High blood pressure, like a silent killer hidden in his body, threatens people’s health silently. For high blood pressure patients, day-to-day monitoring of blood pressure is a crucial part of managing the condition and preventing complications, as is the case for health posts, where the abnormal fluctuations in blood pressure are always observed.
Monitoring tools and methodologies
1. Choice of sphygmomanometers: The sphygmomanometers on the market are diverse and common in electronic sphygmomanometers and mercury sphygmomanometers. Electronic sphygmomanometers are simple, read intuitive and suitable for domestic use. Of these, upper arm electro-sphygmomanometers are relatively high in accuracy and are the preferred for household blood pressure monitoring. Formally produced and certified products should be selected for purchase to ensure accuracy of measurements. Mercury sphygmomanometers, although measured more accurately, require certain operational skills and may be used inappropriately to cause mercury leakage and contamination of the environment. If a mercury sphygmomanometer is chosen, learn to use it correctly and calibrate regularly.
2. Measuring time and frequency: The time for measuring blood pressure should be relatively fixed to better compare blood pressure changes. In general, the blood pressure is measured within one hour of getting up in the morning, after urination, before breakfast (before taking a depressurizer), at which time it reflects the basic blood pressure level; it is measured once in the evening, before sleeping, to understand how the blood pressure fluctuates in the day. For patients whose blood pressure control is unstable or who have just started treatment, the number of measurements can be increased at noon or other times when it feels inappropriate. At the measured frequency, patients with stable blood pressure can be measured for 1-2 days per week; patients with high blood pressure fluctuations or in the process of adjusting their treatment are measured daily.
II. Measuring concerns
1. Pre-measurement preparation: within 30 minutes of measuring blood pressure, severe exercise, smoking, coffee or tea should be avoided, which may result in a temporary increase in blood pressure and affect the accuracy of the measurements. At the same time, it is important to remain quiet, to sit in a chair with a back, with a natural downsliding of legs, to relax and rest for 5 – 10 minutes. When measured, the arm should be at the same level as the heart, and the arm could be placed on the table to keep the cuff Centre in line with the heart.
cuffband selection and wearing: The cuffbands of appropriate sizes are selected in the light of the arms, so that too narrow or too loose the cuff belts result in high measurements and too wide or too tight the measurements are low. Generally, cuffband airbags should cover at least 80% of the upper arm radius. When wearing cufflinks, the cuffband shall be tied flatly to the upper arm, 2 – 3 cm below the elbow nest, loose to fit to insert 1-2.
III. Records and analysis of blood pressure data
1. Importance of records: For each blood pressure measure, the measurement time, blood pressure values (constriction and condensation) and heart rate are carefully recorded. Records can be easily viewed and collated using a special blood pressure recorder or mobile phone application. Long-term records provide an intuitive understanding of blood pressure trends and provide an important basis for doctors to adjust their treatment programmes.
2. Analysis of changes in blood pressure: When observing blood pressure data, care shall be taken of the extent of fluctuations in blood pressure. As a rule, human blood pressure fluctuates in one day, showing a pattern of double-peaks, i.e. high at 6-10 a.m. and 4-8 p.m. and low at 2-3 a.m. If blood pressure is found to increase or decrease continuously over a period of time, beyond normal fluctuations, or is excessive, doctors should be informed in a timely manner. For example, if blood pressure is significantly higher than normal after getting up in the mornings for a few consecutive days, it may be indicative of poor night blood pressure control and the need to adjust treatment; if blood pressure suddenly decreases, it may be overdoses or other health problems have occurred, and attention needs to be given.
Other monitoring indicators
Heart rate monitoring: Heart rate is one of the important indicators of heart function, and hypertension is often accompanied by heart rate anomalies. When measuring blood pressure, the heart rate can be recorded at the same time. The heart rate of normal adults is between 60 and 100 per cent and can increase the risk of cardiovascular disease if the heart rate is too high or too slow. For example, the long-term heart rate exceeds 80 times/min, which may be related to the increased incidence of cardiovascular events in patients with hypertension. For patients with an abnormal heart rate, doctors may adjust the medication, such as β-receptor retardants, to control the heart rate.
Symptomological monitoring: In addition to blood pressure and heart rate, patients with hypertension are concerned with their own symptoms. In the case of headaches, dizziness, heart attack, chest suffocation, nose bleeding, blurred vision, these symptoms may be associated with increased blood pressure or complications. If these symptoms occur, blood pressure should be measured in a timely manner and the specific conditions of the symptoms, such as the severity, duration, frequency of onset, etc., should be recorded and the doctor informed for further examination and diagnosis. For example, headaches are accompanied by a sharp rise in blood pressure, which may be a manifestation of hypertension and require immediate medical treatment.
Daily monitoring of patients with hypertension is a long and detailed “health-care war”. By correctly choosing sphygmomanometers, regulating blood pressure measurements, carefully recording and analysing data and paying attention to other relevant indicators, patients are able to keep abreast of their blood pressure changes, to work closely with doctors, to adjust treatment programmes, to keep blood pressure within the desired range and to effectively prevent the occurrence of complications such as cardiovascular diseases, and to provide a solid foundation for healthy living. Let every blood pressure measure be a powerful act to protect health, to keep blood pressure steady and healthy.
