World Heart Day: Measure the right BP to get your BP right!

Around 26% of Indian adults between the ages of 45-59 years and 32% of those above the age of 60 are affected.

world health day
In the management of hypertension, one important aspect that is often overlooked is the right way of BP measurement.
By Dr Vinay Kumar Bahl,

It was a Sunday morning when I got a frantic call from a patient, a 50 year old male banker – ‘Doctor, I think I have an attack of high blood pressure – my upper number (systolic) is coming as 160!’ Knowing his medical history, I knew that he had mild hypertension that was well under control, and so I decided to dig deeper. He had just come from a run and walked up seven flights of stairs and as he was breathless, his worried wife had checked his blood pressure on a home digital BP machine. I reassured him that it was normal for blood pressure to increase during exercise and that the systolic can reach a level of 200 mmHg with intense exercise.

This was not the first time that this had happened. I have had calls reporting a “very high” abnormal reading. Unfortunately, hypertension is extremely common in India with a high prevalence in the younger working class population. Around 26% of Indian adults between the ages of 45-59 years and 32% of those above the age of 60 are affected. Prolonged uncontrolled high blood pressure damages blood vessels and can lead to a heart attack, stroke, aneurysm (swelling in the wall of blood vessels making it weak), heart failure, kidney damage, loss of vision, and peripheral artery disease. In 2019, hypertension caused more than half the cases of coronary heart disease, stroke and heart failure around the world, and more than 10 million deaths. High blood pressure is responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. The reason the condition is termed as ‘silent killer’ is because more than 30% of people who have high blood pressure are not even aware of it. Hence it is critical to treat, manage, and control hypertension.

In the management of hypertension, one important aspect that is often overlooked is the right way of BP measurement. This is crucial as the dose of the medication depends on how well the BP is being controlled. Earlier, patients usually had their blood pressure checked at a doctor’s clinic. However, with the advent of digital BP measuring instruments being easily available and affordable, more individuals tend to check their BP at home itself. While measuring BP is a common procedure, one can get inaccurate readings if done incorrectly. Errors in BP measurements due to the wrong technique may lead to not just an improper diagnosis but also an incorrect treatment.

Here are some practical tips to be followed for BP measurement that will help ensure accurate readings:

  • BP should be measured preferably in a relaxed phase of mind, if possible early in the morning
  • Before measuring the BP, you must not have smoked, eaten, exercised or drunk any caffeinated drinks at least half an hour prior to taking the reading
  • Before taking the BP, sit down on a chair and stay calm for five minutes
  • It’s critical to have an empty bladder, a full bladder might cause BP readings to be high
  • Talking while measuring BP readings should be avoided by both the patient and the doctor/ caretaker
  • The BP cuff should be of the correct size
  • The BP cuff should be worn on the bare arm, above the elbow and secured tightly. Wearing the BP cuff over clothing can result in a higher reading
  • Posture should be sitting up straight on a chair with back-supported, legs uncrossed and feet flat on the floor, breathing comfortably
  • The arm should be supported at the level of the heart
  • Ensure there is no movement as the measurement is being taken
  • When monitoring blood pressure at home, take three readings and use the average of the last two as the blood pressure reading
  • Maintain a daily track of the BP measurements

Another aspect of measuring BP at home is that wrist and finger BP monitoring smart devices have become popular. But, with these devices, the upper (systolic) and lower (diastolic) pressure can vary substantially, the farther the arteries are from the heart.

The above simple precautions and preparations can go a long way in ensuring accurate BP measurement in the clinic and at home. With teleconsulting on the rise due to the pandemic, home measurement of BP for tracking the effectiveness of a treatment regimen is now an important tool for the physician for effectively controlling hypertension and reducing the risk of health disease.

This ‘World Heart Day’, let us pledge to begin measuring our BP in the right way. Measure correctly. #BPRightKaro

(The author is Cardiologist, Principal Director, Max Hospital, New Delhi , Ex Dean & Head – AIIMS, New Delhi. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)

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