blood pressure

For more information about high blood pressure, see High Blood Pressure. Sphygmomanometer, a device used in measuring arterial pressure

Blood pressure (BP) is the pressure (force per unit area) inserted by blood circulation on the outer membrane of blood vessels and it is one of the major life signals. The pressure of transmitted blood decreases in the direction of the heart through the arteries and capillaries, away from the heart and through the veins. When the meaning is not limited, then the word "blood pressure" usually refers to brachial arterial pressure: that is the main blood vessel of the left or right upper arm, which moves blood away from the heart. However, blood pressure can sometimes be measured in other parts of the body, such as on ankles. The ratio of the blood pressure measured to the ankle's main artery and the ratio of the outer blood pressure, the ankle indicates the external arc index (ABPI).

Measurement चित्र:MMSA Checking Blood Pressure.JPG Blood pressure checking by a medical student using the sphygmomanometer and stethoscope.

The artery arc is commonly measured by the sphygmomanometer, which uses the height of the mercury column to show the historically transmitted pressure (see the indeterminate measurement). Even the value of blood pressure is about millimeters of mercury (mmHg) However, mercury is not used in unscrupulous and electronic devices.

For each beating, blood pressure fluctuates between systolic and diastolic pressures. The systolic pressure is the high pressure of the arteries, which occurs at the end of the heart-cycle, when the heart-cells are compressed. Diastolic pressure is the minimum pressure of the arteries, which occurs at the beginning of the heart-cycle when the blood is filled in the ventricles. An example of commonly measured value for a comfortable, healthy adult man is 115 mmHg systolic and 75 mmHg diastolic (which is written 115/75 mmHg and called "one hundred and fifty five seventy five"). Pulse pressure, systolic And there is a difference between diastolic pressure.

Systolic and diastolic arterial blood pressure are not stable, but there is a natural decrease in between between beats and between the day (in bio-cyclic cycle). They also change from stress, nutrient, medicine, disease, exercise and standing still. Sometimes there is a lot of decrease. High blood pressure indicates arterial pressure to be unusually high, whereas on the contrary, the arterial blood pressure indicates abnormal decrease. The body temperature and pulse rate, along with blood pressure measurement , Is the most common physical criterion.

Arterial pressure can be measured by penetrating (intensifying in the skin and measuring inside the blood vessels) or in an incomprehensible manner. The first method is usually restricted to the hospital environment. Unit

The standard unit of measuring blood pressure is mmHg (millimeter of mercury). For example, normal pressure is written 120 to 80, where there are 120 systolic texts and 80 diastolic rhythms.

Incomprehensible measurement

Unexplicated acoustics (term used for Latin listening) and decreased-scale measurements are simple and quick with measurable measurements, which require less accomplishment to fit properly, in reality without any problem and less uncomfortable for the patient And it's painful. However, the results of the non-measurable measurements can be less accurate and the sequential differences in its statistics results can be. Generally, the indeterminate measurement method is used for routine testing and monitoring.

Touch-testing methods

Raw estimation of the minimum systolic value can be done by touch-testing method without any equipment, it is mostly used in emergencies. The touch test of the exocrine pulse indicates the minimum 80 mmHg blood pressure, the femoral pulse points at least 70 mmHg and the cervical vertex to the minimum 60 mmHg. However, one study indicated that this method is not accurate and often the patient's systolic rate of blood pressure is higher. The precise value of the blood pressure and the exact value of the sphygmomanometer and rectal pulse can be obtained by touch-testing. Could. {3} Diastolic blood pressure can not be assessed by this method.

Auditory methods Acoustic sphygmomanometer with stethoscope Mercury measureometer

Acoustic method uses stethoscope and sphygmomanometer. In this, the air-fitting (Riva-Rockki) wrist-lock, which is surrounded by the upper part of the arm, is almost tied to the vertical height of the heart, which is linked to the mercury or the silent pressure measurement. The mercury measurement measured, measuring the height of the mercury column gives the resultant result, which does not require calibration, and as a result calibration errors and flaws can be avoided, which affects other methods. The use of mercury pressure measurement is often required for diagnostic tests of clinical trials and high-risk patients, such as high blood pressure for pregnant women.

The right-cut wrist-band is tightly and tightly tuned, then pressing the rubber balls with the hand repeatedly, the air is filled until the artery is blocked. By listening to the brachial artery in the nudge with the help of a stethoscope, the testator gradually releases the pressure in the wrist-lock. When the blood flows in the artery, the flux flow creates "screaming" or explosion (the first Korotkoff sound). The pressure at which the sound is first heard, is the systolic blood pressure. Pressure on the diastolic arterial pressure is reduced further by the wrist-stop until no sound (fifth chorotkoff sound) is heard. Sometimes before the auditory, touch-test (pressure by hand) for assessment Is done.

Volatile methods

Oscillation methods are sometimes used in long-term measurements and in general practice. This device is functionally similar to the auditory system, but in order to identify the blood flow, an electronic pressure sensor (transducer) is replaced by the use of stethoscope and specialist ears. In practice, pressure sensor is a calibrated electronic device, which facilitates statistical teaching of blood pressure. Regardless of the precision mercury measured, it should be checked periodically for calibration to maintain the accuracy. In most cases, the pump and valve circulated in the wrist-lock are used, which is done on the wrist (lifting up to the height of the heart), although the upper arm is preferred. There is a lot of difference in their accuracy and their periodic scrutiny should be done and if necessary, it should be re-organized.

Comparative measurements require less skill in comparison to auditing techniques and it may be adaptable for untrained employees and for monitoring of automatic patient homes.

In the wrist-off, the air is filled to produce more pressure than the first systolic arterial pressure and later less than the diastolic pressure in the 30 second period. When the blood flow is zero (more than the wrist-pressed pressure systolic pressure) or uninterrupted (wrist-locked pressure less than diastolic pressure), then the wrist-locked pressure is definitely stable. It is important that the wrist-off size is correct: small-size wrist-lock is more likely to result in blood pressure, whereas large-sized wrist-off can reduce blood pressure significantly. When the blood flow is present, but if it is limited, then the wrist-locked pressure, which is detected by pressure pressure sensor, changes in periodically with the contraction of the arterial artery and the circulation cycle, that is, it drops. The values ​​of systolic and diastolic pressure are computed, not measuring the figures directly by the use of algorithms; Calculated results are shown.

Vulnerable tests, patients with cardiovascular and cardiovascular problems, including arterial sclerosis, Arthritamia, preclampsia, Pallas's Alterons and Pulsus paradoxes, may give incorrect reading.

Practically different methods do not give the same result; The algorithm and experimental received coefficients are used for adjusting the volatile results, so as to enable readings matching the results of the study. Some devices use computer-assisted analysis of instantaneous arterial pressure waveform to determine systolic, medium and diastolic points. Since many moving devices have not been validated and most of them are not conducive to clinical and intensive care conditions, caution is necessary.

The term NIBP is used to define the voluminous test devices for non-invasive blood pressure.

Latent measurement

The precise measurement of arterial blood pressure (BP) is done by the ablation of the arterial line. In measuring the arterial pressure from the intestinal canal, the arterial needle is measured directly by piercing the needle needle (usually in the exocrine, femoral, dorsal foot or braque). This can be done by any licensed doctor or respiratory specialist.

The tube should be connected to a sterile, fluid-filled system, which is connected to the electronic pressure sensor. The advantage of this system is that continuous beating-rate-beats can be monitored at the pressure and a waveform can be represented. This drilling technique is used for human and animal intensive care therapy, anesthesiology and research objectives.

The ducts are often associated with thrombosis, infection and secretion to detect vascular vascular pressure. Microscopic supervision of patients with Vertical Arterial Monitoring is required, as the risk of bleeding is greater when the tube is gone. This is reserved for patients where arterial pressure is expected to change rapidly.

Vascular Vibration Pressure Monitor is a pressure monitoring system that is designed to procure, display and process pressure information. There are many types of acquired vascular pressure monitors available for shock, critical care and operation room applications. These include single pressure, double pressure and multi-parameter (i.e. pressure / temperature). These monitors can be used for measuring and follow-up of arterial, central venous, pulmonary artery, left ventricular, right ventricular, femoral artery, umbilical venous and intracranial pressures.

Vascular pressure parameters are obtained on the microcomputer system monitors. Usually, systolic, diastolic and moderate pressures are represented simultaneously for pulse waveform (i.e. arterial and pulmonary arterial). Some monitors also compute and display CPP (cerebral perfusion pressure). Generally, the zero key in front of the monitor makes the vacuuming of pressure extremely fast and simple. Alarms limits should be set with the help of the medical practitioner responsible for observing the patient. High and low alarms are kept on the displayed temperature parameters.

Home monitoring

For certain patients, blood pressure measurements taken in the doctor's office can not accurately describe their specific blood pressure. In the case of approximately 25% of patients, the blood pressure reading taken at the office remains higher than their specific blood pressure. This type of error is called white coat hypertension and is caused due to the anxiety caused by the test of health care practitioner. Unnecessary and harmful drugs can be given as a result of the misidentification of high blood pressure in these patients. is. Controversy continues in relation to its importance. Some reactive patients also respond to other stimuli in daily life and they need treatment. The white coat effect can be a sign, in relation to which further exploration is required. On the other hand, in some cases, the doctor's office has less than the typical blood pressure of patients, so these patients do not receive the necessary treatment for high blood pressure.

The use of the stabilized blood pressure device has been used to identify and mitigate these problems, which take lessons every half hour, day and night. Except for the duration of sleep, in the remaining time, monitors can be used at home, instead of stabilized blood pressure monitoring devices for these purposes. Monitoring and monitoring the effects of high blood pressure management and lifestyle changes Monitoring at home can be used for improving pressure-related medicine. Compared to the efficient blood pressure measurements, more effective and low-cost alternative to home monitoring Or.

In addition to the white coat effect, in most of the people, the rate of arterial pressure outside the clinical position is generally lesser. Studies of the benefits of reducing the risk of high blood pressure and arterial pressure in the affected patients were based on the readings in the clinical environment.

When the blood pressure is measured, it is expected that the person should not drink coffee, smoke or laborious work 30 minutes before receiving the reading. The bladder's blood pressure may have little effect on the readings, so if urine is urinated, then it should be done before the reading. Five minutes before the appraisal, the soles of the feet are flat on the ground and the hands Keep straight, sit straight on the chair. The wrist-closing of the armpit is always on the naked skin, as the lessons taken on the arm of the shirt can be less accurate. During the reading, the arm used should be loose and at the height of the heart, for example, keep the arm on the table.

Because the arterial blood pressure changes throughout the day, measurements that monitor changes in long intervals should be taken daily at a single time so that the readings can be compared. Time is favorable:

Automated autocomplete blood pressure monitors are available at reasonable prices, in addition to some osmotic methods, are also capable of measuring corotforgraphy, so that patients with irregular heartbeat are able to measure accurate blood pressure at home.

Classification

The following classification of blood pressure applies to adults 18 and older. It is based on the average blood pressure taken in the proper position in 2 or more office hours.

Normal value

Although the average values ​​of arterial pressure can be computed for any group, however, there is a lot of difference between the person and the person; Arterial pressure changes in individuals. Apart from this, the general health of a particular community can be questionable even with its average, so the justification for such average values ​​is also questionable. However, in the study of 100 patients who had no history of blood pressure, the average blood pressure of 112/64 mmHg was found. Which is in the normal sequence.

Normal sequence is less in children than adults. Blood pressure in older age is higher than normal values ​​of adults, especially due to lack of flexibility in arteries. Factors such as age and gender affect blood pressure values. Exercise, emotional reactions, sleep, digestion and blood pressure also change from day to day.

The difference between the left and right hand blood pressure measurements is irregular and when the proper measurement takes place, their average is almost zero. However, in very few cases there is a continuous gap of 10 mmHg, which requires additional screening, such as in the obstructive arterial disease.

The risk of cardiovascular disease increases throughout the entire expansion area of ​​high arterial pressure, starting from 115/75 mmHg. First, after several visits to the doctor, secondary symptom of high arterial pressure with high systolic pressure readings for a long time High blood pressure was diagnosed only when found. 140/90 mmHg readings of patients still in the UK are considered normal.

Clinical trials show that those who maintain arterial pressure at the lowest end of these pressure sequence, their long-term cardiovascular health is better. Those who can not maintain such pressure themselves, to maintain their pressure at the lowest end of this sequence, the main medical dispute is associated with aggression and the relative value of the methods used. Although the elevation observed in older people is generally considered normal, but it is linked to morbidity and mortality.

Physics

Physics of circulatory system is extremely complex. According to which there are many physical elements that affect arterial pressure. Each of them is influenced by physical factors such as food, exercise, disease, medicines or alcohol, stress, obesity.

There are some physical factors:

In practice, the autonomic nervous system of each person responds and regulates all these mutual reactionary elements, so that even though the above mentioned cases are important, both the nervous system and the final components are divided-moment and slow-reaction There is a lot of difference in the actual arterial pressure response of a particular person for reasons. These reactions, transformers and the resulting blood pressure are able to change momentarily.

Medium arterial pressure

Medium arterial pressure (MAP) is the average of a cardiac cycle and its decision is based on cardiac output (CO), the mechanical vascular resistance (SVR) and central venous pressure (CVP).

M A P = ( C O & # x22C5; S V R ) + C V P . {\ displaystyle \! MAP = (CO \ cdot SVR) + CVP.}

An approximation of the MAP can be done, systolic pressure {\displaystyle \!} \! P_{sys} और P s Y s {\displaystyle P_{sys}} Diastolic pressure! Measurements of P_ {dias} P d i a s {\ displaystyle P {days} While the constant heart rate is normal, M A P & # x224A; P d i a s + 1 3 ( P s Y s & # x2212; P d i a s ) . {\displaystyle \!MAP\approxeq P_{dias}+{\frac {1}{3}}(P_{sys}-P_{dias}).}

Pulse pressure

The fluctuation of arterial pressure is the result of the heart-flowing meaning i.e. the vibratory nature of the heartbeat. The determination of pulse pressure, the pulse of the heart, the compliance of the aorta (expansion capacity) and arterial branches is done on the basis of the interaction of the resistance. During the heartbeat, due to pressure, the aorta sprouts and absorbs some force of blood flow. This reduces the pulse pressure, which is otherwise not possible in case of aortic failure.

Vascular pressure can be easily calculated by measuring the systolic pressure and diastolic pressure.

P p u l s e = P s Y s & # x2212; P d i a s . {\displaystyle \!P_{pulse}=P_{sys}-P_{dias}.}

Vascular resistance

Large arteries, which include all major arteries, which do not need to be raised, low-immune tubules (assuming not having advanced orrrosclerotic changes) high-flux ability to reduce pressure .

Vascular pressure wave

Modern physiology develops the concept of Vascular Pressure (VPW) wave (VPW). This wave is produced in the heart and produced in ascending aorta during systole. It is carried in the peripheral arteries by the vascular membranes faster than the blood flow itself. There the pulse of the pressure wave can be seen as peripheral pulse. As the wave reflects on peripheral veins, it goes back centrally. Where the peaks and mirrors of the original wave get, the pressure in the vesicle is greater than the basic pressure of the aorta. This concept is evident from the fact that arterial pressure in the peripheral arteries of the hands and feet of the aortic is more than the arterial pressure, and in the same way, there is a high pressure seen in the ankle compared to the normal ankle brachial pressure indicator value. / p>

Control

The endogenous control of arterial pressure is not considered complete. Currently, three processes that control arterial pressure have been explained clearly.

By making the vasoconstrictor active, the kidneys may reimburse the reduction in blood volume or decrease in arterial pressure.

These different processes need not be independent of each other, as indicated by the link between RAS and Aldosterone. Currently, medicinal ACE inhibitors and angiotensin II receptor opponents have been targeted by the RAS system. Elastosterone system is targeted by Aldosterone anti-Sparronolactone directly. Potassic retention can be targeted by non-astronomers; The high-anticonvulsant effect of diuretics can be due to its effect on blood volume. Normally in hypertension, the barropeceptor reaction is not targeted, because with its blocking, individuals may have problems with orthostatic hapitation and unconsciousness.

Pathology High arterial pressure मुख्य लेख : Hypertension

Overview of the main complications of permanent hypertension

Arterial hypertension can be an indicator of other problems and may have long-term adverse effects. Occasionally this can be a serious problem, for example, high-stress emergency.

All levels of arterial pressure put mechanical pressure on the arterial walls. High pressure increases heart workload and unhealthy tissues (atheroma) which develop within the membranes of the arteries. The higher the stress, the greater the stress will increase, the more atheroma will try to develop, the heart muscles will be thick, try to grow up and become weak over time.

Permanent hypertension is one of the risk factors for paralysis, heart attack, heart stopping and arterial bleeding and is the leading cause of chronic kidney inactivation. A slight increase in arterial pressure levels also leads to short life span. Any person with moderate arterial pressure at extremely high pressure, 50% or above average pressure, can not have expected life expectancy for more than a few years, without proper treatment.

Earlier, diastolic pressure was given more attention; But nowadays it has been learned that both, high systolic pressure and high pulse pressure (numerical difference between systolic and diastolic pressure) are also risk factors. In some cases, a reduction in excessive diastolic pressure can actually increase the risk, possibly by increasing the difference between systolic and diastolic pressure (see article on pulse pressure).

Low arterial pressure मुख्य लेख : Hypotension

Blood pressure, which is very low, is known as hypoglycemia. Confusion can be triggered by its pronunciation of high blood pressure. When symptoms like dizziness, unconsciousness, or severe cases of shock occur, red blood pressure becomes the subject of concern with medical attention.

When the arterial pressure and blood flow decrease from a certain point, then the brain pulping is reduced to a serious level (i.e., the supply of blood is inadequate), which can lead to sorrow of the head, dizziness, weakness or unconsciousness.

Occasionally when the sedentary patient is standing, there is a lot of decrease in arterial pressure. It is known as parallel hypoglycemia; Gravitational reduces the return rate of blood in the heart from the body's veins below the heart, consequently the trauma volume and cardiac output decrease.

When people are healthy, then the vein under their heart gets compressed and heart rate increases, so that the effects of gravity can be reimbursed and reduced. It is involuntarily by autonomic nervous system. The system usually requires a few moments to be fully organized and if the reimbursement is too slow or inadequate, then the person suffers from low blood flow, dizziness and possible unconsciousness in the brain.G- Increasing the loading, As the 'traction G' of air strikes or fighter aircraft operators, this effect greatly increases. Most of the problem can be solved by restoring the body vertically to gravity.

Other reasons included in the causes of low arterial pressure:

Trauma is such a complex situation, which severely reduces suppression. Normal procedures such as decrease of blood volume, blood deposits in the veins, not enough blood in the heart, and / or heart pumping is less effective. Low arterial pressure, especially low pulse pressure, is a sign of trauma and reflects and contributes to the reduction in fluid.

If there is a great difference in the pressure of one arm and the other arm, then it indicates the contraction of any artery (for example, aortic contraction, aortic dissection, thrombosis or anesthesia).

Other places

Blood pressure usually refers to arterial pressure in somatic circulation. However, the measurement of pressure in the venous system and lung vessels plays an important role in intensive care, for which the perforated central venous ureter is required.

Venous pressure

The venous pressure in the venous pressure, the vein or heart venture is in the ventricle. It is less than 5 mmHg in the right ventricle and arterial pressure with 8 mmHg normal value in the left ventricle.

Pulmonary pressure

Normally, pressure in the pulmonary artery is about 15 mmHg in the state of relaxation.

The increase in blood pressure in the lungs leads to pulmonary hypertension, if the pressure exceeds 20 mmHg, interstitial inflammation and pressures greater than 25 mmHg cause uncontrolled pulmonary edema.

Fetal blood pressure For more information see: Fetal circulation # Blood pressure

In pregnancy, to operate the blood through embryonic circulation, the blood pressure from the fetal heart, not the mother's heart.

In 20 weeks of pregnancy, blood pressure in the embryo's aorta is approximately 30 mmHg and in the gestational 40 weeks it increases to ca 45 mmHg. The average of blood pressure in full-time newborn: प्रकुंचन 65-95 mm Hg अनुशिथिलक 30-60 mm Hg

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Footnotes

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