High blood pressure is the silent killer. According to the National Institutes for Health (NIH), “About 1 in 3 adults in the United States has HBP. The condition itself usually has no symptoms. You can have it for years without knowing it. During this time, though, HBP can damage the heart, blood vessels, kidneys, and other parts of your body.”

What is blood pressure?

Blood pressure is the force exerted on the artery walls as heart pumps blood through the circulatory system. Measured in units of millimeters of mercury, the measurement considers two pressures. The first is the pressure as the heart contracts, called systolic blood pressure. The second is the pressure exerted on artery walls while the heart is at rest, called diastolic pressure. It is read as Systolic over Diastolic, for example 119 over 72.

What is High Blood Pressure?

A simple way to look at the question is that any pressure that is not normal is high. The NIH categorizes blood pressure in terms of normal, prehypertension, Stage 1 hypertension, and Stage 2 hypertension. Table 1 illustrates the blood pressure values associated with each category.

Category	Systolic (top number)		Diastolic (bottom number)
Normal	Less than 120	And	Less than 80
Prehypertension	120–139	Or	80–89
High blood pressure
Stage 1	140–159	Or	90–99
Stage 2	160 or higher	Or	100 or higher

Table: 1. Categories for Blood Pressure Levels in Adults (measured in millimeters of mercury, or mmHg) (Source: National Institutes for Health )

Equipment

Electronic blood pressure units are available at most pharmacies and department stores. For this demonstration, we will use a manual cuff and stethoscope.

Preparation

The NIH recommends the following to prepare for measuring blood pressure.

• Do not smoke or drink coffee for thirty minutes before the test.
• Empty bladder before the test.
• Sit for 5 minutes before the test.

The Test

Seat patient with both feet flat on the floor. Allow to sit for 5 minutes.

Expose underside of elbow

 

 

 

 

 

 

Place the cuff approximately 3 finger widths above the bend in the arm.

Align artery arrow on cuff with midline of arm.

Wrap cuff so it is snug but not tight.

Clip gauge to cuff.

Locate thumb nob near bulb and gently tighten.

Inflate cuff bladder with bulb to a pressure of approximately 150.

Place stethoscope diaphragm over bend in the underside of arm.

 

Listen for a pulse.

If present continue to inflate bladder until no pulse is heard.

If pulse is not present back off on thumb screw to slowly deflate bladder.

Listen for an initial pulse. When heard, note dial indication.

 

 

 

 

Continue to listen for pulse sound to stop. When pulse sound first stops, note dial indication.

Record both indications.

 

 

Compare reading to chart in Table 1.

If results are other than normal, seek competent medical advice.