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Blood Pressure (BP) is the pressure exerted by blood on the wall of a blood vessel (Tortora and Grabowski, 1993). When the ventricles are contracting the pressure is at its highest, this is known as 'systolic'. 'Diastolic' is when the ventricles are relaxing and the pressure is at its lowest.

Normal/ideal values

Normal blood pressure ranges between 100/60 to 140/90 mmHg: BP can fluctuate within this range and still be normal (Mallett and Dougherty, 2000).

Hypotension (low blood pressure) is when the systolic is below the normal range. Low blood pressure could be an indication of hypovalemia, septic shock or cardiogenic shock.

Hypertension (high blood pressure) is when the systolic is above the normal range. High blood pressure could be an indication of cardiovascular disease, a side effect of drug medication or trauma.

Recording the blood pressure

The blood pressure is recorded for a number of reasons:

- To acquire a baseline;

- To monitor for fluctuation in blood pressure;

- To aid in diagnosis of disease;

- To aid in assessment of the cardiovascular system;

- To monitor medication e.g. anti-hypertensive drugs.

Blood pressure is usually measured in millimetres of mercury (mmHg) and can be measured in two ways, invasive or non-invasive.

Invasive measurement requires the insertion of a small cannulae into the artery, which is then attached to a transducer. The transducer transmits a waveform to a monitor - this allows continuous measurement of the blood pressure. This method is usually performed in critically ill patients and patients undergoing major operations.

Non-invasive measurement requires the use of a sphygmomanometer and stethoscope or an electronic sphygmomanometer.

Auscultation of sphygmomanometer blood pressure usually reveals five ('Korotkoff') sounds (Woodrow, 2000):

1. First sound heard, sharp thud - systolic pressure;

2. Soft, tapping, intermittent;

3. Loud (not as loud as phase 1);

4. Low, muffled, continuous: start - 1 st diastole;

5. Disappears - 2 nd diastole.

Equipment needed:

- Stethoscope;

Procedure

- Explain to the patient what you are about to do - even if the patient is unconscious.

- Ensure that the patient is comfortable, as relaxed as possible and not distressed.

- Note if the patient has had any medication that may alter the blood pressure.

- Any tight or restrictive clothing should be removed from the patient's arm.

- The position of the patient is not as important as the position of the arm; this should be supported and should be level with the heart (Jowett, 1997).

- Apply the cuff (inside the cuff is the bladder), make sure that the cuff is empty of air before applying; ensure the correct size cuff is used on the patients arm. The width of cuff should cover at least 40% of the arm circumference and the length should cover at least two-thirds of the arm (Jowett, 1997). The centre of the cuff should cover the brachial artery.

- Make sure that you can see the sphygmomanometer and that it is in line with the heart.

- Palpate the brachial pulse and inflate the cuff until the pulse can no longer be felt. This will give an estimate of the systolic pressure. Deflate the cuff and re-inflate to 30mmHg higher than estimated (Jowett, 1997).

- Position the stethoscope over the brachial artery and slowly deflate the cuff at 2-3mmHg per second.

- The first beating sound should be recorded; this is the systolic pressure.

- Continue to deflate the cuff; the last sound to be heard is the diastolic pressure.

- Record the blood pressure on the observation chart. Any abnormalities or irregularities should be documented and reported to the medical team.

- Before leaving the patient make sure any clothing removed is replaced and that the patient is comfortable.

Electronic sphygmomanometer - the same procedure is carried out as above without the use of the stethoscope. Manufacturer's guidelines should be followed and appropriate training completed.

When and how often should the blood pressure be recorded?

The frequency of recording the blood pressure depends on the condition of the patient. Patients in a critical care environment will require their blood pressure to be recorded continuously.

Safety

- The blood pressure should be recorded to the nearest 2mmHg - to maintain accuracy.

- Nurses should wash their hands thoroughly between patients to eliminate the risk of cross infection.

- The correct size cuff should be used - the wrong size cuff will lead to an inaccurate measurements.

The sphygmomanometer (electronic or mercury) should be calibrated and serviced regularly in accordance to manufacturers instructions.

Equipment should be cleaned and precautions against cross infection must be adhered to.

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Blood Pressure (BP) is the pressure exerted by blood on the wall of a blood vessel (Tortora and Grabowski, 1993). When the ventricles are contracting the pressure is at its highest, this is known as 'systolic'. 'Diastolic' is when the ventricles are relaxing and the pressure is at its lowest.

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More than a million under-45s are living with potentially lethal undiagnosed high blood pressure, a new analysis shows.

The British Heart Foundation (BHF) has warned of a "ticking time bomb", with approximately four million people under the age of 65 undiagnosed.

Untreated high blood pressure can increase the risk of heart attacks and strokes, and is also linked to a heightened risk of vascular dementia.

It can usually be managed through lifestyle changes and medication.

The BHF analysis of official statistics suggests around one in 10 - 9.6 per cent - of the 41.5 million adults aged 16 to 64 in the UK have untreated high blood pressure.

Chief executive Simon Gillespie said: "Getting your blood pressure under control is one of the most important things you can do to reduce your risk of having a heart attack or stroke.

"These figures show that millions of adults of all ages are living with untreated high blood pressure - a ticking time bomb that puts their future health in jeopardy.

"Having your blood pressure checked takes less than five minutes, but it is all too easy to put it on the back burner in our hectic day-to-day lives.

"That's why we're urging everyone to take a moment this month and get their pressure checked - it could ultimately save your life."

Professor Jamie Waterall, national lead for cardiovascular disease prevention at Public Health England, said: "If you're over 40, getting your free NHS Health Check is a simple way to find out your blood pressure as well as your risk of other serious conditions.

"Diagnosing high blood pressure earlier and managing it in line with Nice guidance will save thousands of lives and prevent years spent in ill-health."

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Undiagnosed high blood pressure a 'ticking time bomb', say experts

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More than a million under-45s are living with potentially lethal undiagnosed high blood pressure, a new analysis shows. The British Heart Foundation (BHF) has warned of a "ticking time bomb", with approximately four million people under the age of 65 undiagnosed.

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Doctors Health Press - Daily Free Health Articles and Natural Health Advice

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Disclaimer: Results are not guaranteed*** and may vary from person to person***.

One of the most common silent killers, high blood pressure is also a manageable disease when you consume healthy, good foods as part of a treatment plan.

With your blood pressure ever changing throughout the day, knowing the best foods for high blood pressure may help you prevent further complications.

A program known as the DASH diet plan is a commonly recommended treatment for high blood pressure.

First, understanding high blood pressure may help you recognize how treatment works. High blood pressure, or hypertension, is the result of blood flowing through the arteries with excessive force. This constant pounding can cause damage to the artery walls and the heart.

All of this turmoil within the arteries, surprisingly, presents little to no warnings. Monitoring blood pressure regularly may help to prevent two leading causes of death in the United States, stroke and heart disease.

Good Foods for High Blood Pressure: Foods That Help Lower Blood Pressure

1. Grains

Making whole grains part of your regular diet may help treat, and possibly prevent, high blood pressure. This entails the part of the grain known as the kernel, which contains the healthy germ and bran that is removed in the processing of white bread and flour.

Whole grains are high in fiber, iron, selenium, folate, potassium, and magnesium. Nutrient-enriched grains such as ready-to-eat and cooked cereals, popcorn, and unsalted pretzels are examples of grain-based foods that lower blood pressure.

Grains directly and indirectly affect your blood pressure by:

Protecting the walls of the arteries

Reducing high blood pressure with high levels of potassium

Helping you maintain a healthy weight by controlling appetite

Reducing the risk of insulin resistance

2. Fruits and Vegetables

According to research, fruits and vegetables are also foods good for high blood pressure.

In one study, British researchers found that the consumption of nitrate-rich veggies lowered the blood pressure of hypertensive patients over a 24-hour period. The roots of the vegetables gain nitrates through the soil, which turn into a nitric oxide gas. This gas relaxes constricted blood vessels.

Select fresh and frozen fruits and vegetables to include in the diet are potassium-rich as well as low sodium canned vegetables. Remove any additives by rinsing before eating or cooking the produce.

Fruits and vegetables may lower blood pressure by:

Offering substantial vitamin and mineral content

Stabilizing systolic and diastolic blood pressure with at least 400 grams of daily consumption

Counteracting the damage sodium may present, including high blood pressure, with potassium levels

There are certain vegetables and fruits that fall under a group of the best food for high blood pressure.

Beets

Beet juice was shown in a 2013 study to lower the systolic blood pressure by at least four to five points in healthy men.

Published in Nutrition Journal, the study reported that a group of men and women were given the vegetable in form of beet juice. Within six hours, the men showed signs of lower blood pressure readings with the female participants also having lower readings.

Beets are a great source of the naturally occurring nitrates that can ease your blood pressure.

Broccoli

Broccoli is rich with potassium, vitamin C, calcium, fiber, and magnesium. These nutrients help to regulate blood pressure and fight heart disease by releasing constricted blood vessels.

This cruciferous vegetable was also shown to lower blood pressure through nitric oxide, while the vitamin C component strengthens the vessel walls.

Furthermore, a Northwestern University, Chicago study has linked the amino acid glutamic acid, found in abundance in broccoli, to lower blood pressure.

Bananas
Bananas are filled with potassium, one of the key fighters of high blood pressure.
In fact, one banana contains 11% of the recommended daily allowance for a healthy lifestyle. Even higher amounts of potassium can be found in vegetables such as white beans, Swiss chard, and avocado.

Potatoes

Baked potatoes contain potassium as well as magnesium to help regulate blood flow. High potassium levels help to cleanse blood pressure raising agents such as sodium.

Kale

Kale may help to lower blood pressure with its vitamin C, potassium, and magnesium content. These nutrients also work as antioxidants to fight and prevent disorders and disease.

3. Meats

High blood pressure may occur due to excessive amounts of cholesterol and saturated fats in the diet.

While all meats contain some amount of saturated fats, chicken and fish have lower levels than beef, lamb, and pork meats. Salmon and other fatty fish provide benefits with their unsaturated fats.

A study published in Nutrition Journal supports previous research, which suggests that a diet of omega-3 fatty acids can lower high blood pressure, particularly the diastolic pressure.

Researchers concentrated on providing a diet of fish three times a week to a group of obese patients over an eight-week period.

4. Dairy (Probiotics)

Dairy products such as cow's milk have the essential vitamin D and calcium elements to lower blood pressure. This also works to reduce the risk of cardiovascular diseases. A lack of these minerals and vitamins has been been linked to signs of high blood pressure.

The Journal of Human Hypertension published a study in 2012 suggesting a direct link between a diet of low-fat yogurt and milk and a lower risk of hypertension. Cheese was not included.

The study focused on the digestive release of dairy's properties, especially peptides, as well as calcium. Researchers offered no clear explanation for the results but suggested that dairy products with saturated fats may hinder healthy blood pressure levels.

Probiotics have been shown to reduce high blood pressure, as highlighted in the Hypertension journal of the American Heart Association. A review of more than nine blood pressure studies saw a significant reduction in both the systolic and diastolic measurements of participants with high blood pressure over a two-month long diet of probiotics.

That being said, the research did not advocate for a specific type of probiotic. Good bacteria found in yogurt have been part of prescribed diets for high blood pressure.

5. Other Proteins

A protein-filled diet is suggested for those with high blood pressure as studies have shown improvement in the systolic and diastolic readings for both men and women with this eating regimen. Adding fiber to a high-protein diet reduced the risk of high blood pressure.

High-protein foods include legumes, kidney beans, lentils, split peas, seeds, and unsalted nuts, especially peanuts, walnuts, and almonds. These meal additions and snacks fall under what food is good for high blood pressure.

Flaxseeds were shown to help reduce high blood pressure in a study published in Hypertension. While researchers did not identify a specific nutrient among fiber, plant omega-3, alpha-linolenic acid, antioxidants, and lignans as causing the reduction, researchers suggested that all contributed to impairing the enzyme that stimulates an increase in the blood pressure.

6. Chocolates

Good news! Chocolate, particularly dark chocolate, could also be a useful tool in lowering high blood pressure. Cocoa's naturally occurring compounds called flavanols were the subject of a study analysis published in a 2010 issue of BMC Medicine. Both the systolic and diastolic reductions were linked to the flavanols.

7. Olive Oil

The polyphenol content in extra-virgin olive oil may help lower the systolic and diastolic pressure readings.

The American Journal of Hypertension published a study that showed olive oil high in polyphenols reduced blood pressure in more cases than olive oil products with a low polyphenol content.

8. Coconut Oil

Coconut oil is high in omega-3 fatty acids, which are known for helping to lower blood pressure. Unlike other polyunsaturated fats, coconut oil stimulates the blood vessels to expand, alleviating inflammation.

9. Nuts

Balance the high fat source of nuts with the beneficial omega-3 fatty acids of a select few nuts. The fiber, potassium, and magnesium reduce high blood pressure as well as the fats. This does not include seeds and salted nuts.

One study showed pistachios to be potentially responsible for lowering high blood pressure in one of two ways. The results, published in the Hypertension journal, suggest that pistachios in daily but low doses may either reduce the systolic pressure directly or lead to reduction by expanding the blood vessels.

Almonds, mainly the unsalted ones, offer more than 20% of the recommended daily amount of magnesium in a one-ounce serving, plus four grams of fiber and 200 milligrams of potassium. All of these components make almonds a beneficial snack for lowering blood pressure.

Hazelnuts are known for high amounts of fat with only a small amount of saturated fat. They do, however, contain three grams of fiber, 193 milligrams of potassium, and 46 milligrams of magnesium in a one-ounce serving.

10. Spices

A natural and tasty remedy for lowering blood pressure is the use of herbs. The active components of various plants may help, but you should be sure to consult an expert, as some herbs can counteract certain medications.

Basil has been shown to lower high blood pressure for brief periods of time.

Cinnamon may help reduce blood pressure in diabetics when used daily, according to a study published in the Journal of Clinical Nutrition.

Cardamom added to meals has been shown to lower blood pressure in those with stage 1 hypertension when used daily over several months.

Ginger is used to stimulate proper blood circulation and to help the muscles surrounding the blood vessels naturally relax.

Celery seed is an ancient Chinese remedy for high blood pressure, which has been proven effective in some studies.

Turmeric has a natural healing compound known as curcumin, which works as an anti-inflammatory as it lowers high blood pressure.

The DASH Diet

High blood pressure patients are often recommended to follow the Dietary Approaches to Stop Hypertension, or DASH, diet.

It outlines what foods lower blood pressure absent the use of prescribed medication. This eating plan contains healthy and nutritious foods with the main focus on portion control. Foods most highly recommended are high in potassium, magnesium, and calcium.

The DASH diet proposes:

A lifelong commitment to healthy eating

Relying on consumption of whole grains, fruits, and vegetables

Switching to low-fat or fat-free products under the categories of diary, poultry, fish, vegetable oils, and nuts

Limiting, or avoiding, high-sugar snacks, products high in saturated fat, and cooking oils such as palm oil

High Blood Pressure Diet Plan: Best Foods to Lower Blood Pressure

Food Group Daily servings (1,600 calories)Serving Size Examples Components

Lean meats, poultry, and fish

3-6

1 ounce or 1 egg.

No fat or skin; broiled, roasted, or poached.

Sources of protein and magnesium

Nuts, seeds, and legumes

3 weekly

1/3 cup of nuts,
2 tablespoons of peanut butter,
½-ounce of seeds,
½ cup of cooked legumes.

Almonds, hazelnuts, mixed nuts, peanuts, walnuts, sunflower seeds, peanut butter, kidney beans, lentils, and split peas.

Sources of energy, magnesium, protein, and fiber

Fats and Oils

2

1 teaspoon of soft margarine,
vegetable oil

Soft margarine, vegetable oil (canola, corn, olive, or safflower), low-fat mayonnaise, light salad dressing.

DASH study allows 27 percent of calories as fat

Sweets and added sugars

0

1 tablespoon of sugar,
jelly or jam,
½ cup sorbet or gelatin,
1 cup lemonade.

Fruit-flavored gelatin, fruit punch, hard candy, jelly, maple syrup, sorbet and ices, sugar.

Low-fat

*Source: National Heart, Lung, and Blood Institute

Healthy Tips to Lower Blood Pressure

Choose "no salt added" or low-sodium foods.

Limit or avoid foods with high saturated and trans-fat content.

Consume fresh vegetables and fruit.

Choose lean cuts of meat, poultry, and fish.

Use spices to flavor foods when cooking or eating.

Prepare meals rather than pre-packaged or take-out meals.

Have small portion sizes of food.

Maintain a healthy weight.

Drink water, low-fat dairy, and club soda.

When dealing with a high blood pressure diagnosis, there are changes you can make in lifestyle and dietary habits to reduce the risk of complications. High blood pressure may be a manageable condition by monitoring your intake of food and beverages. Regular exercise also is vital to living a healthy life with high blood pressure.

The DASH diet is a common recommendation by medical experts to lower blood pressure. Studies show that consuming fresh fruits and vegetables, low-sodium foods, and lean cuts of meat can not only lower high counts of blood pressure, but can also prevent complications such as stroke and heart disease.
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Hypertension Diet: Healthy Tips to Lower Blood Pressure

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Disclaimer: Results are not guaranteed*** and may vary from person to person***. One of the most common silent killers, high blood pressure is also a manageable disease when you consume healthy, good foods as part of a treatment plan.

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Blood pressure is an indicator of how much force the heart needs to beat in order to get blood pumping through the body. The reading of your blood pressure is given at two numbers, either systolic or diastolic.

Stysolic blood pressure is the highest pressure when your heart beats and pushes blood round your body. Diastolic pressure is the lowest pressure when your heart relaxes between beats.

A person whose reading is higher than 140/90 is categorised as having high blood pressure. Uncontrolled high blood pressure could lead to stroke, blood clots and possibly dementia.

High blood pressure affects more than one in four adults in England and diets high in salt and processed foods are increasing the statistics.

Many people with high blood pressure worry that exercise might make symptoms worse. But in fact, physical activity is one of the best remedies to combating symptoms of high blood pressure.

The NHS said: "Researchers carried out a review of 391 studies and trials which had looked into the effects of either blood pressure medicines or exercise programmes on blood pressure.

"When they compared the effects of the two different interventions, they found exercise produced similar results to medicines for people with high blood pressure.

"The research proved that exercise is a powerful tool to reduce and to control blood pressure.

"The results should encourage everyone to do enough physical activity to keep blood pressure at healthy levels."

Different types of exercise have different effects on the body. For people with high blood pressure - it's all about the heart.

There are many ways to get your heart rate up and making small changes to your everyday life will ensure this.

Where possible, choose to walk rather than take public transport, climbs stairs instead of using lifts and escalators, and do chores at home, as these could be excellent ways to get the blood pumping.

Exercises recommended for high blood pressure are:

It is recommended to consult your GP before embarking on any major physical regime.

If you feel any discomfort whilst exercising such as pains in your chest or dizzy feelings, you should stop immediately. Your doctor might recommend a stress test before hand.

For people worrying if exercise is safe on their body, you could start with light to moderate exercises and gradually work up the intensity.

Even if exercise does not change your blood pressure, it strengthens your heart which in turn reduces the damaging effects such as strokes or dementia.

Ultimately exercise lowers your cholesterol, keeps your weight in check and produces endorphins to make you feel happy and healthy.

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High blood pressure: The best exercises to lower blood pressure levels

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HIGH blood pressure can be lowered by utilising exercise, which has been described as the drug-free approach to reducing symptoms. The risk of high blood pressure increases with age and a balanced diet coupled with exercise is crucial to keeping blood pressure levels normal.

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