March 5, 2012
1. Blood pressure control relies on a complete diary
Blood pressure control relies on a blood pressure diary of high quality: You should measure your blood pressure 2-3x per day and then record the values in a table. However, the wealth of information contained in the blood pressure diary is not self evident: You need to convert the long list of numbers into color coded charts to extract the critical information for treatment. A visual display is much more revealing than naked numbers.
2. Blood pressure watch displays average blood pressure values
A first impression of the state of your blood pressure can be gained from the blood pressure "watch" - this color coded chart presents the average systolic pressure and the average diastolic pressure as obtained within a measurement period. This period can be rather short such as several days or a week or can be longer such as a month or a year.
3. Color coded chart reveals the stage of blood pressure
The two average values are displayed as a blood pressure watch: The left half of the display shows the systolic average value, the right half the average diastolic value. The color at the dial reflects the stage of your blood pressure:
If any of the two pointers of your chart points toward one of the red regions - please see your doctor or nurse practitioner. You may be at an increased risk for a stroke or heart attack.
Note: To generate your individual blood pressure chockpit, go to www.medmobile.at, register for a free account and enter your measurement values: You will then be presented with your version of the medmobile blood pressure cockpit that delineates your current state of health concerning high blood pressure and tells you whether you have achieved blood pressure control.
(The graph shown at the top of this post was generated using the monitoring tools from www.medmobile.at)
February 1, 2012
If you want to control high blood pressure you first need a good understanding of your blood pressure values. You need to be able to answer these critical questions:
1. What is my blood pressure?
Blood pressure varies, sometimes quite a lot. But you still want a single number that tells you your "blood pressure state of health". For that we take the average of the blood pressure values. The average summaries all values obtained within a period (such as a week or a month) into a single number. The average is calculated for both the systolic blood pressure and the diastolic blood pressure.
2. What is the overall variation (distribution) of my blood pressure?
Your blood pressure may show only little changes between measurements and thus be rather constant. However, measurements may also vary a lot with many high values and many low values. The average values between these two situation may be very similar, but the distribution of values among low, normal or high values is quite different. The distribution of values elucidates the variation of measurements values.
3. What is the time course of my blood pressure?
Blood pressure is not constant, it changes over time. Treatment of high blood pressure is a long term strategy. Therefore you need to observe blood pressure values over longer time periods such as weeks and months to see how effective therapy is.
4. What is the daily variation of my blood pressure?
Some people have high values in the morning, some people have high values in the evening. Blood pressure medication is usually taken in the morning and the evening, only in rare cases is medication taken during the day. You need to know at what time of the day your blood pressure tends to be high. With this information your nurse or physician can advise you whether you better take medication in the morning or in the evening.
5. What is the appearance of all my blood pressure measurements?
You want to get an idea whether your blood pressure measurements cluster into different groups or spread evenly. You also want to assess the relation between systolic and diastolic blood pressure values. When your blood pressure is high is it because systolic values are high, is it because diastolic values are high or because both systolic and diastolic values are high.
Easy answers to questions 1-5: Your blood pressure cockpit
You measure your blood pressure regularly, you have a long list of measurement values. But when you look at these columns of data, you cannot easily answer your critical questions. This is were colored graphs come into play. Graphs can be of a tremendous help to elucidate relationships between data points. A visual representation of data is much easier to understand than columns of digits. Color coded graphical charts can highlight important aspects of your blood pressure values: They can help you to answer all the questions from above. Once you understand these color coded graphs you can evaluate your "blood pressure state of health" with a single glimpse of your eye.
The blood pressure cockpit presents different views of your blood pressure data in an easy format: 5 graphs arranged in two rows. The graphs in the cockpit will be explained in further blogs. The cockpit was generated using the monitoring tool www.medmobile.at
March 2, 2011
In most people the pressure from the aorta (the large main artery in the chest) is transmitted equally to both arms so that is makes no difference whether you measure on the left or the right arm. However, in some patients there is a slight obstruction to blood flow either on the right or the left arm so that pressure is actually lower at the side with the obstructed flow. If there is a consistent difference between the measurements obtained on the left and right arm, always the side with the higher value needs to be used. The side with the lower measurements does not accurately reflect the central aortic pressure and thus should not be used.
When pressure measurements on both sides are equal, right handed people usually prefer to measure on the left arm. It is easier use the right hand to place the blood pressure cuff unto the left upper arm. It is the other way around for left handed people.
February 24, 2011
The invasive way of measuring blood pressure uses a needle or a small tube filled with saline that needs to be poked into an artery to directly record the blood pressure. While this is the most accurate method for getting at the blood pressure it is invasive and can lead to complications. Therefore it is only used under life threatening situations in very sick patients in intensive care units. The invasive measurement is based on the transmission of the pressure exerted by the blood through the fluid filled catheter to a pressure gauge located outside the body. While the pressure signal gets slightly altered while travelling from the blood stream through the fluid filled tube to the gauge, the measurement at the gauge nonetheless reflects rather accurate the pressure inside the vessel.
The noninvasive way of measuring blood pressure cannot use any pressure sensor placed inside the body. So clever ways have been devised that give an indication of blood pressure by relying on external maneuvers. First a site for pressure measurement needs to be found. We really would like to measure the blood pressure that is generated by the pumping heart in the chest. But we have no access to this site. But the blood streams from the chest through the arteries to the arms and the hands and at these sites pressure can be assessed. Of course blood pressure could also be measured at the legs or the feet, but this is not really feasible in a routine setting.