Hello, dear readers! Arterial hypertension can be suspected if you have three blood pressure measurements on different days, you found it rising above 140/90 mm Hg. but in order to accurately make a diagnosis, you need a number of examinations, including daily blood pressure monitoring, which allows you to accurately determine whether you have arterial hypertension.
Daily blood pressure monitoring (Smad) is a method for assessing the daily BLOOD pressure rhythm in vivo using portable blood PRESSURE monitors.
Why do I need daily blood pressure monitoring?
Indications for conducting Smad
Clinical blood PRESSURE (measured during visits to the doctor) is the main method for determining the value of blood pressure, but it is strongly influenced by psychological factors and “white coat syndrome”. Self-monitoring of blood pressure at home provides more complete information about the value of blood PRESSURE, but does not take into account blood PRESSURE during “daily” daytime activity, especially in working people,and blood PRESSURE at night.
Smad allows you to provide information about blood PRESSURE fluctuations during the day, clarify the prognosis of cardiovascular complications, and more accurately assess the effect of hypotensive therapy, as it reduces the “white coat syndrome” and placebo.
it Is most appropriate to use Smad in the following situations:
- strong variability of blood PRESSURE during repeated visits to the doctor or during self-monitoring;
- discrepancy between the blood PRESSURE figures and the degree of target organ lesions characteristic of arterial hypertension(there may be high blood pressure in the absence of changes, or Vice versa, low blood PRESSURE figures with pronounced changes);
- large differences in the value of blood PRESSURE at the reception and according to self-monitoring data;
- low effectiveness of antihypertensive therapy;
- episodes of hypotension (low blood pressure), especially in elderly patients and those with diabetes;
- arterial hypertension in pregnant women.
Contraindications and possible complications
There are no absolute contraindications. Possible complications include edema of the forearm and hand, small-point hemorrhages, and contact dermatitis.
How the procedure is performed
The measurement plan provides for the establishment of day(6.00-24.00) and night (00.00-6.00) periods. The multiplicity of measurements in the daytime period is 1 time in 15 minutes, in the night period-1 time in 30 minutes. You record your sleep and Wake periods by clicking the “event” button on the monitor.
The monitor is placed in a case and attached to the body. The cuff is applied to the shoulder(can be over a thin shirt, t-shirt with a sleeve) and fixed.
During Smad, your daily routine should be normal, and with intense physical, emotional, and mental stress, you should write in your diary.
You will learn about the beginning of the measurement by squeezing the shoulder due to the increase in pressure in the cuff. If you were walking at this moment, you need to stop, lower your arm with the cuff along the trunk,relax the arm muscles as much as possible, and do not move your fingers. If you were sitting or lying down, you should leave your hand in the position in which it was.
If the measurement fails, the monitor pumps air back into the cuff after the pressure drops. Blood pressure monitor helps you measure your blood pressure correctly.. Zoom wellness blood pressure monitor should have everyone who suffers from high blood pressure. The monitors are equipped with an “extraordinary measurement” button, which you can press if you have a headache,heart pain,dizziness, etc.
Evaluation of results
Interpretation of results should be carried out by a competent cardiologist.
When analyzing data, the most informative are:
- average blood PRESSURE values per day, day, night;
- maximum and minimum blood PRESSURE values in different periods of the day;
- daily index;
- morning rise in blood pressure.
The daily index (SI) or the degree of nocturnal decline (SNA) shows the difference between daytime and nighttime BP values as a percentage of the daily average. The optimal SNA of blood PRESSURE is from 10 to 20 % compared to daily indicators.
According to the value of SI, there are four groups of patients:
- normal (optimal) SNS AD-SI 10-20%;
- insufficient SNA AD -0<SI<10 %.
- increased SNA AD-SI >20%. Too low night blood PRESSURE is especially dangerous in the elderly, as they often have signs of pain-free myocardial ischemia, as well as disorders of cerebral circulation.
steady increase in nighttime AD-SI<0. This is a risk factor for death from cardiovascular diseases. Each increase C by 5% increases the risk of death by 20 % even at normal values the average blood pressure (less than 135/80).
Morning rise in blood pressure
In numerous studies it has long been noted that the greatest number of cardiovascular complications(myocardial infarction, stroke, sudden death) falls on the morning hours, especially in the first 2 hours after awakening.
The morning is the only time during the day when blood clotting increases, so sharp rises in blood PRESSURE at this time can lead to complications much more often.
If possible, each hypertensive patient should conduct a daily blood PRESSURE monitoring procedure so that it can be repeated to assess the effectiveness of antihypertensive therapy and the risk of possible complications. Be examined in a timely manner and be healthy!