IX -
A good means of controling high blood pressure : The self-measurement
of blood pressure
The measurement of the blood pressure by the patient himself defines the self-measurement
of blood pressure or the out-to-the-office measurement. Thanks to new automatic
devices, this blood pressure measurement becomes increasingly widespread, and
could be used more and more in a few years time.
As a diabetic patient can
manage his treatment, patients with high blood pressure must be able
to measure their blood pressure in order to manage better.
10.1 - Why
using a self-measurement device?
10.2
- The self-measurement device
10.3 - The Inflation
and deflating of the cuff
10.4 - Ideal anatomical
site for the measurement of the blood pressure
10.5 - Validation
of the device
10.6 - Conditions
and number of measurements
10.1 - Why
using a self-measurement device?
10.1.1 - To evaluate
the level of blood pressure as well as possible
10.1.1.1
- Blood pressure fluctuation
The blood pressure level
is extremely variable according to many factors detailed bellow:
- Heart beats
- The breathing cycle
- The cycle during the
day (day/night variation)
- Nervous regulation of
the blood pressure
- Hormonal regulation of
the blood pressure
- External stress
- Physical activities
- Environment : temperature
of the air, season...
- Alcohol, diet, coffee,
tobacco
- Drugs
It is very important to
evaluate a blood pressure as precisely as possible because the practitioner
needs a reliable value of the blood pressure before using an antihypertensive
drug therapy for his patient.
This measurement is interesting
because 20 to 30% of the patients who have a high blood pressure
in the physician office are in fact not hypertensive. This effect
is called the “white coat hypertension” and is defined
as a rise in the blood pressure induced by the presence of the doctor.
This high blood pressure is only due to stress.
10.1.1.2 – In
order to obtain an accurate evaluation of the blood pressure value,
the number of measurements should be increased
Indeed, many medical studies
have showed that the higher the number of blood pressure measurements
the more reliable the precision will be.
In this case, the ambulatory
blood pressure measurement during 24 hours is currently used.
The other technique consists of measuring the blood pressure only a few times
during the day, for a few days in a row. Physicians committees have proved
that at least 15 measurements were necessary to appreciate the real value of
the blood pressure.
These measurements must
be collected in the same conditions to have an optimal reliability.
High blood pressure is defined by a value of blood pressure up to 135 millimetres
of mercury for the systolic blood pressure and 85 millimetres of mercury for
the diastolic blood pressure.
10.1.2 - Another advantage
of the self-measurement device: to control the blood pressure when
symptoms appear
Self-measurement of the
blood pressure device makes it possible to control the blood pressure
when symptoms appear like a faintness, a loss of consciousness (symptoms
of hypotension), headaches, a nosebleed or neurological symptoms
(confusion, agitation….).
A high or low blood pressure
measured on the device can thus induce a consultation in the physician
office or in the emergency service in the hospital.
10.1.3 - Interest of
the self-measurement device to evaluate the effectiveness of an
antihypertensive drug therapy
Before the regulation of
the antihypertensive drug therapy, a precise evaluation of the value
of the blood pressure is important for the practitioner who wants
to eliminate the white-coat hypertension. This kind of hypertension
should not be treated. Moreover, the practitioner can adapt the exact
dose of an antihypertensive drug to the values of the blood pressure.
When the antihypertensive
drug therapy is undertaken, the self-measurement of the blood pressure
enables the practitioner and the patient to make sure that the treatment
is effective and must be continued.
Thanks to this device,
the patient can control his high blood pressure and note the effectiveness
of his efforts.
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last modified on : 28 sep 2003 |
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