What To Do In High Blood Pressure? (Decalogue of apatient
Dr. Stefan Farsky, Slovakia.
- Change your lifestyle and set up your own priorities, with health occupying the
- Decrease the psychic stress * reduce the excessive number of activities, avoid the
time shortage, always have atime reserve, even in keeping the trivial deadlines
(e.g., departure of a public bus). Do not perform more activities simultaneously,
finish the task before starting another one. Increase the support of people who
are close to you; feel the support of relatives, friends, colleagues.
- Increase relaxing activities * introduce regular strolls, passive rest, and asufficient
quantity of sleep, warm spa and whirlpool, autorelaxing and yogism techniques, non-competitive
sports, non-stressful hobby.
- Enrich your weekly schedule with the minimum of 3 x 40 minutes of aerobic activities
(fast walk, jogging, swimming, cycling, cross-country skiing) reaching 50-70% of
the maximum pulse rate. If you suffer from aconcomitant cardiovascular or other
disease, follow the recommendations of the specialist.
- Do not smoke.
- Gradually decrease the content of salt in meals and substitute it by natural plant
spices. Avoid food and beverages with ahigh content of salt (smoked meats, tinned
and instant meals, some mineral waters).
- Prefer meals with high content of fibres and vitamins (5 pieces or 500 g of fruits
daily, raw or stewed vegetables, whole-grain bakery products). Substitute whole
milk and dairy products with low-fat ones (cheese with the content of fat in the
solid ingredients lower than 30 %), reduce the intake of animal fats (butter, egg-yolk,
red meat and products made of it). Increase the intake of fresh fish and fish products.
The meals should be stewed, not fried. If you are overweight, reduce the intake
of calories and increase the output of energy.
- In case of high alcohol consumption, decrease adaily alcohol intake to the maximum
of 0.2-0.3 l of wine, 0.3-0.5 l of beer, or 0.04 l of liquors.
- These changes should be introduced gradually, not simultaneously. Akey to the success
is to focus on 1 or 2 changes. If you reach them and keep them up, then you can
concentrate on other changes.
- Measure your blood pressure regularly at the same time in mornings and evenings,
and calculate the mean values. The aim is to reach the mean values lower than or
equal to 135/85 mmHg. Use calibrated aneroid, the accuracy of which was verified
by comparison with astandard mercury sphygmomanometer (in electronic manometers
prefer those with the accuracy verified according to BHS or AAMI protocols).
Stefan Farsk@, M.D., Ph.D.
Slovak League against Hypertension
House of Heart, Zelena3
03608 Martin, Slovakia
Principles of measuring blood pressure
Standardised way of measuring blood pressure
- The patient sits back, his upper limb is put down on the underlayment at the level
of heart, manometer is also placed at the level of heart.
- The patient should rest for the minimum of 5 minutes prior to examination, smoking
and consumption of beverages with the content of caffeine should be avoided 30 minutes
- Examination should be repeated after 2 minutes, possibly more times, if the difference
between the values is higher than 5 mmHg * the mean is calculated from resulting
- Measuring is possible also in the standing position * in elderly patients and diabetics.
Suitable size of the cuff
- inflated part must embrace at least 80 % of the upper arm
(in circumference of the upper arm > 41 cm, width of the cuff being 18 cm)
Mercury sphygmomanometer or calibrated aneroid, possibly electronic manometer (in
Europe validated according to British Hypertension Society or AAMI, possibly other
relevant standards). Digital gaugers are inaccurate.
In auscultatory technique
- phase 1 * the beat can first be heard * means asystolic pressure
- phase 2 * the beat disappears * means adiastolic pressure
Characteristics of measuring blood pressure at home:
Normal values are somewhat lower than in standard measuring * 135/85 mmHg and below.
Mean value calculated from many measurements is crucial for evaluation of normal
values. It is recommended to measure blood pressure 3 times before breakfast and
3 times before bedtime. In-depth instruction of patients is aprerequisite to the