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Stella Palar
METHODS :
BP MEASUREMENT :
- In the Clinic
- Self Measurement
- ABPM
The Auscultator Method
Korotkoff sounds
200 No sound
180
Clear sound Phase 1 Systolic BP
160
Muffling Phase 2
Auscultatory
140 No sound gap
120
Phase 3
Clear sound Phase 3
100
Muffled sound Phase 4
Phase 4
80 Diastolic BP
60
40 No sound Phase 5
20
0
mmHg
Recommended Equipment for
Measuring Blood Pressure
Automated oscillometric
devices:
Use a validated automated device
according to BHS, AAMI or IP
clinical protocols.
Patient
1. No acute anxiety, stress or pain.
2. No caffeine, smoking or nicotine in the
preceding 30 minutes.
3. No use of substances containing
adrenergic stimulants such as
phenylephrine or pseudoephedrine (may
be present in nasal decongestants or
ophthalmic drops).
4. Bladder and bowel comfortable.
5. No tight clothing on arm or forearm.
6. Quiet room with comfortable temperature
7. Rest for at least 5 minutes before
measurement
8. Patient should stay silent prior and during
the procedure.
Blood Pressure Measurement in the
Clinic:
Patient preparation and posture
Standardized technique:
Posture
From 18 to 26 9 x 18 (child)
12 x 23 (standard adult
From 26 to 33
model)
From 33 to 41 15 x 33 (large)
18 x 36 (extra large,
More than 41
obese)
The seated BP
measurement is the
standard position to
determine diagnostic
and therapeutic
treatment decisions
- duplicate measures,
Monitors A&D or LifeSource Models: 705, 767, 767PAC, 767Plus, 774, 774AC, 779, 787, 787AC
Monitors Omron Models: HEM-705 PC, HEM-711, HEM-741CINT
Monitors Microlife or Thermor (also sold under different brand names)
Models: BP 3BTO-A, BP 3AC1-1, BP 3AC1-1 PC, BP 3AC1-2, BP 3AG1, BP 3BTO-1,BP 3BTO-A (2), BP
3BTO-AP, RM 100, BP A100 Plus, BP A 100
Home BP 135 85
Ambulatory BP
24 hour 130 80
Day 135 85
Night 120 70
Japan Society of Hypertension 2009
Ambulatory Blood Pressure Monitoring -
ABPM
1. 24 hour B.P monitoring
2. Today - 24 hour B.P. control is essential
3. Identifies dippers and non-dippers
4. Excludes white coat hypertension
27
Stage 2 hypertensive dipper
Hypertensive Non-Dipper