Recently, the 31st scientific conference of the European Society of Hypertension " Hypertension and Cardiovascular Protection" released data. In the past 30 years, the number of hypertension patients aged 30 to 79 worldwide has increased from 650 million to 1.28 billion.
As a chronic disease, hypertension requires long-term monitoring and management. Self-testing of blood pressure at home is one of the important measures for prevention and control.
But many people think that self-testing of blood pressure is not accurate, and the values of the left and right arms are different. Should we use the left or right side as the basis?
On October 8 is National Hypertension Day . " Life Times " invites experts to interpret the differences in blood pressure between left and right hands and teaches you scientific ways to measure blood pressure.
interviewed experts
Peking University People's Hospital Chief physician of the Department of Cardiology Liu Jian
Chief physician of the Department of Cardiovascular Medicine of the Chinese Academy of Chinese Medical Sciences Xiyuan Hospital Xu Hao
Associate Chief physician of the Department of Cardiovascular Medicine of Shenzhen University General Hospital Dong Fengquan
The blood pressure of the human limbs has a regularity
Under normal circumstances, the blood pressure of the human limbs has a certain regularity.
The blood pressure on the right upper arm is 5~10mm Hg higher than the left upper arm, and the blood pressure on the left and right lower limbs is basically the same. The systolic pressure on the lower limbs is 20~40mm Hg higher than the upper limbs.
However, if a blood vessel in the upper limb or lower limb is blocked, the above difference is likely to be abnormal.
Right arm vs left arm, which one is more accurate?
Theoretically, the side closest to the source has greater pressure, just like the tap closest to the water source always has the largest pressure and the fastest water outlet.
The right hand The brachial artery comes from the trunk branch of the cephalic cephalic stalk, and the left hand brachial artery comes from the left subclavian artery. According to the "faucet water outlet" theory, the blood pressure measured by the right arm must be higher than the left arm.
Therefore, the authoritative "Diagnostics" recommends that the blood pressure on the right arm is to measure the blood pressure on the right hand.
However, some doctors compared the blood pressure of left and right upper arms of hundreds of patients and found that most people's left upper arm diastolic pressure is slightly higher than the right upper arm. Judging from anatomy , the distance between the blood from the heart to the right brachial artery is a little further away than to the left brachial artery. In this way, the blood pressure on the right upper arm is lower than that of the left upper arm, which seems reasonable.
According to the latest "China Hypertension Prevention and Treatment Guidelines (2018 Revised Edition)", should measure the blood pressure on the left and right upper arms during the first diagnosis, and the side with the higher blood pressure reading should be used as the measurement upper arms .
6Type people need to measure the blood pressure of the limbs
Usually, they only measure the blood pressure of one arm, why do they sometimes test the limbs when they go to the hospital? In fact, blood pressure measurement of limbs is an important clinical examination method.
Through synchronous measurement of blood pressure in the limbs, the blood pressure difference between the two arms, the blood pressure difference between the two ankles and the ankle index can be calculated and obtained. These parameters can help doctors to conduct clinical diagnosis and predict the risk of cardiovascular disease.
Who needs to measure blood pressure in the limbs? The "Chinese Expert Consensus on the Measurement of Blood Pressure in Adults" gives the key recommendation group:
1. If the blood pressure difference between the arms is increased, if the systolic pressure difference between the upper limbs is greater than 20 mmHg, the blood pressure of the limbs should be measured to fully understand the systemic vascular lesions.
2. Adolescent hypertensive patients can eliminate congenital heart disease by measuring the blood pressure of limbs .
3. Patients with acute chest pain mainly use differential diagnosis of acute aortic dissection.
4. In patients with intermittent claudication or limb weakness, fear of cold, and diabetes , blood pressure measurement of limbs can help diagnose lower limb arterial disease.
5. The degree of blood pressure increase is not consistent with the damage to the target organ, and patients with refractory hypertension can help find the specific cause.
6. Patients with suspected large arteritis or who have suffered from large arteritis in the past may experience differences in blood pressure in the limbs.
Since the difference in blood pressure in the limbs is related to the risk of cardiovascular disease, blood pressure measurement of limbs can also be used as a screening measure for high-risk patients with cardiovascular disease.
When is the blood pressure measurement more accurately during the day?
There are two peaks in the daytime blood pressure: 6 to 10 am and 16 to 20 pm. During these two time periods, you can understand the maximum blood pressure in the day.
blood pressure is measured within 2 to 6 hours after taking antihypertensive drugs, which can reflect the maximum antihypertensive effect of the drug.
It should be noted that patients with hypertension should choose to measure at a fixed time every day. The rhythmicity of the blood pressure rise time is different. Patients should conduct self-tests frequently in order to understand the pattern of blood pressure changes.
When you experience discomfort such as headache or dizziness, you should self-test in time; when you start taking medicine or change antihypertensive drugs, you should monitor your blood pressure regularly at home.
Additional hypertension patients or patients with unstable blood pressure
It is recommended to measure blood pressure every morning and evening. When measuring blood pressure, it should be measured at least twice, with an interval of 1 to 2 minutes.
If the difference is ≤5 mmHg, take the average value of the two measurements; if the difference is 5 mmHg, measure again and take the average value of the 3 readings.
It is recommended to measure the family blood pressure continuously for 7 days, and the average blood pressure value will be taken 6 days after 6 days.
blood pressure control is stable and meets the standards
can self-test blood pressure for 1 to 2 days a week, once in the morning and evening. The date, time and all blood pressure readings should be recorded in detail after each measurement, rather than just the average.
There is a standard "position" for blood pressure measurement
Normal blood pressure should be systolic blood pressure <120>
3 Avoid smoking and alcohol before measuring blood pressure
Avoid drinking coffee, drinking and smoking 30 minutes before measuring blood pressure, sit in the backrest chair and rest for 3 to 5 minutes. It is best not to talk or talk during pressure measurement.
Adjust the elasticity of the cuff and the size
Use a cuff of appropriate size. The middle part of the cuff airbag is placed above the brachial artery of the upper arm. Do not roll up the edge of the cuff. The lower edge of the cuff is 2~3 cm above the elbow.
cuffs should be moderately tight. It is generally believed that it is more appropriate to fit 1 to 2 fingers into it.
This posture is more accurate in measuring blood pressure
When measuring, the middle of the upper arm cuff should be on the same horizontal line as the heart. It is best to place your arms straight on the table to maintain a comfortable position.
The blood pressure of the left and right upper arms should be measured for the first time. When the blood pressure of the left and right upper arms is inconsistent, the blood pressure value measured by the arm on the side with a higher value is used.
If the blood pressure is unstable or is in the adjustment period of antihypertensive drugs, if the blood pressure fluctuates greatly, the number of blood pressure monitoring can be increased. When the blood pressure is high, the measurement should be repeated several times before seeking medical treatment in time. The type and dosage of antihypertensive drugs should not be adjusted by yourself.
Patients with high mental anxiety are not recommended to frequently self-test blood pressure. ▲
Editor of this issue: Xu Menglian
Copyright Statement: This article is original by "Life Times" and reproduction is prohibited without authorization.
