1. Blood pressure measurement by automated devices - background information EHES Training Material

2. Hypertension as a cardiovascular risk factor

3. What is blood pressure? Systolic blood pressure (higher value) represents the pressure while the heart contracts to pump blood to the body Diastolic blood pressure (lower value) represents the pressure when the heart relaxes between beats

4. Risk factors of elevated blood pressure Salt intake Obesity Alcohol use Sedentary lifestyle Smoking Fat contents of the food

5. Factors affecting blood pressure levels Measurement environment Noise, temperature Factors related to the participant Factors related to the measurer Measurement device Cuff size

6. Factors related to the participant Emotions – white coat hypertension Exercise Eating before measurement Smoking Use of caffeine containing drinks Alcohol use Full bladder Pain Daily variation Medication

7. Average magnitude of the effects (1/3) EffectSystolic bp (mmHg)Diastolic bp (mmHg) Full bladder  10-15 mmHg, even up to 50 mmHg if bladder uncomfortably distended  10 mmHg, even up to 40 mmHg if bladder uncomfortably distended Not resting 3 to 5 minutes before measurement  10-20 mmHg 14 mmHg Back / feet unsupported  5-15 mmHg 6 mmHg Supine posture instead of sitting posture  3-10 mmHg 1-5 mmHg

8. Average magnitude of the effects (2/3) EffectSystolic bp (mmHg)Diastolic bp (mmHg) Legs crossed  5-8 mmHg 3-5 mmHg Participant talks during the measurement  10-15 mmHg 6-10 mmHg Arm below heart level  10 mmHg Physical exercise before measurement  22 mmHg 7-8 mmHg Left arm instead of right arm  1-3 mmHg 1 mmHg Arm unsupported during the measurement  1-7 mmHg 5-11 mmHg

9. Average magnitude of the effects (3/3) EffectSystolic bp (mmHg)Diastolic bp (mmHg) Cuff too small  3-12 mmHg 2-8 mmHg Cuff too large  10-30 mmHg Cuff over clothing  up to 5 mmHg

10. Acknowledgements Slides Hanna Tolonen