Blood Pressure

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Hello everyone!

For my first post on Prism Natural Health Center’s blog, I have decided to discuss blood pressure and I cross-posted it here.

First, a little definition of what blood pressure is measuring and what that can mean. Blood pressure is a measurement of the pressure of the blood against the walls of the blood vessels as it is pumped through the body by the heart. When this pressure is too high, it can contribute to significant health issues including strokes, cardiovascular disease, chronic kidney disease, and, if it gets very bad, it can be life threatening. These health issues are why your doctor wants to be very proactive when it comes to reducing blood pressure.

When blood pressure is too low, it can lead to dizziness, which can lead to fainting and falling. In emergency situations, bleeding leads to low blood pressure which can lead to shock or even death, though generally your doctor is not worried about that extreme during an office visit!

Now that we know what blood pressure is, I want to talk about how it should be taken to be as accurate as possible.

For people who fit into the standard sizes of blood pressure cuffs designed for the upper arm, this is the most accurate way to take blood pressure. According to Uptodate, the proper cuff sizes are as follows:

  • Arm circumference 22 to 26 cm (8.5 to 10 inches), “small adult” cuff, 12 x 22 cm (4.7 x 8.5 inches)
  • Arm circumference 27 to 34 cm (10.5 to 13 inches), “adult” cuff, 16 x 30 cm (6 x 12 inches)
  • Arm circumference 35 to 44 cm (13.5 to 17 inches), “large adult” cuff, 16 x 36 cm (6 x 14 inches)
  • Arm circumference 45 to 52 cm (17.5 to 20 inches), “adult thigh” cuff, 16 x 42 cm (6 x 16.5 inches)

Regardless of arm size, it is important to use a cuff that is closes to the size of one’s arm. A cuff that is too big could show falsely low blood pressure and a cuff that is too tight could show falsely elevated blood pressure. It is important for people who have arms that are smaller or larger than normal to request an accurately sized cuff!

Sometimes arm cuffs are not safe or practical, such as after the removal of lymph nodes under the arms, the inflating of the cuff is too painful, or if one’s arm is larger than the available cuff sizes. In these case, it is possible to use a wrist cuff, you may have seen these at the dentist office, or take blood pressure with a smaller cuff on the forearm. The drawback of these two methods of taking blood pressure is that they tend to be inaccurate, usually reading higher.

Whatever method used to take blood pressure, it is important to follow some basic guidelines to get the most accurate reading:

  1. Be sure that you haven’t just run into the doctor’s office. If you are out of breath and anxious, request that they take your blood pressure at the end of the visit instead of the beginning. The beginning  of the visit is often the preferred time to take blood pressure, but it can seem falsely elevated if you are anxious and hurried.
  2. Try not to eat or have caffeine within 30 minutes to an hour before having your blood pressure taken. Also, if you are a heavy smoker, you should mention that to your provider and tell him/her when you last had a cigarette, as that can affect your reading.
  3. Make sure you are sitting upright with your feet comfortably on the floor (or a step) with something to lean your back against. Do not cross your legs or arms and do your best to relax.
  4. Your health care professional should hold your arm at heart level (or rest it on a table that is at heart level). Allowing your arm to fall onto your practitioner’s arm or the table will create the relaxation you are looking to achieve.
  5. Do not talk, nor should your health care professional talk. It will not take much time!
  6. Above all, RELAX! Many of us get anxious at the doctor’s office. If you do, be sure to tell your doctor. Try to remember that most health care practitioners have your best interest at heart!

If you have a home blood pressure cuff, make sure that it is calibrated regularly. Also, make sure that you follow the guidelines above as well when you take your own blood pressure. Taking it at the same time every day to get a consistent reading.

Treating high blood pressure can be done with medication, exercise, healthful changes in diet, and even herbs.

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Posted on September 11, 2013, in Uncategorized and tagged , , . Bookmark the permalink. 2 Comments.

  1. Do you have suggestions for how to talk with a health care professional whose procedure for taking BP is less than optimal? I learned these rules a long time ago when I was getting “high” readings at the doctor’s office then acting over-medicated when I got home. Finally someone clued me in that (1) the right size cuff is important, (2) dashing in, out of breath, and perching on a table are not ideal for an accurate reading, and (3) chatting messes up the reading, too. I often go to the doc’s office and am told to sit on the table (no back support) while the nurse insists that the too-small cuff is the right size and then proceeds to chat me up while she takes the reading. I don’t like confrontation, but this is really annoying, since if the reading is going to be wrong, why bother? But I can’t come up with the right words for raising the issue. I don’t want to seem like some know-it-all who has been reading the Internet and thinks it is the equivalent of a medical degree… but… Help?

  2. Of course the things that you can control, like caffeine, smoking, and eating are easy. The other things are things that you can just request.

    If you are feeling rushed and they want to take your BP first, request that they let you relax a bit because you just rushed in and you know it will show a higher reading than normal.

    If there is a chair in the room and is accessible to the cuff, request to sit in it if at all possible (I know I have worked in clinics where this is not the case, in which case everyone does their best). If they are using an automated BP unit, it may move around, which would be ideal.

    If they do not have the right cuff, well, that is a hard one. I would be tempted to point out that it is pointless to have the reading done in the first place because it will not be accurate, therefore, any diagnosis or treatment could be inappropriate as well. The cuffs have markers on them to show the appropriate sized arm. If need be, take a measuring tape in with you to make your case. This may lead to minor confrontation, but it is really worth it in the end. I know I have done some unofficial experiments with patients and friends and cuff size can make a big difference.

    If the doctor you go to does not have multiple sizes of cuffs, you might consider moving your care to another physician, if that is possible.
    As for the talking, you might say,”I understand that either of us chatting during the reading can make a difference in my blood pressure and I would prefer that we be quite while we are doing this. Thank you.”

    Unfortunately, we often have to take control of our own care, which can be very difficult. However, it is worth it in the end to receive quality care and appropriate treatment! Most health care professionals are doing their best, but sometimes individuals get lost in the shuffle. It may help to have someone with you as well to give you some moral support, maybe someone who is more comfortable with confrontation.

    Certainly being aggressive likely won’t help, but being firm and knowing that you are caring for yourself can make you much more brave! I hope this helped some.

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