Home Articles How to measure blood pressure correctly
Adapting medical technologies to the needs of patients makes it possible to monitor blood pressure (BP) values independently. To do this, you need to buy a mechanical or electronic tonometer at the pharmacy. Knowing how to correctly measure blood pressure, you can assess your condition or provide assistance to a loved one. Regular monitoring of blood pressure is necessary for patients with cardiovascular pathologies, diabetics, elderly people, and bedridden patients.
What is intracranial pressure?
This is the pressure inside the cranial cavity. The brain is surrounded by cerebrospinal fluid, a fluid that is necessary to nourish nerve tissue. It is constantly produced and flows from the skull. Due to this process, optimal pressure inside the skull is maintained. Normally it is 10-15 mmHg. Art.
Intracranial pressure is the force with which the brain presses on the walls of the skull
We are talking about high intracranial pressure when the readings exceed 25 mmHg. Art. The critical value is 35 mmHg. Art. and more. The patient is diagnosed with intracranial hypertension or liquor-hypertensive syndrome.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Pathology never occurs independently; it appears for a number of reasons - both congenital and acquired. Slight fluctuations in the direction of increasing intracranial pressure (ICP) are possible when tilting the head, physical activity, or sneezing. But high rates are a consequence of more severe conditions:
- traumatic brain injury (TBI), back injury with spinal cord damage;
- brain tumors, cysts, abscesses;
- hydrocephalus;
- aneurysm or vascular thrombosis;
- infectious diseases: encephalitis, meningitis;
- swelling of the brain after a stroke;
- encephalopathy;
- intracerebral hemorrhage;
- taking potent drugs that can disrupt the production and circulation of cerebrospinal fluid: hormonal agents, antibiotics and others;
- intoxication with chemicals.
At risk are hypertensive patients, people with metabolic disorders, obesity, vascular pathologies, patients who have had a stroke, or surgery on the brain or spinal cord.
Note! Patients with hypertension do not necessarily develop intracranial hypertension. Sometimes even hypotensive people suffer from high ICP.
The causes of high ICP in adults and children are similar. But often the appearance of intracranial hypertension in a child is facilitated by congenital developmental anomalies (hydrocephalus or microcephaly), birth injuries, oxygen starvation, and asphyxia. Premature babies are at risk.
The pressure inside the skull increases for two reasons: cerebrospinal fluid is produced in excess or it flows worse
Depending on the cause of its occurrence, the syndrome can occur in acute or chronic form. The first one is caused by injuries and neuroinfections. The chronic form develops gradually as brain tumors grow and cerebrovascular accidents occur.
If intracranial pressure increases, it is necessary to obtain qualified help from a neurologist. It is important not only to detect the underlying cause and eliminate it, but also to restore impaired cerebrospinal fluid dynamics. If this is not done, the symptoms of the disease will persist even after treatment of inflammation, head or back injury, or tumor removal.
Measuring blood pressure in people with a large upper arm circumference.
The measurement cuff must be selected according to the ruler supplied with the tonometer.
In persons with a large upper arm circumference (obesity, well-developed muscles) or those with a conical-shaped arm, it is difficult to position the cuff correctly, which makes it much more difficult to accurately measure blood pressure. In this case, you need to choose a larger cuff of 32-42 cm with an inner chamber of 15x30 cm (corresponding to size L) or a universal cuff of 22-42 cm.
Blood pressure monitors with a wrist cuff can be used, but the possible difference in pressure between the shoulder and the wrist should be taken into account (with age or disease, the elasticity of the wrist vessels decreases faster than the brachial vessels, which leads to lower blood pressure readings at the wrist).
Can there be a noise in the head due to intracranial pressure?
Head noise and intracranial pressure are interrelated. With high ICP, the patient experiences discomfort from unpleasant buzzing, buzzing, hissing or ringing sounds. The intensity varies depending on the underlying disease.
Headache, noise in the head and ears are the main symptoms of high intracranial pressure. During the day, these symptoms may disappear on their own, reappear suddenly, or develop gradually, repeating over a long period of time.
Their feature:
- worsen in a horizontal position, so the clinical picture is most pronounced in the morning;
- bursting headache, pressing from the inside, not relieved by painkillers;
- pain spreads throughout the entire skull, most pronounced in the forehead, temples and back of the head.
Along with noise and pain in the head, the patient feels like something is pressing on the eyes, which causes vision to deteriorate and blurredness occurs. The pressure increases when the eyeballs move.
With ICP, cerebral vessels dilate, blood flow to the brain increases and its outflow decreases.
Other signs of the disease:
- nausea and vomiting (at the peak of the headache);
- dizziness;
- weather sensitivity;
- sleep disturbance;
- weakness, drowsiness;
- increased sweating;
- blood pressure surges;
- decreased performance;
- deterioration of memory, attention, intellectual abilities.
With high ICP levels, blood pressure increases, breathing is depressed and the pulse slows down, and the person loses consciousness. In severe cases, when vital structures of the brain are damaged, acute cerebrovascular accident occurs, convulsions, coma and death are likely.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Important! Impaired consciousness occurs when ICP increases to 30-40 mmHg. Art., coma – 40-50 mm Hg. Art., death – 50 mm Hg. Art. and higher.
We cannot wait for such serious complications. At the first signs of deterioration in health, you should consult a doctor.
Constant noise in the head is a common consequence of chronic cerebrovascular accident, against the background of which both arterial and intracranial hypertension can develop. Both conditions are life-threatening and can lead to stroke. Their diagnosis and treatment should be carried out by an experienced specialist.
Measuring blood pressure in older people.
In an elderly person, it is more difficult to achieve complete and lasting normalization of blood pressure.
There may be several reasons. With age, the severity of arterial hypertension and the number of concomitant diseases increase; it is more difficult to persuade an elderly person to undergo treatment regularly, especially with decades of experience of high blood pressure. In older people, instability of blood pressure is more common. This is influenced by a decrease in the elasticity of the walls of blood vessels and atherosclerosis due to aging, as well as disturbances in the functioning of blood flow regulation systems. When measuring blood pressure in the elderly, it is especially important to take several consecutive measurements (at least 3) and record their average value. This procedure is greatly simplified by electronic blood pressure meters with MAM technology (Microlife Average Measurement), which perform sequential triple measurements with calculation of an optimized result.
In the elderly, episodes of a sudden drop in blood pressure are common - postural hypotension (a sharp drop in pressure during the transition from the “lying” state to the “sitting” or “standing” state). It is recommended that arterial blood measurements be taken both while sitting and standing, especially in the presence of hypotension or during antihypertensive therapy. In persons over 65 years of age, with concomitant diabetes mellitus and antihypertensive therapy, blood pressure should also be measured after 2 minutes of standing.
Which doctor should I contact?
If symptoms of liquor-hypertensive syndrome appear, you should contact a neurologist. An experienced specialist can be seen at the medical office by appointment. You can make an appointment by phone @. The doctor will see you at a time convenient for the patient.
The neurologist from the SmartMed clinic has many years of experience in treating noise in the head of various origins, including those caused by intracranial hypertension. To determine the cause of poor health, the doctor will conduct a visual examination.
The examination begins with a study of the patient's complaints and neurological testing. It is important for the doctor to know the person’s medical history, conditions of occurrence, frequency and intensity of noise in the head.
Increased VChP cannot be determined by external signs
The doctor must prescribe instrumental research methods:
- Spinal or lumbar puncture. Designed not only for studying cerebrospinal fluid, but also for measuring intracranial pressure. The procedure is invasive and involves inserting a puncture needle into the spinal canal and then connecting a pressure gauge.
- MRI of the head. Allows you to identify the causes and signs of intracranial hypertension: cerebral edema, vascular thrombosis, enlargement or narrowing of the cerebral ventricles, cysts, tumors, hematomas, hemorrhages. The study is the most informative and safe. In medical MRI of the head, it is carried out on a new ultra-precise Siemens Symphony 1.5 Tesla tomograph, thanks to which it is possible to obtain a highly accurate 3D image. The examination takes no more than 15 minutes, no special preparation is required.
- Ultrasound of the head. Used for children of the first year of life. The study is carried out through an open fontanel.
- Ultrasound of the vessels supplying the brain. Allows you to assess the condition of the arteries, as well as the direction, speed and intensity of blood flow in them, to identify the main vascular disorders that can cause high ICP and noise in the head.
- Electroencephalography. Designed to study the electrical activity of the brain, it allows you to identify areas of irritation of various brain structures.
Additionally, the neurologist may prescribe a consultation with an ophthalmologist. Papilledema, which can be detected during fundus examination, is a sure sign of increased ICP. If necessary, other highly specialized specialists are involved in the examination: a neurosurgeon, an oncologist.
Important! The reliability of the examination for intracranial pressure depends on the technical parameters of the diagnostic equipment and the qualifications of the diagnostician.
Measuring blood pressure in people with arrhythmia.
Arrhythmia is a violation of the frequency, rhythm and sequence of contractions of the heart. In people with arrhythmias, systolic pressure can vary significantly from beat to beat.
To assess the level of blood pressure in such a situation and obtain a reliable result, it is necessary to perform several consecutive measurements (at least 3), and then calculate the average value of the measurements. Modern devices with MAM (Microlife Average Measurement) technology allow you to do this by pressing only one button. When using mechanical blood pressure monitors, deflate the cuff more slowly.
Today, there are electronic blood pressure meters with PAD (Pulse Arrhythmia Detection) technology, which makes it possible to obtain an accurate result in individuals with pulse arrhythmia.
Measuring blood pressure in pregnant women.
Blood pressure in pregnant women is one of the important indicators on which general and uterine blood circulation and the successful course of pregnancy depend.
The presence of arterial hypertension before pregnancy or that develops during pregnancy can often interfere with successful delivery. In order to minimize the likelihood of serious complications in the mother and child by normalizing blood pressure, there are modern control methods, including mandatory and repeated blood pressure measurements during pregnancy and training pregnant women in self-control skills.
Blood pressure in pregnant women should be measured in a reclining position. The “white coat effect” is observed in 30% of pregnant women. To avoid unnecessary treatment, you need to regularly monitor your blood pressure at home!
