The Highs and Lows of Blood Pressure

Posted by administrator Wednesday, August 6, 2008

If there's one disease most people are unaware of, it's high blood pressure or hypertension. And many are paying the price for their ignorance.

In the United States alone, about 73 million people age 20 and above have hypertension according to the American Heart Association (AHA). Of that number, over 50,000 die yearly as a result of the condition. Over 150,000 people die each year from strokes, one of the many complications of hypertension, while 2,980,000 Americans have been disabled by the disease.

"It's a very common disease all over the world, especially in the West. Hypertensive patients make up from 25 to 30 percent of the population. But many people don't know they have high blood pressure - it's a hidden disease," according to Dr. Gianfranco Parati, clinical associate of the Department of Cardiology, Istituto Scientifico Ospedale San Luca in Milan, Italy.

Blood pressure is the force created by your heart as it pumps blood into the arteries. This is measured by a sphygmomanometer that consists of an inflatable rubber cuff (which is slipped around your upper arm) and a manometer or pressure-measuring instrument.

The sphygmomanometer was first described a hundred years ago by the Italian doctor S. Riva Rocci in 1896. Since then, it remains one of the most important tools in diagnosing high blood pressure. How does it work?

When the cuff is inflated, it shuts off blood flow to a main artery of the arm. A stethoscope is placed on the arm near the cuff which is slowly deflated. While doing this, the doctor or nurse listens to the arterial pulse with the stethoscope.

The first sound heard is the systolic pressure which reflects the pressure of the heart each time it contracts. The last sound is the diastolic pressure which is the pressure in the arteries between beats. These are expressed in millimeters of mercury or mm Hg. So if your systolic pressure is 134 and your diastolic pressure is 90, your reading would be 134/90 mm Hg.

Still, the sphygmomanometer has limitations. Parati says readings can be influenced by many things such as observer bias and white coat hypertension - the emotional effect of seeing a doctor that can lead to hypertension.

If you're a stickler for details, you can benefit from intra-arterial ambulatory blood pressure monitoring (ABPM) which gives precise readings throughout the day. However, Parati said this invasive technique is time consuming and requires costly and complex computer analysis.

There are other blood pressure measuring devices in the market today that are cheaper and less cumbersome than the sphygmomanometer or ABPM. Some take readings from the wrist or fingers. There's even one that you can wear like a watch. But they're the worst of the lot, according to Parati, because they're very unreliable.

"These are nice toys. They may tell you how your blood pressure changes from here to there but they won t give you a clear picture of your condition," said Parati, associate professor at the Postgraduate School of Cardiology, University of Milan.

So until someone comes up with a better way of measuring blood pressure, it looks like we're stuck with the sphygmomanometer. (Next: Get high and die with hypertension.)

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Sharon Bell is an avid health and fitness enthusiast and published author. Many of her insightful articles can be found at the premier online news magazine

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