1. Measuring Blood Pressure Blood pressure is indicates your heart health Blood pressure is indicates your heart health It is determined by the contractions of the heart It is determined by the contractions of the heart Your pressure varies depending on the condition of your heart and blood vessels Your pressure varies depending on the condition of your heart and blood vessels Pressure is measured in millimeters of mercury (mm Hg) Pressure is measured in millimeters of mercury (mm Hg)

2. © Continuing Medical Implementation …...bridging the care gap Diseases Attributable to Hypertension Hypertension Heart failure Stroke Coronary heart disease Myocardial infarction Left ventricular hypertrophy Aortic aneurysm Retinopathy Peripheral vascular disease Hypertensive encephalopathy Chronic kidney failure Cerebral hemorrhage Adapted from: Arch Intern Med 1996; 156:1926-1935. All Vascular

3. What is Blood Pressure Blood pressure is the force that blood exerts against blood vessel walls. Blood pressure is the force that blood exerts against blood vessel walls. The pumping action of the heart generates the flow The pumping action of the heart generates the flow Pressure occurs when the flow is met by resistance from blood vessel walls Pressure occurs when the flow is met by resistance from blood vessel walls

4. Laminar Flow Blood flows faster in the center of a blood vessel, because the blood near the sides are hitting the walls of the vessels. Blood flows faster in the center of a blood vessel, because the blood near the sides are hitting the walls of the vessels. Is caused by the friction (resistance) between the blood and the vessel walls. Is caused by the friction (resistance) between the blood and the vessel walls.

5. Blood Pressure Graph By taking your pulse, you can feel that blood pressure fluctuation with each heartbeat. By taking your pulse, you can feel that blood pressure fluctuation with each heartbeat. The pulse which you feel is actually a pressure wave that travels from your heart though your arteries The pulse which you feel is actually a pressure wave that travels from your heart though your arteries Systolic Dicrotic Notch Diastolic Average Pressure Pulse Pressure

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10. Systolic Pressure Systolic pressure is the maximum pressure exerted by the blood against the artery walls. Systolic pressure is the maximum pressure exerted by the blood against the artery walls. It results when the ventricles contract. It results when the ventricles contract. Normally, it measures 120 mm Hg. Normally, it measures 120 mm Hg. Systolic

11. Dicrotic Notch The Dicrotic Notch represents the interruption of blood flow due to the brief backflow of blood that closes the aortic semilunar valve when the ventricles relax. The Dicrotic Notch represents the interruption of blood flow due to the brief backflow of blood that closes the aortic semilunar valve when the ventricles relax. Dicrotic Notch

12. Diastolic Pressure Diastolic Pressure is the lowest pressure in the artery. Diastolic Pressure is the lowest pressure in the artery. It result when the ventricles are relaxed and is usually around 80 mm Hg. It result when the ventricles are relaxed and is usually around 80 mm Hg. Diastolic

13. Blood Pressure Sounds A cuff is inflated to constrict an artery so that no blood flows. A cuff is inflated to constrict an artery so that no blood flows. As the cuff pressure is slowly released, but the artery is still partially constricted, blood flow begins again. As the cuff pressure is slowly released, but the artery is still partially constricted, blood flow begins again. Sounds can be heard because the blood flows violently causing audible sounds. Sounds can be heard because the blood flows violently causing audible sounds. When the artery is fully open, the blood flows freely and the sounds disappear. When the artery is fully open, the blood flows freely and the sounds disappear.

14. Checking Blood Pressure The first sounds that are heard indicate systolic pressure (top number). The first sounds that are heard indicate systolic pressure (top number). When the sounds stop, diastolic pressure has been reached (bottom number). When the sounds stop, diastolic pressure has been reached (bottom number). Average blood pressure is: Average blood pressure is:120 80 80