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For a better understanding of blood pressure The follow-up of a high blood pressure
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IX - A good means of controling high blood pressure : The self-measurement of blood pressure

The measurement of the blood pressure by the patient himself defines the self-measurement of blood pressure or the out-to-the-office measurement. Thanks to new automatic devices, this blood pressure measurement becomes increasingly widespread, and could be used more and more in a few years time.

As a diabetic patient can manage his treatment, patients with high blood pressure must be able to measure their blood pressure in order to manage better.

10.1 - Why using a self-measurement device?
10.2 - The self-measurement device
10.3 - The Inflation and deflating of the cuff
10.4 - Ideal anatomical site for the measurement of the blood pressure
10.5 - Validation of the device
10.6 - Conditions and number of measurements

10.1 - Why using a self-measurement device?

10.1.1 - To evaluate the level of blood pressure as well as possible - Blood pressure fluctuation

The blood pressure level is extremely variable according to many factors detailed bellow:

  • Heart beats
  • The breathing cycle
  • The cycle during the day (day/night variation)
  • Nervous regulation of the blood pressure
  • Hormonal regulation of the blood pressure
  • External stress
  • Physical activities
  • Environment : temperature of the air, season...
  • Alcohol, diet, coffee, tobacco
  • Drugs

It is very important to evaluate a blood pressure as precisely as possible because the practitioner needs a reliable value of the blood pressure before using an antihypertensive drug therapy for his patient.

This measurement is interesting because 20 to 30% of the patients who have a high blood pressure in the physician office are in fact not hypertensive. This effect is called the white coat hypertension and is defined as a rise in the blood pressure induced by the presence of the doctor. This high blood pressure is only due to stress. In order to obtain an accurate evaluation of the blood pressure value, the number of measurements should be increased

Indeed, many medical studies have showed that the higher the number of blood pressure measurements the more reliable the precision will be.

In this case, the ambulatory blood pressure measurement during 24 hours is currently used.
The other technique consists of measuring the blood pressure only a few times during the day, for a few days in a row. Physicians committees have proved that at least 15 measurements were necessary to appreciate the real value of the blood pressure.

These measurements must be collected in the same conditions to have an optimal reliability.
High blood pressure is defined by a value of blood pressure up to 135 millimetres of mercury for the systolic blood pressure and 85 millimetres of mercury for the diastolic blood pressure.

10.1.2 - Another advantage of the self-measurement device: to control the blood pressure when symptoms appear

Self-measurement of the blood pressure device makes it possible to control the blood pressure when symptoms appear like a faintness, a loss of consciousness (symptoms of hypotension), headaches, a nosebleed or neurological symptoms (confusion, agitation&.).

A high or low blood pressure measured on the device can thus induce a consultation in the physician office or in the emergency service in the hospital.

10.1.3 - Interest of the self-measurement device to evaluate the effectiveness of an antihypertensive drug therapy

Before the regulation of the antihypertensive drug therapy, a precise evaluation of the value of the blood pressure is important for the practitioner who wants to eliminate the white-coat hypertension. This kind of hypertension should not be treated. Moreover, the practitioner can adapt the exact dose of an antihypertensive drug to the values of the blood pressure.

When the antihypertensive drug therapy is undertaken, the self-measurement of the blood pressure enables the practitioner and the patient to make sure that the treatment is effective and must be continued.

Thanks to this device, the patient can control his high blood pressure and note the effectiveness of his efforts.

File last modified on : 28 sep 2003

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