that varies depending on a person’s activity. For example, with physical exertion, emotional stress, blood pressure rises, with a sharp rise can fall. Therefore, to obtain reliable parameters, blood pressure should be measured in the morning without getting out of bed. In this case, the tonometer should be located at the level of the patient’s heart. The arm with the cuff should lie horizontally at the same level.
Such a phenomenon as “white coat hypertension” is known, when the patient, regardless of treatment, stubbornly gives an increase in blood pressure in the presence of a doctor. Also, blood pressure can be slightly increased by running up the stairs or straining the muscles of the legs and hips while measuring. To have a more detailed idea of the level of blood pressure of a given person, the doctor may recommend keeping a diary where the pressure is recorded at different times of the day.
Reasons for high blood pressure
Blood pressure norm is an average indicator, optimal for a healthy person of middle age. In this case, individual deviations from the norm are allowed (from 10 to 20 mmHg), which are not a pathology. It is also taken into account that normal pressure changes throughout the day depending on:
- state of the nervous system;
- overeating or malnutrition;
- drinking alcohol, strong tea and coffee;
- weather changes;
- time of day (in sleep and in the middle of the day, the pressure level is lower, in the morning after waking up and in the evening before bedtime, the indicators increase);
- mode and adequacy of sleep;
- emotional state.
Given the physiological characteristics of the body, it is recommended to measure the pressure in children and adults at approximately the same time of the day so that the result reflects the correct cyclic conditions of the cardiovascular system.
|Age,||Norm for men, mmHg||Norm for women, mmHg||Heart rate, beats. min|
|1 – 10||112/70||100/70||90 – 110|
|10 – 20||118/75||115/75||60 – 90|
|20 – 30||120/76||116/78||60 – 65|
|30 – 40||125/80||124/80||65 – 68|
|40 – 50||140/88||127/82||68 – 72|
|50 – 60||155/90||135/85||72 – 80|
|Older than 70||175/95||155/89||84 – 85|
The norm of pressure in a person varies depending on age. In newborns, the level of blood pressure is the lowest – approximately 70/50 mm Hg. As the child grows, the norm of the indicators of the cardiovascular system grows from 90/60 to 100/70 mm mercury column. In this case, the children’s blood pressure level may also differ from the norm depending on:
- term of birth (in premature babies hypotension is observed);
- activity of the child (in active children, daily fluctuations in pressure are observed at 23-30 mm Hg);
- growth (higher children have higher values);
- gender (in childhood, girls tend to have higher rates than boys).
In adolescence, the following blood pressure indicators are considered normal: upper – from 110 to 136 mm Hg, lower – from 70 to 86 mm Hg, and differences are the result of hormonal changes in the body and an unstable emotional state in the period from 12 to 16 years.
Norms of blood pressure in adults vary depending on individual characteristics from 110/80 to 130/100 mm. Hg. Art. With age, an increase in the norm by 20 units is observed in older people (from 120/80 to 150/90 mmHg). Moreover, the norm in men is slightly higher than in women.
One of the main reasons for the chronic increase in indicators is a thickening and increased stiffness of the vascular walls. The following pathologies are also associated causes of pressure changes with age:
- irregularities in the mechanisms that regulate the heartbeat (for example, a pacemaker, neural network);
- defects in the structure of the heart and blood vessels, both congenital (defect) and acquired (atherosclerosis, vascular thrombosis);
- violation of the structure of the walls of blood vessels (develop with diabetes mellitus, atherosclerosis, gout);
- decreased or increased vascular tone;
- decreased elasticity of the vascular walls;
- violation of hormonal processes (diseases of the adrenal gland, thyroid gland, pituitary gland, etc.).
Arterial hypertension or hypertension is a chronic disease in which daily high blood pressure is observed, regardless of the emotional state. There are two varieties of the disease: primary and secondary hypertension.
Primary hypertension is high blood pressure found in 85-90% of people with circulatory problems. It is believed that the following factors contribute to the development of primary hypertension:
- age (after 40 years, the average parameter increases by 3 mm Hg per year);
- bad habits (smoking and alcohol cause vascular spasms, decreased elasticity of the walls of the arteries and increase the likelihood of a stroke);
- poor nutrition (especially the abuse of coffee, salt, and foods with hydrolyzed fats in the composition);
- obesity (if the body mass index is more than 25, then there is an increased risk of developing primary hypertension);
- reduced physical activity (lack of regular exercise reduces the body’s adaptive ability to physical and emotional stress);
- lack of sleep (the likelihood of developing hypertension increases if you regularly sleep less than 6 hours a day);
- increased emotionality and prolonged negative experiences.
Secondary hypertension occurs in 10-15% of patients and is a consequence of the development of common diseases. The most common causes of increased pressure in secondary hypertension are as follows:
- pathology of the kidneys or renal arteries (chronic glomerulonephritis, renal artery atherosclerosis, fibromuscular dysplasia);
- endocrine diseases (pheochromocytoma, hyperparathyroidism, acromegaly, Cushing’s syndrome, hyperthyroidism, hypothyroidism);
- damage to the spinal cord or brain (encephalitis, trauma, etc.).
In some cases, the cause of secondary hypertension is medications, such as corticosteroids (dexamethosone, prednisone, etc.), antidepressants (moclobemide, nialamide), non-steroidal anti-inflammatory drugs, hormonal contraceptives (when used after 35 years).
Symptoms of high blood pressure may not occur for a long time, gradually worsening the condition of the heart, kidneys, brain, eyes, and blood vessels. Signs of hypertension in advanced stages of the disease:
- noise in ears;
- heart palpitations (tachycardia);
- “Flies” before the eyes;
- numbness of the fingers.
High blood pressure can be complicated by a hypertensive crisis – a life-threatening condition (especially in old age), which is accompanied by a sharp jump in pressure (upper – more than 160), nausea, vomiting, dizziness, excessive sweating and irregular heart function.
Reducing pressure with medications is used at high risk of complications of hypertension, namely:
- at stably high parameters (more than 160/100 mm mercury column);
- with a combination of hypertension (130/85) with diabetes mellitus, renal failure, coronary artery disease;
- with moderate indicators (140/90) in combination with pathological conditions of the excretory, cardiovascular system (high cholesterol, abdominal obesity, increased creatinine in the blood, atherosclerosis, etc.).
To normalize the pressure, several groups of antihypertensive drugs are used that have a different effect on the cardiovascular system, namely:
- diuretics (dicretics);
- calcium channel blockers;
- beta blockers;
- drugs acting on the renin-angiotensin system;
- medications that affect the central nervous system;
- neurotropic drugs.
Drugs for the treatment of hypertension are prescribed depending on the degree of the disease, concomitant pathologies, weight and other indicators, etc.
If the increase in pressure is accompanied by the usual symptoms and poor health, then you can reduce the indicators using these simple methods:
- rest and relax for 15-20 minutes;
- conduct respiratory gymnastics (should be inhaled by 3 counts and exhaled by 6, while during a long exhalation the parasympathetic nervous system relaxes, which leads to a decrease in tension and pressure);
- lower your hands on the elbow bend in cold water for 4-5 minutes; do the same for the legs;
- apply a compress with cold water to the thyroid gland;
- lie on the floor and place a towel roll under the neck area of the neck, then gently turn your head to the right and left for 2 minutes.
For the prevention of increased pressure, it is necessary to normalize weight, eat right, reduce the intake of salt and fatty foods, engage in physical activity for at least 30 minutes a day.
Arterial hypotension (hypotension) is a chronically lowered blood pressure at which the following parameters are observed: for men – below the norm of 100/70, and for women – below 95/60 mm Hg. Distinguish between physiological (natural for the body) and pathological hypotension.
The state of hypotension is considered the norm in people with a genetic predisposition, among residents of the highlands and among representatives of some professions with high physical activity (ballerinas, athletes, etc.).
Hypotension as a chronic disease occurs as a result of pathological processes in the body (the so-called secondary hypotension) or as an independent disease (primary hypotension). The main reasons that lead to chronic hypotension:
- psycho-emotional stress, vulnerability;
- asthenic physique;
- neurocirculatory dystonia of a hypotonic type;
- mitral stenosis;
- Iron-deficiency anemia;
- lack of vitamins of group B.
Symptoms of hypotension are often confused with signs of fatigue, nervous strain and lack of sleep. Reduced reduced pressure is manifested as follows:
- drowsiness, lethargy, lethargy;
- frequent yawning;
- lack of vigor after a night’s sleep.
A tendency to hypotension often occurs in people who are sensitive to changes in atmospheric pressure, as well as prone to fainting.
You can increase the pressure with the help of agents that have a mild stimulating effect on the body. As a rule, alcohol tinctures or tablets from medicinal plants are used:
Medicines based on plants to eliminate hypotension have a tonic effect and strengthen blood vessels. In this case, the possibility of allergic reactions must be considered. The duration of the course of treatment depends on the individual characteristics of the disease.
Medications with which they raise the level of pressure have different effects on the body and are divided into groups:
- preparations with caffeine in the composition;
- CNS stimulants;
- alpha adrenomimetics;
Low blood pressure is associated with a decrease in vascular tone, so people who are prone to hypotension need to exercise regularly, as regular exercise helps maintain the cardiovascular system in good condition.
- Essential arterial hypertension (hypertension, see drugs with high blood pressure) gives persistent increases in pressure and hypertensive crises.
- Symptomatic hypertension (adrenal tumors, renal vascular disease) gives the clinic a similar hypertension.
- Vegetative-vascular dystonia is characterized by episodes of jumps in blood pressure, not exceeding 140 to 90, which are accompanied by autonomic symptoms.
- An isolated increase in lower pressure is inherent in renal pathologies (developmental abnormalities, glomerulonephritis, renal vascular atherosclerosis, or their stenosis). If the diastolic pressure exceeds 105 mmHg. for more than two years, the risk of cerebral catastrophes has increased by 10, and heart attack by five times.
- Systolic blood pressure rises more often in the elderly, people with thyroid pathologies, patients with anemia and heart defects.
- An increase in pulse pressure is a serious risk of heart attack or stroke.
In Russia, it is customary to correlate the numbers Blood pressure with age, and optimal pressure is regarded as the norm only for young and healthy people. This, in fact, is correct, since from birth to old age changes in the vessel wall are inevitable, in addition, somatic diseases join in, blood viscosity changes – all this affects the systolic and diastolic blood pressure indicators, the level of which a person’s well-being depends on.
Upper or systolic blood pressure (SBP) is a marker of the heart, lower or diastolic (DBP) – blood vessels. Since the physiological characteristics of man, his anatomical structure are unique, the pressure of each of us is individual. In his youth, potential self-regulation abilities were preserved, which help to cope with overwork, overstrain, climate change, colds, maintaining pressure at a normal, comfortable level.
Since different people have their own physiological characteristics, fluctuations in blood pressure levels in different people may vary.
The norm of blood pressure by age (table)
|20 years||123 on 76||116 on 72|
|30 years||126 on 79||120 on 75|
|40 years||129 on 81||127 on 80|
|50 years||135 on 83||135 on 84|
|60-65 years||135 on 85||135 on 85|
|Older than 65||135 on 89||135 on 89|
Blood pressure, the norm of which varies slightly with age, is reflected in the table above. Blood pressure is slightly less in women at a young age against a background of less muscle mass. With age (after 60), the risks of vascular catastrophes are compared in men and women, therefore, blood pressure levels are equalized in both sexes.
In healthy pregnant women, blood pressure does not change until the sixth month of pregnancy. Blood pressure is normal in non-pregnant women.
Further, under the influence of hormones, some increases can be observed, not exceeding 10 mm from the norm. In pathological pregnancy, gestosis can occur with jumps in blood pressure, damage to the kidneys and brain (preeclampsia), or even the development of seizures (eclampsia). Pregnancy with arterial hypertension can worsen the course of the disease and provoke hypertensive crises or a persistent increase in blood pressure. In this case, the correction of drug therapy, observation by a therapist or treatment in a hospital is indicated.
Rules for measuring blood pressure
In order to get a reliable picture of a person’s state of health, it is important to correctly measure blood pressure, this is easy:
- for an hour (at least 40 minutes) do not smoke, do not eat anything sharp, fatty, salty, do not drink hard drinks, coffee, tea;
- do not engage in physical labor;
- the pose for measurement should be comfortable, in a sitting position, the hand for tonometry – on a hard surface;
- two measurements are taken, with an interval of several minutes;
- the cuff is placed above the elbow, so that when using a stethoscope, it is convenient.
Pressure measurement at home is carried out by an auscultatory (sound) method using a mechanical, semi-automatic and automatic tonometer:
- The principle of measuring pressure with a mechanical device is to inject air into the compression cuff, after which the appearance and intensity of the sound of the artery is monitored with a stethoscope.
- The semi-automatic tonometer includes a special screen on which digital parameters are displayed, while the compression cuff is manually filled with air.
- The automatic blood pressure monitor does not require additional actions, since air injection and measurement takes place automatically after the device is turned on.
The essence of pressure measurement by the auscultatory method is to register arterial tones, which go through several stages:
- the appearance of tone (sound), which means systolic pressure;
- tone intensification;
- maximum sound amplification;
- sound attenuation;
- the disappearance of arterial tones – the level of diastolic pressure.
The auscultatory method is generally accepted in all medical institutions and is characterized by relatively high accuracy while observing the correct measurement procedure.
General rules for measuring blood pressure at home, which must be followed regardless of the type of tonometer:
- Before the procedure, you can not drink coffee and strong tea, smoke and apply vasoconstrictive drops (eye, nose).
- 5 minutes before the measurement must be at rest.
- The procedure is carried out while sitting, while the back should rest on the back of the chair, and the legs should be free to stand.
- The compression cuff is worn on the forearm at the level of the heart, while the relaxed hand should lie on the table, palm up.
- Re-measurement of pressure is carried out after three minutes to confirm the result. If after the second measurement a difference of more than 5 mmHg is detected, the procedure must be repeated.
Measurement of blood pressure using a compression cuff and tonometer has several disadvantages that can lead to incorrect determination of the result of the procedure, namely:
- use of a mechanical tonometer requires skills;
- displacement of the cuff and phonendoscope on the arm, as well as extraneous noise cause an error;
- clothing squeezing the forearm on top of the cuff affects the performance;
- the placement of the phonendoscope head incorrectly (not at the maximum pulsation spot on the elbow) leads to distortion of the results.
If normal blood pressure is noted, then in this case, measurements are taken at any time of the day. In cases where hypertension or hypotension is observed, it is recommended to monitor blood pressure in the following cases:
- after physical or psycho-emotional stress;
- with deterioration in well-being;
- in the morning after waking up and before bedtime;
- before and after taking drugs that normalize the work of the cardiovascular system.
In the process of treating diseases of the heart, blood vessels and with a tendency to hypo- or hypertension, it is necessary to measure blood circulation parameters daily.
To reliably find out what normal pressure is typical for a particular patient, it is necessary to correctly measure it.
The algorithm for determining blood pressure includes several specific actions in a certain sequence:
- Take a comfortable position so as not to feel discomfort during the procedure. Half an hour before the study, refrain from taking stimulant drugs, tonic drinks, excessive physical activity.
- Prepare a tonometer. On a mechanical apparatus, assess the condition of the pressure gauge and bulb, connecting tubes, cuffs. Open the valve on the supercharger and empty the cuff air cylinder from the air as much as possible by rolling it into the tube. At the electronic device, press the power button, check the operability of the power supply unit (batteries).
- Place the arm on which the measurement will be taken on a flat surface, approximately at the height of the middle of the chest.
- Put on the cuff, locking it in accordance with the instructions for the device. It is necessary to avoid excessively tight or excessively loose overlapping: the index finger should freely fit between the skin and the inner surface of the lining.
- On a mechanical device, place the phonendoscope head on the skin of the elbow bend at the site of the most distinct pulsation of the artery. Close the supercharger valve and inflate the cuff. At the electronic device, press the “Start” button.
- Take a measurement and evaluate the result.
When determining the pressure with a manual device during bleeding the cuff, it is necessary to listen to the resulting Korotkov tones through a phonendoscope. The noise must be correlated with the numbers. Blood pressure on the dial of the pressure gauge. The beginning of the pulsation will correspond to the value of systolic pressure, its end to the value of diastolic.
An electronic device measures, interprets the data and demonstrates the result on its own, without user intervention.
The norm of blood pressure in children
For a child, blood pressure is higher, the greater his age. The level of blood pressure in babies depends on the tone of the vessels, the working conditions of the heart, the presence or absence of malformations, the state of the nervous system. For a newborn, normal pressure is 80 to 50 millimeters of mercury.
What norm of blood pressure corresponds to this or that children’s age, can be seen from the table.
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