Blood Pressure Measurement Essay
To learn about external means to measure blood pressure, observe features of venous circulation, and observe the effects of exercise on blood pressure and heart rate and practice using mercury sphygmomanometer and check the BP within 2 minutes. To compare yours resting BP with different apparatus. Methods: All you need to perform a blood pressure measurement is a cuff and a device (stethoscope or microphone) to detect the sound of the pulse in the artery. While the subject is in a sitting posture, have him/her alternate 6 seconds of deep inhalation followed by 6 seconds of deep exhalation, for one minute. Instrument: 1. Sphygmomanometer (A sphygmomanometer consists of an inflatable bag inside a covering called a cuff, an inflating bulb, a manometer from which blood pressure can be read, and a valve that is used for deflation.) 2. Stethoscope 3. Chair 4. Blood Pressure Measurement Essay.Table or other surface to support arm 5. 40℃ Water for foot-bathing and keeping this degree for 3 min. 6. 600ml Water for drinking To observe the effect of the following factors on BP: The First one, we are measured left arm and right arm the blood pressure by the partner. The second one, we are measured the postural BP each a minute when 6 minutes are finished. We are measured three different actions. Blood Pressure Measurement Essay. The zero minute, we are measured the baseline. The first minute, we are measured standing. The second, third, and fourth minutes, we are measured lay. The fifth and sixth minutes, we are measured standing again. The third one, we are measured the different BP test which are drank 600ml water fast, walked 5mins stairs, kept 40℃ water for foot-bathing for 3mins, sat quietly. This four measurement are measured the blood pressure which is the baseline, immediate after action finished, 5 min and 10 min. Results: (Pulse pressure) Postural BP BP Test Discussions: Blood pressure is a measurement of the force applied to the walls of the arteries as the heart pumps blood through the body. The pressure is determined by the force and amount of blood pumped, and the size and flexibility of the arteries. Blood pressure is continually changing depending on activity, temperature, diet, emotional state, posture, physical state, and medication use. Blood pressure differentiates between diastolic blood pressure and systolic blood pressure. Blood pressure is usually measured while you are seated with your arm resting on a table. Your arm should be slightly bent so that it is at the same level as your heart. The upper are should be bare, with your sleeve comfortably rolled up. The normal values which in adults, the ideal top number (systolic pressure) should be less than 120 mmHg. The bottom number (diastolic pressure) should be less than 80mmHg. Diastolic pressure also increases with age but rather less. Repeated measurements are important. A single high measurement does not necessarily mean you have high blood pressure. On the other hand, a single normal measurement does not necessarily mean that you don’t have high blood pressure. Blood pressure readings taken at home can provide important information. Many people become nervous while they’re blood pressure measurement and have higher readings. In experiment2, blood pressure measurements were taken in supine and standing positions for each team member. In order to obtain more accurate results and conclusions, we combined the results from the entire class (60 students).Blood Pressure Measurement Essay. To better understand the results, we calculated the means of all the data for the standing and supine SBP, DBP, MAP, and HR. The experimentally collected mean values for each of these data points are similar to the normal values for a healthy individual and demonstrates a degree of accuracy in the data collected. When the means of the supine and standing are compared, it is apparent that the results of the standing readings are higher than the results from the supine readings. In comparison between the two positions, blood is pumped against gravity while standing. Gravity thus causes a higher blood pressure required to pump the blood to the upper part of the body from the lower extremities. Furthermore, we separated the class by gender, and calculated the mean values for both standing and supine SBP, DBP, MAP, and HR for males and females. We found that collectively, the means found for the females are generally lower than the class mean while the means of the males are generally higher than the class means. The results that were found coincided with the fact that men tend to have higher blood pressure than females. For the standing position, the heart rate values are higher than for supine, as is to be expected. To make these measurements, we employed the auscultatory method using a sphygmomanometer and stethoscope. Through the use of these instruments, we measured the systolic and diastolic pressures by listening for the Korotkoff sounds. Sitting which mean that in a resting individual the left ventricle of the heart pumps typically 5 litres of blood each minute into the aorta and arteries of the body. Downstream, the small arterioles restrict the outflow of blood from the arteries and are therefore known as the main ‘resistance vessels’. The combined effect of the energy generated by the heart and the outflow restriction results in a distending pressure in the arterial system which is referred to as the blood pressure. At rest, each time the heart contracts, it ejects typically 70 ml of blood into the arterial system. This causes a steep increase in arterial pressure, the magnitude of which is dependent both on the volume ejected and on the distensibility of the arteries. Older people have less distensible arteries, which explains why their systolic blood pressure is usually higher than in younger subjects. Because the shape of the arterial pressure pulse is roughly triangular, the mean level of pressure is nearer to the diastolic value. The importance of blood pressure is that it effectively provides a store of energy.Blood Pressure Measurement Essay. Foot-bathing generated by the heart, available to cause blood to flow through the working tissues. It is actually the flow of blood, providing oxygen and nutrients and removing waste products including carbon dioxide, which is really the important factor, but without pressure there would be no flow. Humans, being upright bipedal animals, have a particular problem in supplying blood to all parts of the body. Due just to gravity, pressure in arteries supplying the head is about 100 mm Hg less than that in arteries in the feet. The fact that the brain must have an adequate arterial pressure places a limitation on the range of effective pressures in the upright person. The 5-minute walk which we are immediately measured the blood pressure higher than the baseline. 5 minutes and 10 minutes after, we are measured the blood pressure is lower than the baseline. Exercise, along with an active lifestyle, may decrease blood pressure. During exercise, your systolic blood pressure increases to improve blood flow, thus increasing available oxygen to the working muscles. Your blood vessels may also become more relaxed, or dilated, to allow for the increased blood flow. This may mean a slight lowering of your diastolic blood pressure. Right after exercise, your blood pressure is probably a little bit lower than before you started. This is a very positive response of the body. Regular exercise has been shown to result in a reduction in blood pressure for those who may be hypertensive. While this method of measurement is a useful diagnostic tool for determining blood pressure and the vascular health of an individual, there are various sources of error involved. One of the biggest sources of error is the inexperience of individuals in taking blood pressure readings. It is possible that individuals inaccurately measured results, and this can be attributed to many different factors, including background noise and technique. As a result of the excessive noise in the room, the Korotkoff sounds were difficult to hear. Also, there was only one size of cuff available, and in many cases, it was not the size needed to get an accurate reading on an individual. Cuffs that are either too short or too narrow inaccurately result in lower blood pressure readings. Measurements taken from the same arm less than five minutes apart and an incomplete deflation of the cuff in between these measurements could have had an effect on the results. It should be noted that every person in a group was asked to try and obtain a blood pressure reading, but in many cases, within the groups there was an inconsistency in the technique used. For the heart rate measurements, no explicit instructions were given about the technique to be used. While some individuals took their reading from the carotid artery, others determined their radial pulse. Generally, a measurement from the carotid artery is more precise. Also, having the same person take the measurements would reduce the individual error involved. It would also be better to have each team take measurements in separate rooms so that excess noise from the large number of people would be reduced. Conclusions: Blood pressure, like all biological variables, varies widely in different people and, in the same individual, at different times of the day. Blood pressure is continually changing depending on activity, temperature, diet, emotional state, posture, physical state, and medication use. And then, we do different thing which has measured the different blood pressure. Therefore, if we were measured the high blood pressure, it’s not really had a high blood pressure. It is because it maybe affect by something such as running, walking, hot-drink, smoking.
ORDER A PLAGIARISM-FREE PAPER NOW
In this essay the reasons why we monitor high blood pressure will be discussed. In order to do this it will first be necessary to explain what blood pressure is and what we mean by high blood pressure. The implications of having high blood pressure will be considered followed by how and why it should be monitored. Both the social and economic implications of high blood pressure and it’s monitoring will be assessed.
Blood pressure is the measure of the force the heart uses to pump blood through the arteries. NHS Choices. (21/07/2014). These arteries manage the flow of the blood by controlling its speed and direction. Blood pressure depends two things; how forcefully the heart pumps the blood and how narrow or relaxed the arteries are. Gill. S, Kristensen. SD. (08/02/2011).
High blood pressure is caused when blood is forced through the arteries at an increased pressure. Artery walls have tiny muscles which allow them to become narrower or wider. The narrower the arteries the less space there is for the blood to flow and the harder the heart will have to work. The muscles in the artery wall react to the flow of blood by working harder, which makes them grow bigger. The wall then becomes thicker reducing the space for the blood to flow through. When the heart has to pump harder to push the blood through narrowed arteries the blood pressure rises. If an artery becomes blocked or bursts, the part of the body that the blood was going to will be deprived of energy and oxygen and will be damaged or die. In this instance the pressure of the blood causes the damage. Fullick. A (2008). Blood Pressure Measurement Essay.
Arteries can become damaged in other ways. They can become hardened (atherosclerosis) as a result of fat, cholesterol and other substances building up in the walls of the arteries. Hence life style can be a major contributor in high blood pressure. If an individual is overweight, smokes, eats too much salt, doesn’t exercise enough and, or consumes too much alcohol they will be susceptible to high blood pressure. In addition, if a person has relatives with high blood pressure, has a history of cardiovascular disease, or is of African or Caribbean descent they are more prone to it. Finally, as a person gets older so does their chance of getting high blood pressure, as the blood vessels become stiffer and less flexible. NHS Choices. (04/07/2014).
Having continued high blood pressure (also known as hypertension) increases a persons risk of many serious illnesses, for example; cardiovascular disease, stroke, embolism, aneurysm and kidney disease, to name a few. Approximately one in five people in the UK suffer from hypertension. Gill. S, Kristensen. SD. (08/02/2011). However many of these aren’t aware, as there are not always obvious symptoms. For this reason it is sometimes known as the silent killer. NHS Choices. (04/07/2014). In some instances, with continued levels of very high blood pressure, individuals may display persistent headaches, blurred or double vision, nosebleeds and shortness of breath. The only way to know if a person has a problem with their blood pressure is to get it measured. The NHS recommend that every adult should have their blood pressure checked every 5 years. NHS Choices. (04/07/2014).
The chart opposite shows the different levels of blood pressure and at what point they are considered low, normal and high.Blood Pressure Measurement Essay. This chart is suitable for adults of any age as, although a persons blood pressure might change with age, the levels at which the pressure is considered high, normal or low do not. Blood Pressure Association . (2008).
When taking a person’s blood pressure there are two readings. The top number is the systolic blood pressure. This is the highest pressure when the heart beats and pushes blood around the body. The bottom number is the diastolic blood pressure. This is the lowest pressure when the heart is relaxed between beats. Low blood pressure is anything less than 90/60. Ideal blood pressure is between 90/60 and 120/80. Readings up to 140/90 mean that the blood pressure is a little high and should be reduced slightly but anything over 140/90 is an indication of high blood pressure. Only one of either the systolic or diastolic numbers has to be higher than it should be to indicate that a person has high blood pressure . Blood Pressure Association . (2008). If blood pressure is 120 diastolic or below the risk of cardiovascular disease as a result of blood pressure is minimal but as it rises up to 140 diastolic the risk doubles and then by 160 over it doubles again. For every 20mm diastolic increase the risk of death from cardiovascular disease doubles. Blood Pressure Association. (2008).
Figures published by Public Health England in November 2014 showed that diseases caused by continued high blood pressure cost the NHS over £2bn every year and monitoring accounts for 12% of all GP visits. £850 million could be saved over a period of 10 years if overall blood pressure was reduced. In addition, over the same period of time, if 15% more people were diagnosed, a further £120 million could be saved. Finally, if another 15% currently being treated controlled their blood pressure more effectively, another £120 million could be saved. Blood Pressure Measurement Essay.Public Health England. (2014).
However, the act of measuring blood pressure is problematic. The whole process of going to visit a G.P to have your blood pressure monitored can in itself increase blood pressure. This is commonly known as the white coat effect; where a blood pressure reading is higher when taken in a medical setting than when it’s taken at home. This may be because patients are more nervous in such settings. It is reported that such an increase may occur in as many as 25% of those diagnosed with high blood pressure. This can lead to improper diagnosis of high blood pressure. NHS Choices. (24/08/2011). NICE (National Institute for Health and Care Excellence) reports that this effect is more common in pregnancy and with increasing age. McManus. R et al (2011). Thus other methods of monitoring are being considered more widely. One of these methods is ambulatory blood pressure monitor (ABPM). This is where blood pressure is measured for up to 24 hours. A small digital blood pressure monitor is secured around a patients waist and connected to a cuff at the top of their arm. It is small enough not to affect daily life and can even be used when asleep. It measures the blood pressure at regular intervals over 24 hours, so a doctor is able to get a clear idea of how a patient’s blood pressure changes throughout the day. It avoids the problem of misleading spikes in blood pressure because a patient is feeling anxious about being tested.
Pickering found that 21% of 292 patients with borderline high blood pressure actually had normal daytime readings. These patients were defined as having “white coat” hypertension, and they were more likely to be female, younger and to weigh less. Pickering. TG et al (1988). Staessen undertook a similar study and found that more patients measured by ABPM stopped treatment than those measured in a medical setting.Blood Pressure Measurement Essay. Staessen. JA et al (1997). Therefore the benefits to large portions of society who might be able to stop taking drugs as a result of mis-diagnosis could be quite substantial.
ABPM is, however, expensive. In 2011 NICE released the findings of a study that found that although it was the most accurate method of diagnosing hypertension, it was also the most expensive. However, the savings made as a result of reduced cost of drugs and GP visits meant that it was still the most cost effective means of measuring and confirming diagnosis. McManus. R et al (2011). Staessen also found that drug intervention could be reduced and that blood pressure and overall general health was improved as a result of treatment based on ABPM reading. Staessen. JA et al (1997). Therefore the social and economic benefits of ABPM would appear to be wholly worth the cost.
However, Law, Wald and Morris Law. M, Wald. N, Morris. J. (2003). suggest there are problems with restricting the measurement of blood pressure purely to those with high blood pressure. They argue that although blood pressure is an important cause of stroke and heart disease it is not a good screening test to distinguish who will or will not develop them. They claim that most strokes and coronary heart disease occurs in people who do not have high blood pressure (only 10% of people with the highest blood pressure experience less than one third of all strokes and one fifth of all coronary heart disease events) and that older people with average blood pressure have a substantially greater risk than younger people with high blood pressure.They suggest that the term hypertension intimates that blood pressure is a disease in itself, rather than an indication of more serious problems and that monitoring with a view to reducing high blood pressure ignores those whose blood pressure might be relatively normal or borderline but whom for other reasons may develop stroke or heart disease. Blood Pressure Measurement Essay. They found that lowering blood pressure reduces the risk of heart disease and stroke whatever the starting blood pressure. They suggest that the main method of screening should be to identify all those with a history of stroke or heart attack. They further suggest that there is little point in measuring blood pressure after a first event as subsequent deaths account for about half of all deaths from stroke and heart disease.
Surprisingly, Law, Wald and Morris suggest that changes in diet and lifestyle have only a limited effect in reducing average blood pressure, although they do acknowledge that a major reduction in the salt content of manufactured foods by the food industry would have an impact. They argue that blood pressure lowering drugs are the only way to ensure substantial reductions in blood pressure. As such they suggest that blood pressure reducing drugs should be given to all those identified as susceptible to heart disease or stroke, including those over a certain age, regardless of the level of their blood pressure.
The impartiality of Law, Wald and Morris findings are questionable as they see medication as the only way forward. It is not clear if their research is funded by a pharmaceutical company and care would need to be taken when relying upon their findings. They give no credence to the social benefits of life style changes, for example general well being from a reduced diet or alcohol intake, as well as the benefits brought about from the socialising aspect of exercise. Their recommendations also take no account of the reluctance of otherwise healthy individuals to a lifetime of drug taking. As highlighted by Honigsbaum, Honigsbaum. M.. (2012). who, at the age of 47, living a healthy life style, rejected the notion of having to take pills for the rest of his life. Honigsbaum is an example of those in Law’s study, whose life style did not suggest a problem with high blood pressure but whom had a genetic pre disposition to the condition.
ORDER A PLAGIARISM-FREE PAPER NOW
In conclusion, it would appear that there is consensus of agreement that high blood pressure is a major world health problem and that monitoring is essential.Blood Pressure Measurement Essay. However, there is still a lot to be done in terms of education about lifestyle and adoption of values that underpin this, for example encouragement of healthier lifestyles and for the food industry to take take responsibility for a reduction in salt in manufactured foods. There is further a growing body of agreement that ambulatory blood pressure monitoring is the most effective in terms of diagnosis and as such the higher costs are justified. In addition, questions remain regarding how to identify those with pre existing or inherent predisposition to cardiovascular disease who may not have high blood pressure.
References
Gill. S, Kristensen. SD. (08/02/2011). High blood pressure (hypertension). Available: http://www.netdoctor.co.uk/diseases/facts/hypertension.htm#ixzz3QISs6hUI. Last accessed 30/01/15.
Blood pressure association . (2008). What high blood pressure (hypertension) can do. Available: http://www.bloodpressureuk.org/BloodPressureandyou/Yourbody. Last accessed 30/01/15.
Blood pressure association . (2008). Blood pressure chart. Available: http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Bloodpressurechart. Last accessed 30/01/15.
NHS Choices. (21/07/2014). What is blood pressure?. Available: http://www.nhs.uk/chq/Pages/what-is-blood-pressure.aspx. Last accessed 30/01/15. Blood Pressure Measurement Essay.
NHS Choices. (04/07/2014). High blood pressure (hypertension). Available: http://www.nhs.uk/conditions/Blood-pressure-(high)/Pages/Introduction.aspx. Last accessed 30/01/15.
NHS Choices. (04/07/2014). High blood pressure (hypertension) – Symptoms. Available: http://www.nhs.uk/Conditions/Blood-pressure-(high)/Pages/Symptoms.aspx. Last accessed 30/01/15.
NHS Choices. (24/08/2011). High blood pressure to be tested ‘at home’. Available: http://www.nhs.uk/news/2011/08august/pages/high-blood-pressure-test-home.aspx. Last accessed 30/01/15.
Pickering. TG, James. GD, Boddies. C, Harshfield. GA, Blank. S, Laragh. JH.. (1988). How common is white coat hypertension?. National Institute of Health. 259 (2), 225-8.
McManus. R, Jowett. S, Barton. P, Hodgkinson. J, Mant. J, Martin. U, Heneghan. C, Hobbs. R.. (2011). Cost-effectiveness analysis – blood pressure monitoring for confirming a diagnosis of hypertension. Hypertension. 1 (1), 446.
Staessen. JA, Byttebier. G, Buntinx. F, Celis. H, O’Brien. ET, Fagard. R.. (1997). Antihypertensive treatment based on conventional or ambulatory blood pressure measurement. A randomized controlled trial. Ambulatory Blood Pressure Monitoring and Treatment of Hypertension Investigato. National Institute of Health. 278 (13), 1065-72.
Law. M, Wald. N, Morris. J.. (2003). Lowering blood pressure to prevent myocardial infarction and stroke: a new preventive strategy. Health Technology Assessment NHS R&D HTA Programme. 7 (31), 3.
Honigsbaum. M.. (2012). Home truths about high blood pressure. Available: http://www.theguardian.com/society/2012/jan/08/high-blood-pressure-mark-honigsbaum. Last accessed 30/01/15. Blood Pressure Measurement Essay.