Measurement of arterial pressure - the basic method of diagnostics of an arterial Hypertension symptoms.
Arterial pressure can is spontaneous vary over a wide range within day, week, months.
The arterial hypertensia is diagnosed on the basis of repeated measurements of arterial pressure. If arterial pressure is raised slightly repeated measurements are necessary for continuing within several months that as can be defined more precisely « usual, habitual » arterial pressure
On the other hand, if there is a substantial increase of arterial pressure, defeat of bodies of targets or high cardiovascular risk repeated measurements of arterial pressure spend within several weeks or days. As a rule, the diagnosis of an arterial Hypertension symptoms can be established on the basis of double measurement of arterial pressure at, at least, 2 or 3 visits though in especially heavy cases it can be diagnosed already at the first visit.
· Conditions of measurement arterial pressure (HELL)
o Measurement should be spent in quiet comfortable conditions at a room temperature.
o 30-60 minutes prior to measurement it is necessary to exclude the use to exclude smoking, reception of tonics, caffeine, alcohol, and also physical activity.
o The HELL is measured after rest of the patient within more than 5 minutes. If procedure was preceded with significant physical or emotional loading, the period of rest should be increased till 15-30 minutes Hypertension symptoms.
o The HELL is measured at various times day.
o Legs should is on a floor, and hands to be unbent and to lay freely at a level of heart.
· The Technique of measurement arterial pressure (HELL)
o The HELL on a humeral artery in position of the patient laying on a back or sitting in a convenient pose Is defined.
o The Cuff is imposed on a shoulder at a level of heart, its bottom edge on 2 sm above an elbow bend.
o The Cuff should be such size to cover 2/3 bicepses. The bubble of a cuff is considered long enough if it surrounds more than 80 % of a hand, and the width of a bubble is equal, at least 40 % from a circle of a hand. Hence, if measurement the HELL spend at the patient suffering adiposity it is necessary to use a cuff of the greater size.
o After clothing a cuff, in it force pressure up to values above expected Hypertension symptoms pressure.
o Then pressure gradually reduce (with a speed 2 ΠΌΠΌ.ΡΡ.ΡΡ./ΡΠ΅ΠΊ), and by means of ΡΠΎΠ½ΡΠ½Π΄ΠΎΡΠΊΠΎΠΏΠ° listen to tones of heart above a humeral artery of the same hand.
o It is not necessary to squeeze strongly an artery a membrane of a phonendoscope.
o That pressure at which the first tone of heart will be listened, is ΡΠΈΡΡΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΠΌ the HELL.
o Pressure at which tones of heart are not listened any more, name the HELL.
o By the Same principles are guided at measurement the HELL on a forearm (tones listen on a beam artery) and a hip (tones listen on a popliteal artery).
o Measurement the HELL is made three times, with an interval 1-3 minutes, on both hands.
o If first two measurements the HELL differ among themselves no more than on 5 mm hg, measurements should be stopped and average value of these sizes is accepted to a level of arterial pressure.
o If there is a distinction more than 5 mm hg, the third measurement which is compared to the second is spent, and then the fourth measurement is (if necessary carried out also.
o If tones are very weak, it is necessary to lift a hand and to execute some compressing movements by a brush, Hypertension symptoms then measurement repeat.
o At patients 65 years are more senior, at presence sugar Π΄ΠΌΠ°Π±Π΅ΡΠ° and at receiving Π°Π½ΡΠΈΠ³ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΠ²Π½ΡΡ therapy it is necessary to measure also the HELL in 2 minutes of stay in position standing.
o Patients with a vascular pathology (for example, at an atherosclerosis of arteries of the bottom finitenesses) accept definition the HELL on both top and bottom finitenesses. For this purpose the HELL is measured not only on humeral, but also on femoral arteries in position of the patient on a stomach (the artery is listened in popliteal poles).
o Hypertension symptoms
, containing mercury, are more exact, automatic devices for measurement the HELL in most cases less exact.
o Mechanical devices should be calibrated periodically.
· The Most frequent mistakes leading wrong measurement of arterial pressure
o Wrong position of a hand of the patient.
o Use of the cuff mismatching scope of a shoulder at completeness of hands (the rubber inflated part of a cuff should cover not less than 80 % of a circle of a hand).
o Small time of adaptation of the patient to conditions of a medical cabinet.
o High speed of pressure decrease in a cuff.
o Absence of the control of asymmetry of arterial pressure.
· Self-checking by the patient of arterial pressure
The major information is given to the doctor with self-checking by the patient of arterial pressure in out-patient conditions.
o To receive additional data on decrease (rises) of arterial pressure in the end of an interval of batching Hypertension symptoms means.
o To raise adherence of the patient to treatment.
o To receive the average parameter for some days which, according to researches, has greater reproducibility and value in comparison with "office" arterial pressure.
The mode and duration of self-checking, type of the used device steal up individually.
It is necessary to note, that few of the existing devices assuming measurement of arterial pressure upon a wrist Hypertension symptoms, have passed adequate Π²Π°Π»ΠΈΠ΄ΠΈΠ·Π°ΡΠΈΡ.
It is not necessary to recommend house measurement of arterial pressure if it causes alarm in the patient or conducts to independent change of the scheme of treatment.
It is necessary to inform the patient, that normal values of the arterial pressure measured in various conditions, differ from each other a little.
Target "normal" figures of arterial pressure.
Conditions of measurement
Systola the HELL
Diastola the HELL
Office, or clinical
NEWS and PUBLICITY
absolutely healthy That who considers itself absolutely healthy, it is recommended to measure pressure not less often than time in 3 months. To the people, suffering Hypertension symptoms.
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