Everyone knows that blood pressure needs to be kept under control. Most people for these purposes have not resorted to the help of health workers for a long time, but use special devices for home use. The tonometer instructions describe how to use the device, but on which hand to measure blood pressure, it does not say anything. And is it so important and what else do you need to know in order for the control results to be reliable.
Blood Pressure: Definition
Blood pressure is an integral indicator that reflects blood pressure on the walls of blood vessels and chambers of the heart. It is one of the main conditions of hemodynamics. Blood pressure varies depending on the needs of the body, which is an adaptive reaction. Neurohumoral, metabolic factors and functional systems take part in maintaining the constancy of blood pressure. Deviations from the norm in indicators indicate failures in the work of supporting factors and systems.
Why do I need to measure pressure
Blood pressure is one of the significant parameters by which a state of health is judged. It allows you to evaluate the health of internal organs and the state of the body as a whole.
Changes in blood pressure are signs of a violation of the hemostatic system or its regulation systems. Marked changes in themselves become the cause of pathologies. An increase in pressure may indicate arterial hypertension. Deviations from the norm can also be symptoms of kidney pathologies (pyelonephritis), hormone-active tumors (corticosteroma, pheochromocytoma), diseases of the central nervous system, pulmonary vessels (pulmonary hypertension).
A pathological decrease in blood pressure is observed with pituitary, adrenal gland insufficiency. A significant decrease can lead to stroke, crisis, coronary heart disease.
Monitoring indicators helps to detect the disease in time. In order for the indicators to be as accurate as possible, you need to know on which hand to measure blood pressure. With distorted blood pressure indicators, you can incorrectly make a diagnosis.
What affects blood pressure
Blood pressure is strongly influenced by certain factors that must be considered:
- Caffeine. In people who constantly drink coffee, tea, chocolate, the risk of developing hypertension is much higher. For accuracy, an hour before measuring pressure, you should refrain from consuming caffeinated foods and drinks.
- Medicines, including homeopathy. Two hours before measuring pressure, stop taking drugs that increase or decrease blood pressure. Patients undergoing drug therapy should inform the doctor about this.
- Body position. Different pressure on the hands for a short period of time may be due to an uncomfortable posture. The position of the body should be such that the blood circulates freely throughout the body.
On which hand do you need to measure blood pressure?
Blood in the human body circulates in a circle, and various systems try to maintain approximately the same pressure. In newborns, indicators are removed from all four limbs. Different pressure on the arms and legs can be a symptom of a pathology that needs to be identified as early as possible.
Young children are often very active, measuring blood pressure with a conventional blood pressure monitor is problematic. In such cases, a compact tonometer is used, which is put on the finger. Although doctors do not trust the device 100%, preferring traditional methods.
If a person has cast, there are serious injuries, a paralyzed arm, then use a healthy arm or leg to measure pressure. The best option is to measure the pressure on both hands. Moreover, it is necessary to take readings regularly, especially if there is a threat of the development of pathology.
Why do different hands have different pressures?
When measuring blood pressure on the left and right shoulder, you can notice the difference in indicators. Significant deviations (10-20 units) may indicate serious pathologies.
If the pressure on the left hand is within normal limits, and on the right hand is increased, then it will be useful to diagnose vegetovascular dystonia. Also, the individual morphological features of the arteries of the upper extremities may be the cause of the difference in indicators.
If the indicators are normal on one arm and lower on the other, then the cause may be a blockage in the lumen of the brachial or subclavian artery. Violation of patency of blood vessels may be a consequence of the following diseases:
- Atherosclerosis is the deposition of cholesterol on the vascular walls.
- Thromboembolism - clogging of blood vessels by blood clots.
- Aortoarteritis (Takayasu disease) - narrowing of the aorta and major arteries.
- Aneurysm is a pathological extension of the aorta.
- Nuffziger syndrome (scalenus syndrome) - neurovascular disorders between the scalene muscles of the vessels and muscles.
- Malignant and benign neoplasia in the soft tissues and bones of the chest.
- Violation of the integrity of the arteries as a result of injuries or surgical procedures.
If the pressure on one arm slightly exceeds the norm, and on the other hand the indicators are much higher, then the causes may be lack of sleep, stress, hypertension, neurocircular dysfunction.
In some cases, the difference between the indicators between the right and left hand is considered the norm
Pressure varies slightly depending on the needs, activity and characteristics of the body. Deviations of indicators by 5-10 units. in either direction are considered the norm.
Why do different hands have different pressures? The reason may be different factors that must be considered:
- Age. In adolescence and in old age, the body changes greatly, a slight irregular asymmetry is the norm in this condition.
- Right-handed or left-handed. On the hand that a person is most deftly, and therefore more often uses for personal needs, indicators will always be slightly higher. This is due to the large wear of muscles and blood vessels.
- A slight excess of indicators on the left hand is sometimes associated with anatomical features. Blood supply to the left arm is provided by the subclavian artery, which departs from the aorta, and the pressure in it is always higher.
- Incorrect load distribution. Most people inconsistently distribute the load on the muscles. Constant involvement of one and the same muscle group can lead to ruptures of small capillaries in them, which affects pressure indicators.
Methods of measuring blood pressure
There are two methods for measuring pressure: indirect (compression) and direct. The latter is invasive and performed by a physician.
The direct method has high accuracy, regardless of which hand you measure blood pressure on. A special needle (cannula) is inserted into the artery, which is attached to the pressure gauge. An anticoagulant is introduced into the vessel with the help of a microinfuser, and the pressure gauge continuously records the indicators. The method is usually used during cardiac surgery.
The compression diagnostic method is used in medical facilities and at home. The most commonly used methods are:
- Auscultatory. Pressure is measured using a sphygmomanometer. The artery of the shoulder is squeezed by a compression cuff and air is pumped into it to the maximum compression. Then the air is released and the tone is heard using a phonendoscope. The first tone (knock) is an indicator of systole (upper number), the disappearance of a knock is an indicator of diastole (lower number).
- Oscillometric Blood pressure is measured using an electronic or semi-mechanical blood pressure monitor. The artery on the arm is pressed down with a cuff, and the apparatus captures the micropulsation of air during blood flow. The final result is shown on the display. For home use, the oscillometric method is the most optimal.
The main types of tonometers
There are 4 groups of tonometers:
- Mechanical. The use of a sphygmomanometer implies the possession of special skills and knowledge, since the procedure is performed by a person. The devices are inconvenient for home use, mainly used in medical facilities or the emergency team.
- Semi-automatic. The air in the cuff is pumped mechanically, and the readings are taken by the device.
- Electronic. All actions are performed by the device. To understand how to correctly measure blood pressure with a tonometer, the detailed instructions attached to it help.
- Automatic for the wrist or finger. The readings are taken by the device. The results are greatly distorted, so doctors advise nevertheless to measure the pressure by applying a cuff to the shoulder. The device is suitable for a car kit.
Preparation for the procedure
Which arm to measure blood pressure on? For greater accuracy, it is better to take readings from both upper limbs, and 2-3 times. Before measuring pressure, certain conditions must be met:
- No matter where and who performs the procedure, you need to relax before the diagnosis.
- Half an hour before measuring blood pressure, you should stop smoking.
- An hour before the procedure, it is necessary to refrain from drinking tea, coffee, soda.
- If alcohol was consumed the day before, indicators will be unreliable. If there is a medical examination in the morning with a measurement of blood pressure, you should not take alcohol in the evening.
- For several hours, it is necessary to stop any active physical activity.
Blood Pressure Algorithm (Nursing)
In medical practice, for each manipulation, there is a certain procedure. They must be performed in accordance with established rules.
Algorithm for measuring blood pressure:
- Seat the patient, if the condition does not allow, then lay him down.
- Place the arm bare to the shoulder with the palm up.
- Place the cuff on the arm 3 cm above the elbow. Put a roller under your arm. The dimensions of the cuffs of the tonometers should be selected so that when they are applied between them and the patient’s hand, the finger passes freely. There are 4 of them: children (15-22 cm), standard (22-32), large (32-42 cm), universal (22-42 cm).
- Use your finger to feel the pulsation on the ulnar artery and attach a phonendoscope to the place.
- Attach the cuff to the tonometer and proceed to pump air until the ripple disappears.
- Open the valve and gradually bleed the air in the cuff.
- To fix on the scale the appearance of the first tone (knock) - an indicator of systole.
- Mark on the scale the termination of the last tone - an indicator of diastole.
After the pressure on the right hand has been measured, a similar procedure is performed on the left. For greater accuracy, the procedure is repeated twice. All are fixed for further analysis.
Errors in blood pressure measurement
Inaccurate values are obtained due to incorrect procedure:
- Arrangement of the hand. It should not hang down, but lie flat on a hard surface above the level of the heart.
- You need to know what time to measure blood pressure. Morning and afternoon readings are always different. It is better to measure pressure no earlier than an hour after sleep.
- Restless condition. The procedure is non-invasive and short, for the time of its implementation should sit quietly and silently.
- The cuff is twisted or too tight.
- Pressure is measured for 7-10 minutes. The interval between measurements should not exceed 3 minutes.