Blood pressure

Question 1

Aim of manual blood pressure taking

Answer 1

Reliability
Accuracy
Ease of spotting Atrial Fibrillation

Question 2

What is an average BP range for a healthy adult and what are the target?

Answer 2

120/80 mmHg.

Clinic BP <140/90 mmHg under 80 years
Ambulatory or Home BP <135/85 mmHg under 80 years
Clinic BP < 130/80 mmHg should be considered for those with established atherosclerotic cardiovascular disease, or diabetes in the presence of kidney, eye, or cerebrovascular disease.

Question 3

What would a patients BP have to be to classify as stage 2 hypertension?

Answer 3

Clinic blood pressure 160/100 mmHg or higher,andambulatory daytime average or home blood pressure average 150/95 mmHg or higher

Question 4

Blood pressure monitoring - considerations

Answer 4

Service provision and service specification
	Current guidelines
	Patient factors
	Consent
	Likely outcome
	Likely next steps
	Equipment 
	Hygiene / infection control
	Documenting / reporting

Question 5

How to estimate systolic blood pressure

Answer 5

To estimate Systolic find the patients radial pulse
Ensure air is released from air valve, then tighten
Pump cuff rapidly to 70mmHg and then by 10mmHg intervals using the air bulb
Note the level ofpressureat which the pulse disappears and subsequently reappears during deflation (untighten air valve)
This will be thesystolicblood pressure

Question 6

Define systolic blood pressure

Answer 6

Systolic pressure = maxpressureyour heart exerts while beating (ventricular contraction)

Question 7

Define Diastolic blood pressure

Answer 7

Diastolic pressure = amount ofpressurein your arteries between beats (when heart is at rest) (ventricles filling)

Question 8

How to measure BP manually

Answer 8

Place your stethoscope over the brachial artery
With valve closed, inflate cuff 20 -30mmHg beyond the estimate
Slowly open the valve releasing pressure from cuff, ideally 2-3 mmHg per second
You’re listening for when you start to hear the beats - Systolic
… and then when they disappear - Diastolic

Question 9

What sound are you listening?

Answer 9

Korotkoff sounds

Question 10

Stage 1 Hypertension

Answer 10

clinic BP 140/90 mmHg or higher with subsequent ABPM above 135/85 mmHg

Question 11

Stage 2 Hypertension

Answer 11

(clinic BP 160/100 mmHg or higher with subsequent*) ABPM above 150/95 mmHg

Question 12

Stage 3 hypertension

Answer 12

Severe hypertension (SHT) – clinic SBP above 180 mmHg or clinic DBP above 120 mmHg.