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Raised Blood Pressure has become the single largest cause of global mortality, accounting
for 10.4 million deaths per year. A series of serious complications are caused by
hypertension, such as stroke, coronary heart disease, heart failure, kidney disease and etc.
It brings heavy pressure and burden to society and families.
The scariest thing about high blood pressure is its invisibility. The vast majority of high
blood pressure is asymptomatic. Many people with high blood pressure are unaware of it until
they are diagnosed. A one-time or short-term increase in blood pressure may be just part of
normal physiological activity. However, a sustained increase in blood pressure can harm our
health all the time.
Then here are some questions we might have:
How do I know if i have hypertension?
How to measure blood pressure accurately?
Today, let’s talk about these issues here.
How Do I Know If I Have Hypertension?
First of all, the measurement of blood pressure in the clinic or office is widely accepted
as the basis for hypertension diagnosis and follow-up. Any one-time or short-term increase
in blood pressure may not represent anything. For example, emotional stress and anxiety can
also temporarily increase blood pressure.
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According to 《2020 International Society of Hypertension Global Hypertension Practice
Guidelines》, hypertension can be diagnosed when a person’s systolic blood pressure (SBP) in
the office or clinic is ≥140 mmHg and/or their diastolic blood pressure (DBP) is ≥90 mmHg
following repeated examination.
Table 1 provides a classification of BP based on office or clinic BP measurement.
Table 1 Classification of Hypertension Based on Office Blood Pressure Measurement
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Secondly, if possible and available, the diagnosis of hypertension should be confirmed by
out-of-office BP measurement. Table 2 below provides 24-hour ambulatory and home BP values
used to define hypertension. These BP categories are designed to align therapeutic
approaches with BP levels.
Table 2 Criteria for Hypertension Based on Office, Ambulatory (ABPM) and Home Blood Pressure
(HBPM) Measurement
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How To Measure Blood Pressure Accurately?
Whether the measurement is performed in the office, the environment in which the blood
pressure is measured, the posture and position of the measurement, the device used for the
measurement, the position and tightness of the cuff, and whether the operating
specifications are followed according to the guideline will all affect the accuracy of the
blood pressure measurement.
Office blood pressure measurement has been regarded as the most important basis for the
diagnosis of hypertension. In order to eliminate interference as much as possible and ensure
the accuracy of the measurement, Table 3 indicates the recommendations for blood pressure
measurement in the office.
Table 3 Recommendations for Office Blood Pressure Measurement
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Conditions
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Quiet room with comfortable temperature.
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Before measurements: Avoid smoking, caffeine and exercise for 30 min; empty bladder;
remain seated and relaxed for 3–5 min.
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Neither patient nor staff should talk before, during and between measurements.
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Positions
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Sitting: Arm resting on table with mid-arm at heart level; back supported on chair;
legs uncrossed and feet flat on floor (Figure 1).
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Device
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Validated electronic (oscillometric) upper-arm cuff device suggested.
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Cuff
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Size according to the individual’s arm circumference (smaller cuff overestimates and
larger cuff underestimates blood pressure).
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Size according to the individual’s arm circumference (smaller cuff overestimates and
larger cuff underestimates blood pressure).
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For manual auscultatory devices the inflatable bladder of the cuff must cover
75%–100% of the individual’s arm circumference.
For electronic devices use cuffs according to device instructions.
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Protocol
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At each visit take 3 measurements with 1 min between them. Calculate the average of
the last 2 measurements. If BP of first reading is < 130/85 mmHg no further
measurement is required. |
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Interpretation
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Blood pressure of 2–3 office visits ≥140/90 mmHg indicates hypertension
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The following figure shows the correct posture and some precautions when measuring blood
pressure:
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(Source from: 2020 International Society of Hypertension Global Hypertension Practice Guidelines)
In addition, the following two points can allow the results of office blood pressure
measurement to make more sense:
1.Whenever possible, it should be 2-3 office visits at 1-4-week intervals (depending on the
BP level) to confirm the diagnosis of hypertension. The diagnosis might be made on a single
visit, if BP is ≥180/110 mmHg and there is evidence of cardiovascular disease (CVD).
2.At each visit take 3 measurements with 1 min between them. Calculate the average of the
last 2 measurements. If BP of first reading is < 130/85 mmHg no further measurement is
required.
In many occasions, out-of-office BP measurement is necessary for the
accurate diagnosis of hypertension and for treatment decisions. Out-of-office BP
measurements including home and 24-hour ambulatory blood pressure monitoring are more
reproducible than office measurements, more closely associated with hypertension-induced
organ damage and cardiovascular risk from hypertension. If office BP results are high-normal
or grade 1 hypertension (systolic BP 130-159 mmHg and/or diastolic BP 85-99 mmHg), further
diagnosis by home or 24-hour ambulatory BP monitoring is required.
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There are also recommendations for performing home and ambulatory BP measurement (see Table 4).
Table 4 Clinical Use of Home and Ambulatory Blood Pressure (BP) Monitoring
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Home
Blood Pressure
Monitoring
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24-Hour Ambulatory
Blood Pressure
Monitoring
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Condition
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As for office blood pressure (see above)
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Routine working day
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Position
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As for office BP (see above)
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Avoid strenuous activity. Arm still and relaxed during each measurement.
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Device
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Validated electronic (oscillometric) upper-arm cuff device suggested
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Cuff
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Size according to the individual’s arm circumference
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Protocol
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Before each visit to the health professional:
3–7-day monitoring in the morning (before drug intake if treated) and the
evening.
Two measurements on each occasion after 5 min sitting rest and 1 min between
measurements.
Long-term follow-up of treated hypertension:
1–2 measurements per week or month.
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24-hour monitoring at 15–30 min intervals during daytime and nighttime.
At least 20 valid daytime and 7 nighttime BP readings are required. If less, the
test should be repeated.
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Interpretation
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Average home blood pressure after excluding readings of the first day ≥135 or 85
mmHg indicates hypertension
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24-hour ambulatory blood pressure
≥130/80 mmHg indicates hypertension (primary criterion).
Daytime (awake) ambulatory blood pressure ≥135/85 mmHg and nighttime (asleep)
≥120/70 mmHg indicates hypertension
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(Source from: 2020 International Society of Hypertension Global Hypertension Practice Guidelines)
A Portable and Accurate Home Blood Pressure Monitoring device?
It’s YHE BP Doctor Pro, a wearable blood pressure smartwatch.
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As an innovated blood pressure smartwatch, BP Doctor Pro can provide high-precision blood
pressure detection and it’s portability and mobility facilitate blood pressure monitoring in
a variety of life and work scenarios. Its air-pump blood pressure monitoring system uses a
medical-grade pressure sensor and applies oscillometric method of measurement (which is the
same measuring approach that an electronic upper-arm cuff device uses) to meet the
high-accuracy requirements for blood pressure detection.
In addition to blood pressure measurement function, BP Doctor Pro also measures HRV (Heart
Rate Variability), analyzes sleep conditions, tracks fitness status including blood oxygen
saturation, and assists user’s daily life with features including reminders, alarms and push
notifications.
YHE BP Doctor Pro achieved impressive sales of millions of dollars after its landing in
global market in early 2020.
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