HIGH BLOOD PRESSURE DURING PREGNANCY

If you have high blood pressure and are planning to have a baby or if you are already pregnant and have high blood pressure here is information about prevention and treatment, along with antenatal care and pre-eclampsia.


What do I need to know if I already have high blood pressure and plan to become pregnant?
If you already have high blood pressure and you are planning to have a baby you should talk to your doctor about preparing to conceive. You can, like any other woman, have a successful and healthy pregnancy but you have a slightly greater chance of complications than other women do if you have high blood pressure. For this reason you will need to be more closely monitored than women without high blood pressure.

It is important to plan your pregnancy if you can
If at all possible your doctor will stop any medicines that you take for high blood pressure before you become pregnant. You should not become pregnant whilst you are taking atenolol (beta-blocker), ACE Inhibitors or Angiotensin Receptor Blockers as these medications can affect the development of your baby. Therefore it is important that you plan your pregnancy if you can.

Examples of ACE inhibitors and Angiotensin Receptor Blockers:-

ACE Inhibitors: Captopril, Cilazapril, Enalapril, Fosinopril, Lisinopril, Perindopril, Ramipril, Trandolapril

Angiotensin Receptor Blockers: Candesartan, Eprosartan, Irbesartan, Losartan, Telmisartan, Valsartan

However, some women will have to continue to take tablets for high blood pressure. If this is the case then you may find that your blood pressure falls in the middle of your pregnancy. If this happens, the tablets might be stopped. There are certain medicines that can safely be taken during pregnancy, so if you need to continue to take medications, there are choices available.

Throughout your pregnancy you will need to have your blood pressure checked regularly, at least once a month. Some women find it useful to buy a monitor to use at home, so that they can check their blood pressure levels in between the times when they see their doctor or midwife. Check with your midwife or doctor before you decide to buy a monitor, as home measurement may not be appropriate for everyone. Make sure that you use an accurate, properly validated machine. See the information about measuring your blood pressure, which explains how to take your blood pressure readings properly and identifies details of accurate blood pressure monitors

The Microlife 3BTO-A (2) is supplied with two different sized cuffs provided and is ideal for use during pregnancy and other validated machines with different cuff size are available from Medisave

What do I need to know if I have developed high blood pressure during my pregnancy?
5% or one in every twenty women will develop high blood pressure whilst they are pregnant. If your blood pressure rises by a small amount and your urine contains no protein, then this is called gestational hypertension. If your blood pressure rises by a large amount, and your urine contains protein then this is called pre-eclampsia. It is now thought that gestational hypertension may be a milder form of pre-eclampsia so careful monitoring is essential.

Pre-eclampsia is caused by a problem with the placenta, which joins mother and baby and supplies the baby with nutrients and oxygen from the mother's blood. It is potentially very dangerous for both mother and baby if it is undetected. The signs and symptoms are a rise in blood pressure and protein in the urine. Sometimes the baby may be slow to grow and the mother may have swollen hands and feet, though there are other things that can cause these symptoms. It is very important that all pregnant women have regular checks by their midwife throughout their pregnancy, so that any problems can be spotted early and dealt with.

If you are found to have pre-eclampsia then you and your baby will be closely monitored. The only way to stop pre-eclampsia is for the baby to be delivered, which can sometimes mean a premature birth. Action on Pre-Eclampsia is an organisation that provides information on pre-eclampsia.

High blood pressure can be treated during pregnancy. Your doctor may ask you to make some changes to your diet, or change your lifestyle and if your blood pressure is very high, may ask you to take medications to lower it. There are medicines that are safe for you and your baby, but you will need to be monitored closely. Your doctor will avoid medications unless there is no alternative.

Methyldopa is the medicine most commonly used to manage high blood pressure during pregnancy. Diuretics, ACE inhibitors, Angiotensin Receptor Blockers and atenolol (a beta-blocker) should not be used during pregnancy. Other beta-blockers, such as labetolol are occasionally used, though there is very little evidence about their effects during pregnancy. Likewise, there is very little information on the use of calcium channel-blockers in pregnancy. If your blood pressure is sufficiently high, then these latter drugs will be used to reduce it.

If you develop high blood pressure during your pregnancy then it is very important that once the baby is born that you make sure your blood pressure is regularly checked until it returns to its usual level. Blood pressure levels can rise sharply in the days following the delivery of a baby and can continue at high levels for a few weeks. In most women it returns to the same levels as prior to the pregnancy, but it is important to check that this has happened.

If I already have high blood pressure prior to becoming pregnant am I more likely to develop pre-eclampsia?
If you already have high blood pressure then you do have a slightly greater chance of developing pre-eclampsia in pregnancy. Your doctor and midwife will closely monitor your blood pressure and then decide to use treatment if it starts to rise.

There is no way of preventing pre-eclampsia, though you should eat a healthy diet (low in salt and saturated fats and high in fruit and vegetables) throughout your pregnancy, to ensure that you and your baby are healthy.

What do I need to know if I had high blood pressure during a previous pregnancy?
High blood pressure in a previous pregnancy does not necessarily mean that you will have it again during further pregnancy, though you do have a slightly greater chance of having it than a woman who has never had a raised blood pressure. Many women who have high blood pressure during pregnancy have a normal blood pressure in later pregnancies.

There has been some research which suggests that women who have high blood pressure or pre-eclampsia during pregnancy may be more likely to have a stroke or heart disease much later in life. It is important for everyone to know what their blood pressure is and to make sure that it is checked regularly so that any rise in your blood pressure can be picked up and treated when necessary. If you have had pre-eclampsia or high blood pressure during a pregnancy, it is even more important that you have your blood pressure checked as you grow older, ideally every year.

Can I breast feed my baby if I am taking medicines for high blood pressure?
There is some evidence that atenolol gets into breast milk, although this has affected the baby in just two cases. All other medicines for high blood pressure are safe in breast-feeding, but in general doctors are keen to avoid using medicines in women who breast-feeding. You should make sure that your GP knows if you intend to breast-feed.

WHAT IS WHITE COAT HYPERTENSION ?

Hypertension is the medical term for high blood pressure, and ‘white coat’ refers to a doctor’s white coat, and therefore a clinical or medical environment. Simply put, white coat hypertension means having a high reading only when your blood pressure is measured away from your normal home environment, usually in a clinic or surgery. You can choose from a wide selection of accurate monitors online at medical supply specialist web site Medisave

Most people with consistently high readings (140/90mmHg or above) do have high blood pressure but there are a few who will have white coat hypertension. People with white coat hypertension have high readings (140/90mmHg or above) only when they have their blood pressure measured at their doctors surgery or in a clinic, and have normal blood pressure readings outside a clinic environment. A small number of people may have white coat hypertension that goes unrecognised which could mean being wrongly diagnosed as having high blood pressure and receiving unnecessary treatment.


What causes white coat hypertension?

Blood pressure goes up and down throughout the day and night in everyone, which is normal. For example, when you are excited or in pain, when you have just exercised or when you are angry your blood pressure rises; when you are asleep or resting then your blood pressure falls.

White coat hypertension and the white coat effect are caused by anxiety, when your body stimulates your ‘fight or flight’ response. Many people are aware that they feel nervous or anxious, but many others may think that they are relaxed when, in fact, they are not. It can affect anyone, young or old, male or female and some people find that anxiety can raise their blood pressure by as much as 30mmHg on the systolic (top) number. Being relaxed, in a quiet environment and being given reassurance can help to reduce this effect.

How do I know if I have white coat hypertension?

There are no symptoms of white coat hypertension, you won’t feel unwell if you have it. The only way to find out if you are affected is to have your blood pressure measured outside your doctor’s surgery or clinic. There are two ways of doing this- Taking readings yourself at home and or Ambulatory Blood Pressure Measurement (ABPM) - sometimes also called 24-hour monitoring

A few people will be asked to have ABPM, which is a test to see what your blood pressure is like over a period of 24-hours. A small portable monitor takes readings regularly and automatically over a day and a night. Your doctor can then look at an average of the daytime readings and this should show whether you have a normal blood pressure at home. If the average reading is 135/85mmHg or less then it is normal. Some doctor’s surgeries now have ABPM equipment or alternatively you may need to go to your local hospital outpatients department to have the machine fitted. .

You may also be asked to use an automatic or a semi-automatic blood pressure machine to take a series of readings yourself at home. Some doctors and clinics will lend you a monitor, usually for two weeks, and ask you to take readings at certain times of the day. After you have taken these readings your doctor or nurse will analyse them and work out an average. You can also buy a blood pressure monitor to use at home, to monitor your blood pressure levels.

Will I need to be treated if I have white coat hypertension?

Doctors believe that if you have white coat hypertension you are at less risk of heart disease or stroke than someone who has sustained high blood pressure, but at a greater risk than someone who has normal blood pressure at all times. For this reason it is important to make sure that you have your blood pressure checked regularly – at least once a year. This is to make sure that if your blood pressure does start to rise, you can take steps to lower it as soon as possible.

Many people with white coat hypertension go on to develop high blood pressure in the future. For this reason, particularly if you have other risk factors like smoking, or high
You can help to prevent a rise in blood pressure by following a healthy lifestyle. This means eating a diet low in fat and salt and high in fruit and vegetables, being active and the right weight for your height and not drinking alcohol excessively. You can also buy a blood pressure monitor to use at home, to monitor your blood pressure levels. See the information sheet ‘Measuring your blood pressure at home’.

If you are thinking about buying a blood pressure monitor online medical suppiers offer some of the lowest prices on British Hypertension Society approved machines. Check the range of accurate monitors recommended for home use (opens in new window)

I have been diagnosed with high blood pressure, could it be white coat hypertension?

A small number of people that are diagnosed with high blood pressure may have white coat hypertension. If you have ‘mildly’ raised blood pressure, ie, up to 160/99mmHg, then white coat hypertension could account for this level of blood pressure. Above 160/99mmHg it is likely that even if you took into account a rise in blood pressure because of anxiety, it would still be high. For example, if you had a systolic reading of 180mmHg in the surgery and took into account a possible white coat effect of 30mmHg then it means your systolic reading would be 150mmHg, which is still a high reading.

If your high blood pressure has been diagnosed from a small number of readings (unless the blood pressure is very high) then it is possible that white coat hypertension could be a factor. A diagnosis of high blood pressure should be made after a series of readings, over a period of time, to take into account the possibility of white coat hypertension.

Finding out whether you may have white coat hypertension is important as it can make the difference between being treated, or not, and can affect other aspects of your life such as insurance and work. If you are concerned, talk to your doctor or nurse.

A fundamental part of the Blood Pressure Association's work is to draw attention to the need to improve detection, management and treatment of high blood pressure. The BPA are represented on Government committees to improve the management of people with high blood pressure and to extend and update the standards used to measure the accuracy of blood pressure monitors available to the general consumer

MEASURING YOUR BLOOD PRESSURE AT HOME

Measuring your blood pressure needs to give accurate readings if it is to be worthwhile. You may have been advised to measure your blood pressure at home in order to get a more accurate record or your readings.

The following information is from the Blood Pressure Association's fact sheet "Measuring Your Blood Pressure at Home"


Many people with high blood pressure measure their blood pressure at home, in between visits to their doctor or nurse. Some people may also be asked by their doctor or nurse to take measurements at home for a short period of time to find out whether they have high blood pressure or not.

There is a wide range of blood pressure monitors available to buy and choosing the right one is important to make sure you get accurate readings. It is also important that you know how to take readings, what to do with the results and what might affect the readings.



Why do people monitor their blood pressure at home?
Some people are asked by their doctor or nurse to measure their blood pressure at home for a short period of time, usually two weeks, to find out what it is like away from the surgery or clinic. Sometimes your blood pressure is only raised when taken in a clinical or medical environment, such as your doctor’s surgery. This is called white coat hypertension and can be caused by feeling anxious, or by being in a busy or noisy environment. This can affect readings by as much as 30mmHg (systolic readings).

Blood pressure readings taken at home are often lower than those taken at a doctor’s surgery, whether a doctor or a nurse takes them. Readings taken away from the clinic are now seen to give a more accurate picture of your blood pressure.

To be sure that you have high blood pressure your doctor needs more than one reading, and home measurements can be a good way of finding out what your blood pressure is like when you are relaxed and going about your daily life. The other way of doing this is by having 24-hour (ambulatory) blood pressure monitoring done.

Monitoring blood pressure over a period of time at home can also provide your doctor or nurse with more information about how well your treatment is working and how you respond to medications. Home blood pressure monitoring can also be useful for people who have high blood pressure and who are taking medications as it can mean that you are able to cut down on the number of visits to your surgery for checks.

Many people enjoy measuring their own blood pressure and monitoring their condition because it helps them to feel in control of their high blood pressure and health, and involves them in making decisions about their treatment.

Is monitoring my blood pressure at home the right thing for me?
Most people feel more in control of their condition if they take and monitor their blood pressure at home. Once they are familiar with how to take their readings and are comfortable doing so, they make it part of their daily routine. Doing so helps to show that their medicines and lifestyle changes are working and they understand much more about their condition. However, taking readings at home is not for everyone. It makes some people more anxious. If this happens, talk to your doctor and see if you are taking the readings too frequently or if you should stop doing so. Generally speaking, it is not necessary in the long term to take readings more than once a week unless your doctor has specifically asked you to do so.

There are a few physical conditions that can make monitoring at home difficult. If you have an irregular heart rate, such as atrial fibrillation, then you may not be able to get a good reading – a digital machine may read ‘error’. If you have difficulty bending or moving your arms you may find putting on the cuff and taking a reading without help difficult. If you have lymphoedema, or have had a lymphectomy, then you should not have a blood pressure reading taken on the affected arm, as the pressure can cause or make lymphoedema worse.

Before you buy a blood pressure monitor
Talk to your doctor or your nurse about monitoring at home. Many health professionals actively encourage people with high blood pressure to take and then monitor their readings themselves. You can discuss how often you need to take readings and what contact you should have with the surgery while monitoring your blood pressure. You can work together to ensure you are well informed and that your blood pressure is being treated effectively. A few doctors may be unhappy about you monitoring at home. If this is the case, talk to them about your reasons for wanting to monitor at home.

Work out some guidelines with your doctor or nurse. Agree how often you should take your readings and at what time of day, as well as when you need to go back to the surgery. For example if your readings go above a certain level, how and when will you let your doctor or nurse know.

Choosing an accurate machine
Machines for measuring your blood pressure are not available on the NHS so you will have to buy your own. They range in price from about £30 to £150. Many of the leading brands and top models are available at very discounted prices online on web sites such as Medisave

Most people who measure at home use an automatic or semi-automatic machine. These are simple to use and will often store your readings in their memory and provide you with a printout. Automatic machines inflate and deflate the cuff for you. With semi-automatic machines you will need to inflate the cuff by hand.

Having a consistently accurate reading that you can trust is important, not only for you when you are testing at home but also for your health professional. Inaccurate readings can lead to misdiagnosis, and can mean the difference between having treatment or not. Therefore the first priority when buying a monitor is to choose one that you know is accurate. So:

· Choose a machine that measures from the top of the arm, rather than the wrist or the finger. Finger monitors will not give accurate readings and wrist monitors are also less likely than upper arm monitors to give an accurate reading.

· Choose a monitor that has passed independent testing for accuracy. When you look at blood pressure machines, you should find they carry a “CE” marking on their packaging. However, although monitors marked with “CE” show that they have undergone some testing, this is not a reflection of their accuracy. The British Hypertension Society (BHS) has therefore compiled a list of accurate monitors as a guide for home users. The monitors on this list have been independently tested to a protocol set by the British Hypertension Society or the European Society of Hypertension, and have been found to be accurate. The BHS list is compiled from research papers and not direct testing, but you may find it a useful guide when you buy a monitor. All the monitors on this list measure blood pressure from the upper arm (upper arm monitor).

This list is regularly updated, so do check the web site for the latest information.

Using the right size of cuff is important for an accurate reading. Four out of every five people are able to use the standard size cuff that comes with the monitor and get an accurate reading. However, some people have very thin or very large arms and a standard size cuff may produce inaccurate readings. If the cuff is too small the reading may be falsely high and if it is too big the reading may be falsely low. If you have any doubts, ask the manufacturer of your monitor about the cuff sizes they have available and check with your doctor or nurse that you are using the right one.

It is now possible to buy monitors that connect to your computer to allow you to use a computer programme to record readings. A and D instruments also make a version of the UA-767, for use by people who are visually impaired, which ‘talks’ to you. Visit Medisave who stock a wide range of machines.

Taking readings - When and how often should I take readings?
When and how often you take readings will depend on your blood pressure. Some people may need to take a number of readings over a short period of time, others will need to take a reading once a week. Your doctor or nurse will be able to advise you. If you take readings less than once a week you may be likely to forget, so try and make your readings part of your routine. A few people find that there is a difference between readings taken on days when they work and days when they do not, so try taking readings during these times as well.

When you first start taking readings at home discount the first day’s measurements. They may not be accurate because you are unfamiliar with the monitor and could be anxious. It is useful to take readings at the same time of day so that you are consistent and are comparing ‘like with like’.

Which arm should I use to measure blood pressure?
There can be a difference between the readings on each arm. When you first use the monitor take a reading on both the left and right arm and then in future use whichever arm gives you the higher reading. Always use the same arm for readings. If you find that the difference between the readings on either arm is greater than 20mmHg systolic (top number) or 10mmHg diastolic (bottom number) talk to you doctor or nurse about your readings.

How do I take a blood pressure reading?
· Wear a short sleeved T-shirt or loose fitting clothing so that the sleeve can be rolled up comfortably
· Before taking readings rest for five minutes. You should be sitting down, preferably at a desk or a table, in a quiet place, with your arm resting on a firm surface. It is very important that your arm is supported so that the cuff around the arm is at the same level as your heart. You may need to support your arm with books to make sure it is at the correct height. Ensure that the arm is totally relaxed and not tensed
· The deflated cuff needs to be tight, but not too tight. You should be able to insert two fingers between it and the skin
· If you are using a machine that needs you to set the systolic level for the cuff inflation, choose a setting that is at least 20mmHg above your last reading. For example, if your last systolic reading was 153, set the machine to inflate to 180.
· Start the machine – keep still and silent whilst the reading is taken. Moving and talking can affect the reading
· Take two or three readings each about two minutes apart. If you take two readings disregard the first and use the second, if you take three readings disregard the first and take an average of the second and third
· Some people find that when they take two or three readings the first is always highest and then the readings become lower each time they take them. If this is the case keep taking readings until they level out and then use this as your reading
· Record the reading either in the memory of the machine or on computer or paper. Make sure you keep accurate records – some people are tempted to round the numbers up or down, or to record a lower blood pressure. This can affect your treatment and therefore your long-term risk of stroke and heart attack. Also record any medications you have taken and when, and any other information such as whether you have just eaten or exercised.

What is my ideal level of blood pressure?
The aim of treatment for high blood pressure is to reduce it, when measured by your doctor or nurse, to below 140/85mmHg. When it is measured in a clinic, particularly by a doctor or nurse, it may be higher than when you are more relaxed at home. It is therefore important that with home measurements they should at least be below 140/85mmHg and preferably below 130/80mmHg. This can be hard to achieve for some people and your doctor or nurse may set you a different target.

What do I do if my blood pressure readings start to go up?
As blood pressure varies in everybody by quite a large amount, you may get unexpected ‘one off’ high readings, so always repeat the measurement again at another time. However, if you find that on repeated measurement your blood pressure over a period of time is higher than usual go and see your doctor or nurse, taking details of the measurements with you. The important readings are the averages over a period of time and not individual readings.

Is there anything that might affect my blood pressure readings?
There are several factors that can make your blood pressure rise temporarily; exercise, alcohol, caffeine, tobacco, a full bladder, talking, anxiety, excitement and pain are just a few. It is worth recording what you have been doing before a reading, as it will act as a guide for you and your doctor or nurse.

HIGH BLLOD PRESSURE

High blood pressure also called hypertension affects millions of people increasing the risk of stroke, heart attack and heart failure.

High blood pressure usually has no symptoms. The only way for you to know if you have high blood pressure is to have it measured with a blood pressure monitor.


High blood pressure causes strain on the blood vessels carrying blood around your body. This strain can cause vessels to become clogged up or to weaken, and this can lead to narrow blood vessels and clots that can cause damage to the heart or brain. Having high blood pressure can also cause heart and kidney failure.

Iit is important to realise that the higher your blood pressure, the higher your risk of heart disease or stroke. This means that all of us should be adopting a lifestyle that will help to lower our blood pressure whether we have high blood pressure or not.

How can I lower my blood pressure?
Fortunately there is a wealth of quality information about things you can do now to begin to understand, lower and control your blood pressure as well as prescription drugs and medicines.

Leading a healthy lifestyle means exercising, healthy eating - a diet low in fat and salt and more fruit and vegetables, being the right weight for your height, drinking sensibly and not smoking. By following these guidelines the risk of having a heart attack or stroke in the future is reduced.

High blood pressure can be treated and there are many things that help lower it. To see the impact on lowering your blood pressure by changes in your lifestyle, diet and medicines many people find encouragement in regularly measuring their own blood pressure with automatic digital home monitors

Where can I buy an accurate blood Pressure Monitor?
Medisave is a UK stockist of British Hypertension Society validated machines from Microlife, Omron and A and D Instuments. Make an informed purchase and trust machines that are considered accurate by th British Hypertension Society. To visit the blood pressure monitor department at Medisave

This information presented her is to give you information about your blood pressure and help you understand more about treatments and help you keep your blood pressure controlled.

What is blood pressure?
Your heart pumps blood around your body through a network of tubing called arteries. Every time your heart pumps it forces blood through these arteries and into smaller blood vessels called capillaries. The force that your heart produces in your arteries when it pumps is called your blood pressure. When the heart contracts and forces blood through the arteries your blood pressure goes up, when the heart relaxes it goes down.

This pressure can be measured and is usually written down like this:

140/90mmHg

The top number, which is called the systolic pressure, shows the pressure in your arteries when your heart is forcing blood through them. The bottom number, called the diastolic pressure, shows the pressure in your arteries when your heart relaxes. The top number can be anywhere from 90 to 240 and the bottom number can be anywhere from 60 to 140. Blood pressure is measured in millimetres of mercury, which is written down as: mmHg

Everyone has a different blood pressure and it can change in the same person during the day and night.

What is high blood pressure?
High blood pressure is also known as hypertension. The higher your blood pressure the higher the chnace of heart disease or stroke.

140/90mmHg is the level of blood pressure used to diagnose high blood pressure. If your blood pressure is consistently raised at these levels and above, it will need to be treated. Treatment may involve making changes to your lifestyle and/or taking medication. This level of 140/90mmHg is the level for high blood pressure for everyone, male/female, young/old.

140/85mmHg is the target blood pressure for people who are receiving treatment for their high blood pressure. The only exception to this target level is if you have diabetes, kidney disease or have already suffered a stroke or heart attack. Then it may be worthwhile lowering your blood pressure even further.

Why is high blood pressure important?
High blood pressure increases risk of heart disease, stroke, kidney disease and dementia. If you have high blood pressure the greater your risk of developing these conditions.

Having high blood pressure causes strain on the vessels carrying blood around your body. This strain can cause vessels to become clogged up or to weaken and this in turn can lead to narrow blood vessels and clots, which can cause damage to the heart or brain. Having high blood pressure can cause heart failure. High blood pressure can cause kidney failure and some eye conditions.

High blood pressure is a serious condition that you should not ignore. However it can be lowered either by changing your lifestyle or if necessary adding in tablets. The lower your blood pressure the lower your risk of heart disease, stroke, kidney disease.



How common is high blood pressure?
In the United Kingdom there are about 16 million people with a blood pressure higher than 140/90mmHg. One in every three women and two in every five men now have high blood pressure, with larger numbers affected in older age groups. For example, about half of all people over the age of 75 have the condition. Although you may be said to have high blood pressure, or a normal blood pressure, it is important to realise that the higher your blood pressure, whatever it is, the higher your risk of heart disease or stroke. This means that all of us should be adopting a lifestyle that will help to lower our blood pressure whether we have high blood pressure or not.

How is blood pressure measured?
Your blood pressure can be measured either by using a device called a sphygmomanometer or by using a digital machine.

A sphygmomanometer is the older kind of equipment that measures blood pressure using a column of mercury. These are used less frquently now as they can often give inaccurate measurements

These day automatic, or partly automatic, digital machines are used to measure blood pressure. Models that have been validated by the British Hypertension Society are considered accurate when used properly. See the fact sheet How to Measure Your Blood Pressure.

In order to be sure that you have high blood pressure, you will be asked to have readings taken several times. This is to make sure that you have consistently high blood pressure, rather than high blood pressure because you are anxious or nervous in medicall environments or have rushed to be there - see White Coat Hypertension

What causes high blood pressure?
There is no definite cause for their high blood pressure for most peple and doctors call this essential hypertension. The small blood vessels in the body narrow and this causes the pressure to build up.

High blood pressure can run in the family, and if you have a parent with high blood pressure then you are more likely to have high blood pressure yourself.

Some other conditions are also linked to high blood pressure, such as diabetes, kidney disease and heart disease. If you have any of these conditions then it is even more important that your blood pressure is well controlled.

Your blood pressure is very much affected by your lifestyle. The important factors are:

· Eating too much salt
· Not eating enough fruit and vegetables
· Not exercising enough
· Being overweight
· Drinking excessive amounts of alcohol

You cannot change your genes, or the fact that you will grow older, you can change your lifestyle. Changing your diet and exercising more will help lower your blood pressure.

Can high blood pressure be treated?
High blood pressure can be treated. Lowering blood pressure causes a large reduction in strokes, heart attacks, heart failure and kidney disease that would otherwise have occurred and may reduce your risk of developing some kinds of dementia.

How will my high blood pressure be treated?
How your high blood pressure is treated will depend on how high it is and on what other ‘risk factors’ you have for heart disease and stroke.

If your blood pressure is between 140-160/90-100mmHg then you will probably be asked to make some changes to your lifestyle. You will probably not need to take tablets providing that the changes you make work. In this way you can lower your own blood pressure without needing to take tablets. However, some people with a blood pressure in this range may be prescribed medication to take. This is usually if they are older or have other risk factors for heart disease and stroke, such as high cholesterol, smoking or already have complications such as a previous stroke or heart attack.
So if you have a blood pressure reading in this range you should make the lifestyle changes described at below.

If your blood pressure is 160/100mmHg or more you will probably be given tablets as well as being asked to make changes to your lifestyle. You are aiming to reach a target blood pressure of 140/85mmHg or less whilst feeling fit and well. There will, however, be a small number of people who may find their blood pressure very difficult to control even with medication.

Changing your lifestyle to lower high blood pressure.
All people who have high blood pressure should make changes to their lifestyle. These changes can be enough to lower your blood pressure to a level where you may not need to take tablets. Even if you need tablets, the changes to your lifestyle will make the tablets more effective.

These changes to your lifestyle should be adopted by the whole family, as, increasing evidence suggests that this will lower blood pressure and prevent high blood pressure from occurring later in life. A healthy diet will also make you feel much better.

These are the five main changes you can make to help lower high blood pressure:

1. Cut down on your salt

We each eat about 10 grams of salt (sodium chloride) each day and this can easily be reduced by half to 5 grams each day. That means cutting down from a dessert spoon of salt every day to a teaspoon. You should not add salt to food or use it in cooking. However, most salt is hidden in many processed foods and this may not be obvious, for example salt may be hidden in bread, many cereals and ready meals so avoid these high salt foods where possible.

2. Eat more fruit and vegetables

Fruit and vegetables contain potassium, which has the opposite effect of salt and can help to lower blood pressure. If you can manage to increase the amount of fruit and vegetables and cut down the amount of salt that you eat then you should see your blood pressure fall by quite a lot. We should all be eating seven to nine portions of fruit or vegetables each day.

3. Exercise - be more active

Being active can help you to lower your blood pressure. It will also help you to lose weight and reduce the amount of fats (cholesterol) in your blood. Being active doesn't have to mean jogging, it can mean walking the dog regularly and gradually increasing the amount you do over three to six months. You should aim to be active for at least 30 minutes, five times a week.

4. Weight -

Everyone has an ideal weight. Your ideal weight will depend on how tall you are and whether you are male or female. If you are overweight you should try and get down to a weight within the ideal range for you.

Many people find losing weight, and maintaining weight loss, difficult. A healthy diet is an essential first step. Once you are eating a healthy diet cut down the amount of food you eat until you start to lose weight.

5. Drink alcohol in moderate amounts only

As well as the five factors set out above there are two other key risk factors for stroke and heart disease, smoking and eating too much saturated fat. They don't in themselves cause high blood pressure but they do make you more at risk of heart disease or stroke. However, the combined effect of stopping smoking, cutting down the amount of saturated you eat and lowering your blood pressure causes a very large reduction in your risk of having a stroke or having a heart attack.

Giving up smoking

Smoking is the biggest risk factor for having a heart attack. If you smoke it will not directly affect your blood pressure, but it will cause your arteries to narrow, just as high blood pressure does. So, if you smoke and you have high blood pressure your arteries will narrow much more quickly. There are now lots of ways in which you can make giving up smoking easier for yourself. Nicotine replacement therapy, in the form of patches and gum, for example, and groups to help smokers quit are just a few. If you have difficulties talk to your doctor or nurse.

Cutting down on saturated fat

We all eat too much fat. The type of fat that causes the most problems is saturated fat, for example animal fats and some vegetable oils such as palm and coconut oil. Fat increases the amount of cholesterol in your blood. The higher the level of cholesterol in your blood the greater your risk of heart disease and stroke. If you have high blood pressure reducing you saturated fat intake is very beneficial.

These changes to your lifestyle will reduce your risk of heart disease or stroke, but they may not lower your blood pressure enough. It may be necessary for you to take tablets as well.

Medicines for high blood pressure

If you need tablets, there is very strong evidence that they will reduce your risk of stroke and heart disease, provided your blood pressure is well controlled. Tablets can prolong life and reduce the risk of complications from high blood pressure. In most people lowering blood pressure with tablets causes no problems, in fact many people feel better.

As with any medicines, those for high blood pressure can cause side effects in some people. Side effects are rare and only happen in a small number of people. It is important that if you feel that any medicine you are taking is makes you feel unwell that you should go back to your doctor to talk. Tablets and combination of drugs can be changed to find the best ones that keep your blood pressure controlled, and leave you feeling well. Most people are prescribed more than one tablet to control blood pressure and it may take time to find the combination of tablets that suits you best. The aim of any tablet, combined with lifestyle changes, is to get your blood pressure to below 140/85mmHg.

Taking tablets for high blood pressure is something that most people will have to do for the rest of their lives and continuing to take them is very important. You may have no symptoms from your high blood pressure, but if it is left untreated you will put yourself at risk from heart disease or stroke. As soon as you stop taking tablets your blood pressure will go back up, as will your risk of heart attack or stroke. Many people find that once they get into a routine with their tablets, they become a part of their daily lives, like cleaning their teeth.

The purpose of both the lifestyle changes that you make and the tablets that you take is to control your blood pressure with you feeling completely well. Once your blood pressure is controlled you should be able to lead your life as normal.

If you are considering buying a blood pressure monitor to measure your blood pressure accurately at home visit Medisave to see their range of latest approved automatic digital machine

YOU & YOUR BLOOD PRESSURE

Your blood pressure directly affects your health and careful measuring with the right equipment is essential for accurate readings
High Blood Pressure affects millions of people in the UK increasing the risk of stroke and heart attack. It has no symptoms. The only way for you to know if you have low, normal, or high blood pressure is to have it measured using an accurate blood pressure monitor.

A recent study showed that people who measure their blood pressure at home have better control of their condition. It found that blood pressure was lower in people who had been checking their blood pressure at home.

To understand more about what blood pressure is and why it is important to lower high blood pressure read the full information on the high blood pressure page. This site also contains information about low blood pressure.

Blood pressure monitoring needs to give accurate readings if it is to be worthwhile. You may have been advised to measure your blood pressure at home in order to get a more accurate record or your readings or just want to keep a check on your own blood pressure. On this site you can access a comprehensive fact sheet about how to measure blood pressure.



Blood pressure is more and more often measured using an automatic blood pressure monitor that can also be used at home. For ease of use these machines can be fully automatic and measure blood pressure correctly on the upper arm at heart level. The readings are given on a digital display and can be stored in the monitor's memory or printed out.


It is worth noting that electronic blood pressure measuring devices have the following advantages:

Electronic blood pressure measuring devices are becoming the norm now mercury is being phased out because of its hazardous nature.
Most of these are now accurate enough for routine clinical use and are relatively inexpensive.
They eliminate many of the errors in blood pressure measurement that human beings can generate.
You can buy top models of blood pressure monitors from online medical supply shops such as Medisave who offer the latest approved models from leading brands such as Omron, A&D and Microlife at heavily discounted online prices. Learn more...

The British Hypertension Society produce an up to date list of blood pressure monitors suitable for both clinical and home users which have been tested and approved. Find out more about these machines and how to use them properly.

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THE HISTORY OF BLOOD PRESSURE MESUREMENT

The ancient Greek physician Galen first proposed the existence of blood in the human body. Building on ideas conceived by Hippocrates, the body was comprised of three systems. The brain and nerves were responsible for sensation and thought. The blood and arteries filled the body with life-giving energy. He also believed that the liver and veins provided the body with nourishment and growth.

It was not until 1616 when William Harvey announced that Galen was wrong in his assertion that the heart constantly produced blood. Instead he proposed that there was a finite amount of blood that circulated the body in one direction only. But Harvey's views were initially met with a lot of resistance and scepticism. The idea that blood was not constantly produced in the body raised doubts about the benefit of bloodletting, a popular medical practice at the time.

Harvey was neither the only nor the first to question Galen's ideas. The Egyptians knew that blood flowed through the body and used leeches to unblock what they thought were passages of blood.

The first recorded instance of the measurement of blood pressure was in 1733 by the Reverend Stephen Hales. A British veterinarian, Hales spent many years recording the blood pressures of animals. Fifteen years beforehand, he took a horse and inserted a brass pipe into an artery. This brass pipe was connected to a glass tube. Hales observed the blood in the pipe rising and concluded that this must be due to a pressure in the blood. At this time the technique was invasive and highly inappropriate for clinical use.

It was not until 1847 that human blood pressure was recorded. The method used Carl Ludwig's kymograph with catheters inserted directly into the artery. Ludwig's kymograph consisted of a U-shaped manometer tube connected to a brass pipe cannula into the artery. The manometer tube had an ivory float onto which a rod with a quill was attached. This quill would sketch onto a rotating drum hence the name 'kymograph', 'wave writer' in Greek. However blood pressure could still only be measured by invasive means.

The lack of a non-invasive method of determining this new idea of blood pressure lead to many physicians working in this field. Once such man, Karl Vierordt, found in 1855 that with enough pressure, the arterial pulse could be obliterated. Vierordt used an inflatable cuff around the arm to constrict the artery.

Etienne Jules Mary, a French physician/cinematographer, developed this idea further in 1860. His sphygmograph could accurately measure the pulse rate, but was very unreliable in determining the blood pressure. Yet this design was the first that could be used clinically was a small degree of success.

In 1881, Samuel Siegfried Karl Ritter von Basch invented the sphygmomanometer. His device consisted of a water-filled bag connected to a manometer. The manometer was used to determine the pressure required to obliterate the arterial pulse. Direct measurement of blood pressure by catheterisation confirmed that von Basch's design would allow a non-invasive method to measure blood pressure. Feeling for the pulse on the skin above the artery, was used to determine when the arterial pulse disappeared.

However von Bacsh's design never won a keen following, many physicians of the time being sceptical of new technology, claiming that it sought to replace traditional ideas of diagnosis. In addition, many questioned the medial usefulness of information about the blood pressure. This did not stop some from attempting to produce a more useful device. A spring-based sphygmomanometer won some support, but they were difficult to calibrate and were very unreliable when dealing with acutely ill patients.

Scipione Riva-Rocci developed the mercury sphygmomanometer in 1896. This design was the prototype of the modern mercury sphygmomanometer. An inflatable cuff was placed over the upper arm to constrict the brachial artery. This cuff was connected to a glass manometer filled with mercury to measure the pressure exerted onto the arm.

Riva-Rocci's sphygmomanometer was spotted by the American neurosurgeon Harvey Cushing while he was travelling through Italy. Seeing the potential benefit he returned to the US with the design in 1901. After the design was modified for more clinical use, the sphygmomanometer became commonplace. Cushing and George Crile were major advocates of the benefits.

This sphygmomanometer could only be used to determine the systolic blood pressure. Observing the pulse disappearance via palpitation would only allow the measuring physician to observe the point when the artery was fully constricted. Nikolai Korotkoff was the first to observe the sounds made by the constriction of the artery in 1905. Korotkoff found that there were characteristic sounds at certain points in the inflation and deflation of the cuff. These Korotkoff sounds were caused by the abnormal passage of blood through the artery, corresponding to the systolic and diastolic blood pressures.

A crucial difference in Korotkoff's technique was the use of a stethoscope to listen for the sounds of blood flowing through the artery. This auscultatory method proved to be more reliable than the previous palpitation techniques and thus became the standard practice.

Modern developments have led to more accurate auscultatory sphygmomanometers, and newer oscilliometric models. These sphygmomanometers measure the pressure imparted onto the cuff by the turbulent blood squirting through the constricted artery over a range of cuff pressures. This data is used to estimate the systolic and diastolic blood pressures.

Development of the stethoscope

The development of the stethoscope owed much to the work of Leopold Auenbragger. Auenbragger believed that the sounds heard from tapping on the patient's chest would reveal any irregularities. This technique, 'thoratic percussion' was published in 1761, but was largely ignored until the early 19th Century.

Next came Nicolas Corvisart. He was a supporter of Auenbragger's thoratic percussion and was vigorous in his promotion of 'auscultation', listening to the sounds body cavities made when tapped firmly. One follower of Corvisart was René Laennec. Laennec took a particular interest in the auscultation of the thorax.

The standard auscultatory technique for the physician would be to press their head against the patient's chest in order to listen to the resonations. However this left Laennec in an awkward situation, if the following anecdote is to be believed. During his days as a young doctor, in 1816, he was presented with a young buxom lady who was showing all the signs of heart disease. Wanting to ascultate the chest for confirmation of his diagnosis, the tenderness of Laennec's years left him too inhibited to act. Rather than cause himself undue embarrassment, he rolled a piece of paper into a tube, and used that rather than plant his head into her chest. To his astonishment, he could hear the heart just as well as if he had been diagnosing a man instead.

After careful experimenting, Laennec decided upon a hollow tube 3.5cm in diameter, and 25cm long. He investigated the sounds made by the heart and lungs with his new stethoscope and published the results in 1819. He found that his diagnosis was backed up with the observations in the autopsies.

Using Laennec's stethoscope was no more accurate than placing the head to the chest. Thus the benefit of the stethoscope was more social than clinical. It allowed the doctor some dignity during diagnosis and later became a 'badge of office' for the physician.

There were many alterations to Laennec's original idea such as one developed by N.P. Commins in 1828. He added a hinge and connected the two halves with tubing. This design allowed more flexibility to observe parts of the body hard to reach with the rigid design. There were many attachments available to the physician. One such was an extension that could be screwed in. This was of great benefit to the timid physician, or the doctor whose next patient had a particularly unique aroma.

The binaural stethoscope was developed in the 1890s complete with the recognisable rubber tubes. The onset of radiography has rendered the stethoscope obsolete in hospitals. However it is still a useful diagnosis tool for a GP or a cardiologist, so the humble stethoscope will remain a doctor's trusted friend for a little while longer.

HOW BLOOD PRESSURE IS MEASURED USING A SPHYGMOMANOMETER ?

The non-invasive ausculatory method is one of the most common ways of monitoring a patient's blood pressure. The subject sits down and rests their arm on a table so the brachial artery is level with the heart. This is important when monitoring blood pressure, as pressure is proportional to height ( Δp = ρgΔh ). For example, if one measures the blood pressure at head height, the systolic/diastolic pressure readings will be approximately 35mmHg less compared to readings taken at heart level, whereas at ground height the pressure readings will be 100mmHg greater. A sphygmomanometer cuff is wrapped around the subject's upper arm, just above the elbow and a stethoscope is placed on the hollow of the elbow, over the brachial artery as shown below.



The cuff is 'pumped- up' to a pressure of 180mmHg, compressing the brachial artery hence causing the artery to collapse once the systolic pressure (the maximum pressure exerted by the blood against the wall of the brachial artery when the heart beats) has been exceeded. At the point where the pressure of the cuff is greater then the systolic pressure, the artery has collapsed thus, there is no flow of blood through the brachial artery.

The valve on the pump is loosened slowly to allow the pressure of the sphygmomanometer cuff to decrease. Once the systolic pressure is reached (approximately 120mmHg in the 'normal' case), the brachial artery opens causing volatile blood flow, which cause vibrations against the artery walls. These noises are called Korotkoff sounds (named after their discoverer) and can be heard through a stethoscope as the pressure exerted onto the brachial artery falls. The blood flow through the brachial artery increases steadily, until the pressure of the sphygmomanometer cuff falls below the diastolic pressure (the pressure between successive heart beats, the low pressure), approximately 80mmHg. This is the point where the blood flow through the artery is laminar.

The Korotkoff sounds

The Korotkoff sounds are the sounds heard through the stethoscope as the pressure cuff deflates. The sounds are first heard when the cuff pressure equals the systolic pressure, and cease to be heard once the cuff has deflated past the diastolic pressure.

It is generally accepted that there are five phases of Korotkoff sounds. Each phase is characterised by the volume and quality of sound heard. The figure below illustrates these phases. In this example, the systolic and diastolic pressures are 120mmHg and 80mmHg respectively.



Phase 1

With the pressure cuff inflated to beyond the systolic pressure, the artery is completely occluded and no blood can flow through it. Consequently, no sounds are heard above the systolic pressure. At the point where cuff pressure equals the systolic pressure, a sharp tapping sound is heard. We recall that the blood pressure oscillates between systolic and diastolic pressure. At systolic, the pressure is great enough to force the artery walls open and for blood to spurt through. As the pressure dips to diastolic, however, the artery walls bang shut again. It is the closing shut of the artery walls that results in the tapping sound.

Phase 2

This phase is characterised by a swishing sound, caused by the swirling currents in the blood as the flow through the artery increases. Sometimes, if the cuff is deflated too slowly, the sounds vanish temporarily. This happens when the blood vessels beneath the cuff become congested, and is often a sign of hypertension. The congestion eventually clears, and sounds resume. The intervening period is called the auscultatory gap.

Phase 3

In this phase, there is a resumption of crisp tapping sounds, similar to those heard in phase 1. At this stage, the increased flow of blood is pounding against the artery walls.

Phase 4

At this point, there is an abrupt muffling of sound. The blood flow is becoming less turbulent. Some medical practitioners choose to record this point as the diastolic pressure.

Phase 5

This is the point at which sounds cease to be heard all together. The blood flow has returned to normal and is now laminar. The pressure cuff is deflated entirely and removed

BLOOD PRESSURE : SOME FACTS

Blood pressure is the pressure in the blood due to the beating heart. There are two types of blood pressure: systolic and diastolic. The systolic blood pressure corresponds to the pressure of the blood when the heart has imparted the maximum pressure. The diastolic blood pressure is the pressure when the heart is in the resting phase.

A more detailed description can be found here.

Why measure blood pressure?

High blood pressure is a very common condition in modern society. It has been estimated that one in five Americans, around 50 million people, suffer from high blood pressure. In general more men than women have high blood pressure, and the number of sufferers of both genders increases rapidly with age.

In around 5% of cases of high blood pressure is caused by kidney problems, but the causes of the other 95% of cases are unknown. There are a number of factors such as race, age, obesity, stress, smoking and lack of exercise that can contribute to the likelihood of a person developing high blood pressure but usually no one cause is directly responsible.

The majority of people with high blood pressure experience no symptoms, but if left untreated high blood pressure can lead to major health problems. Consequently the monitoring of blood pressure is vitally important in order to detect cases of high blood pressure and treat them early before health problems can develop.

Prolonged high blood pressure damages the lining of artery walls, making them thick and stiff. This condition is known as arteriosclerosis. Cholesterol is more likely to cling to the damaged artery walls, narrowing the arteries and thus preventing the blood from flowing through the body properly.

The heart has to work harder to compensate for the narrowed arteries. Over time this causes the heart to thicken and stretch, eventually failing to function normally, and causing fluids to back up into the lungs.

If the heart cannot work hard enough to compensate for the narrowing of the arteries then less blood can get around the body. Reduced blood flow to the heart can cause chest pain and angina, and eventually the flow may be stopped completely, causing a heart attack.

The function of the kidneys is to filter waste from the blood, but if blood flow to them is reduced then they become less efficient and waste builds up in the blood. Eventually they may fail completely, and dialysis or a kidney transplant will be required.

High blood pressure can also lead to brain damage and impaired vision. If a blood clot occurs in one of the narrowed arteries leading to the brain a thrombotic stroke may occur. Alternatively the weakened blood vessels in the brain may break due to the high pressure leading to hemorrhagic stroke.

A 25-year study of 11,000 individuals has confirmed that young men with high blood pressure are more likely to die from heart disease or other causes than those with normal blood pressure, translating to an estimated shorter life expectancy of two to four years.

The researchers called for increased population-wide prevention of increased blood pressure through healthy lifestyle habits and efforts to detect rising blood pressure in children, teenagers and young adults so that control of blood pressure can be started early.

HIGH BLOOD PRESSURE AND WHY IS IT DANGEROUS ?

Blood pressure is the force your blood exerts on your arteries as it flows through your body. If you have high blood pressure it means that your blood is exerting too much force on your arteries and is making your heart's job--pumping blood--more difficult than it should be.

Now, your heart is a powerful and efficient muscle, but if it's forced to work too hard for too long it can enlarge, wear out or fail, causing a heart attack, stroke, aneurysm... and an early death.

When you have your blood pressure taken, you're given two numbers referred to as your Systolic and Diastolic blood pressure.

Your Systolic blood pressure is the measurement of the pressure your blood exerts on your arteries when your heart beats, while your Diastolic blood pressure is the measurement of the pressure your blood exerts on your arteries when your heart is at rest.

What's The Difference Between Normal Blood Pressure and High Blood Pressure?

For an average adult:

Blood Pressure Stage Systolic Diastolic
Normal <120 <80
Pre-Hypertension 120-139 80-99
Stage One Hypertension 140-159 90-99
Stage Two Hypertension 160+ 100+

If your blood pressure consistently reads in the Hypertension or Pre-hypertension categories, then you need to take immediate and lasting action if you want to live a long and healthy life.

According to the American Heart Association, about 65 Million Americans over the age of 20 have high blood pressure. That's about one in three adults.

In 2003 more than 52,000 Americans died from complications related to high blood pressure. Between 1993 and 2004 the rate of death from high blood pressure rose nearly 30 percent

FREQUENTLY ASKED QUESTIONS ABOUT BLOOD PRESSURE ?

Why is there so much concern about high blood pressure?
High blood pressure stresses the heart and can contribute to coronary artery disease, heart attack and stroke.

When is blood pressure considered "high"?
Blood pressure is expressed as a ratio of systolic pressure over diastolic pressure. Normal blood pressure for adults is considered to be below 120/80 millimeters of mercury (mmHg). In general, blood pressure above 140/90 is considered to be high for adults, and blood pressure under 90/60 is considered to be low for adults.

What is prehypertension?
Prehypertension is a new category for individuals with systolic pressures of 120 to 139 mmHg and/or diastolic pressures of 80 to 89 mmHg. Such individuals are typically not prescribed medication, but they are advised to adopt lifestyle modifications to help keep blood pressure from rising. Lifestyle modifications might include weight loss, diet, exercise, reducing salt intake and quitting smoking.

Can high blood pressure damage the body?
Untreated, high blood pressure will cause the heart to overwork itself to the point where eventually serious damage can occur. For example, the heart muscle can thicken and begin to function abnormally, or dilate and contract less forcefully. High blood pressure can cause injury to the brain, the eyes and/or the kidneys.

Does taking birth control pills affect the risk of high blood pressure?
Taking birth control pills does put you at increased risk for high blood pressure, especially if you are over age 35. High blood pressure is typically two to three times more common in women taking birth control pills than those not taking them. The risk is especially high in women who take the Pill and are overweight or obese.

How many people have high blood pressure?
High blood pressure is a major health problem in the United States, where more than 50 million people over age six (and one in four adults) have the condition, according to the U.S. Centers for Disease Control and Prevention.

Who is at risk for high blood pressure?
High blood pressure is not evenly distributed throughout the population. Until age 55, it is more common among men than women. At age 75 and beyond, it is much more common among women than men. High blood pressure also occurs frequently in the black community. Black women, especially, are prone to high blood pressure. They have an 85 percent higher rate of medical care visits for high blood pressure than white women.

Can I be at risk for high blood pressure if I haven't had a heart attack or stroke?
High blood pressure is present in about half of people having first-time heart attacks and two-thirds of those having first-time strokes. Most cases of high blood pressure have no cure, but the overwhelming majority can be managed and controlled with diet and medication.

Is there any relationship between pregnancy and high blood pressure?
During pregnancy, some women may develop high blood pressure even if they have never had the condition before. This gestational hypertension has been shown to increase the risk of high blood pressure and stroke later on in life. Some women who already have high blood pressure may see it worsen during pregnancy. Also, preeclampsia, a condition related to high blood pressure and the presence of protein in a pregnant woman's urine, is the second leading cause of maternal death in the United States.

Can high blood pressure occur in children?
High blood pressure may occur in either adults or children. In fact, high blood pressure in children appears to be increasing, and an estimated 5 percent of children in the United States have it. Unlike for adults, there is no exact range used to define high blood pressure in children. Children's blood pressure readings are measured according to their height, gender and age.

Is there any way I can check my blood pressure at home?
Reliable blood pressure monitors are available for people who are interested in monitoring their own blood pressure or that of their family members. When purchasing, it is important to consult with a doctor or a consumer product rating agency regarding their reliability.

Is it possible for my blood pressure to go too low?
Low blood pressure is defined as blood pressure that falls below 90/60. Low blood pressure that does not cause symptoms is generally considered to be a sign of good cardiovascular health because there is less stress on the heart and blood vessels.

WHAT DOES MY BLOOD PRESSURE READING MEAN ?

Normal blood pressure is 120/80 or lower. High blood pressure is 140/90 or higher. If your blood pressure is between 120/80 and 140/90, you have something called "prehypertension" (you are in the beginning stages and at risk of high blood pressure). Only your doctor can tell you whether you have high blood pressure. Most doctors will check your blood pressure several times on different days before deciding that you have high blood pressure. If you have high blood pressure or prehypertension, you need to check your blood pressure regularly and keep in touch with your family doctor.


Systolic (first number) Diastolic (second number)
Normal Less than 120 Less than 80
Prehypertension 120–139 80–89
High blood pressure: Stage 1* 140–159 90–99
High blood pressure: Stage 2 160 or higher 100 or over
*If you have diabetes or kidney disease, high blood pressure ranges may be lower than it is for other people. Talk to your doctor about what is considered high blood pressure for you.

HOW DO I USE A DIGITAL MONITOR ?

Put the cuff around the arm. Turn the power on, and start the machine.
The cuff will inflate by itself with a push of a button on the automatic models. On the semiautomatic models, the cuff is inflated by squeezing the rubber bulb. After the cuff is inflated, the automatic mechanism will slowly reduce the cuff pressure.
Look at the display window to see your blood pressure reading. The machine will show your systolic and diastolic blood pressures on the screen. Write down your blood pressure, putting the systolic pressure before the diastolic pressure.
Press the exhaust button to release all of the air from the cuff.
If you want to repeat the measurement, wait 2 to 3 minutes before reinflating the cuff.

BLOOD PRESSURE

Understanding the medical terms
Blood pressure is the force of blood against the walls of the artery.
Hypertension means high blood pressure.
Hypotension means low blood pressure.
Brachial artery is a blood vessel that goes from your shoulder to just below your elbow. You measure the pressure in this artery.
Systolic pressure is the highest pressure in an artery when your heart is pumping blood to your body.
Diastolic pressure is the lowest pressure in an artery when your heart is at rest.
Blood pressure measurement is made up of both the systolic and the diastolic pressure. It is normally written like this: 120/80, with the systolic number first.

BLOOD PRESSURE MONITORING IS ESSENTIAL !

Why should I measure my blood pressure at home and keep a record of it?
Measuring your blood pressure at home and keeping a record of the measurements will show you and your doctor how much your blood pressure changes during the day. Your doctor can use the measurements to see how well your medicine is working to control your high blood pressure. Also, measuring your own blood pressure is a good way to take part in managing your health.
Features to look for in a blood pressure monitor
The right cuff size is very important. Ask your doctor, nurse or pharmacist to tell you the cuff size you need, based on the size of your arm. Blood pressure readings will be wrong if your cuff is the wrong size.
The numbers on the monitor must be easy for you to read.
If you are using a stethoscope, you must be able to hear heart sounds through it.
Cost may be an important factor. Since home blood pressure units vary in price, you may have to shop around. The most expensive units might not be the best or the most accurate.

AVERAGE BLOOD PRESSURE RANGE

BLOOD PRESSURE CHART

HOW TO KEEP YOUR BLOOD PRESSURE UNDER CONTROL

High blood pressure contributes to an alarming number of deaths each year. Although it may not have apparent symptoms, high blood pressure leads to heart attacks and strokes aside from also causing kidney failure. You can reduce your blood pressure by reducing your weight (if you're obese) and making a few small changes in your life, say doctors.

- Walk it out — Walking at a brisk pace can help lower your pressure. A good workout will ensure the heart uses oxygen more efficiently. Getting a rigorous cardio workout 4 to 5 times a week can make a huge difference. Start by incorporating about 15 minutes of exercise in your daily routine and slowly increase the time and difficulty level.

- Deep Breathing — Learning some slow breathing and meditation techniques can do you wonders. It will help reduce stress drastically and keep your blood pressure in check. Try taking out 10 minutes every morning and at night. Inhale and exhale deeply. If you can, join a yoga class for some time so that you can learn the proper method.

- Go for potassium-rich foods — You have probably heard of the negative effects of sodium on the body and potassium is an essential mineral to counter the effects of sodium on blood pressure. Fruits and vegetables are rich in potassium. Try adding sweet potatoes, tomatoes, orange juice, potatoes, bananas, peas, and prunes and raisins to your regular diet.

- Go slow on the salt — Whether you have a family history of high blood pressure or not, reducing your intake of salt can make a huge difference to your health. Before adding that extra pinch of salt to your food, think if you really need it. Try substituting salt with lime, garlic, pepper or other herbs and spices. Go slow on processed and packaged foods. Potato chips, frozen chicken nuggets, bacon etc are high in sodium. Try calculating your daily sodium consumption. Keep a food diary and you may be surprised at how much you're taking in.

- Dark chocolate benefits — The darker variety of chocolate has flavonols that make blood vessels more elastic. Choose one that has at least 70 per cent cocoa to really reap the benefits.

- Alcohol alert — While it does provide some health benefits, alcohol can also be bad for your health. If consumed in small amounts, it can help prevent heart attacks and coronary artery disease. But, more than one or two drinks and the benefits are gone. Keep a check on your drinking patterns and if you're a heavy drinker, start reducing slowly. Never indulge in binge drinking. Consuming four or five drinks in a row can cause a sudden increase in blood pressure.

- Tea benefits — Herbal teas are the way to go. In a study conducted, those who sipped on hibiscus tea daily lowered their blood pressure. Many herbal teas contain hibiscus or you can always opt for green tea. The effects of caffeine are still debatable. Drinking caffeinated beverages can temporarily increase pressure. The solution is to check your pressure within 30 minutes of drinking a cup of coffee to determine if it works for your body.

- Reduce work and relax — Reducing the number of hours you spend in office can help lower hypertension. Working overtime makes it hard to exercise and eat healthy. Ensure that you get out of office at a decent hour. Learning to relax by listening to soothing music (Classical, Oriental or Indian instrumental) can help.