Advice from the BP Measurement Experts
The American Heart Association just released a scientific statement on blood pressure (BP) measurement that outlines new guidelines for accurately measuring blood pressure. This is the first time the AHA has made significant updates to their recommendations since 2005. In the statement they describe and compare different methods of measuring BP and make many recommendations. What are the key points that a physician should learn from this new paper?
On top of reducing the risk of cardiovascular disease, aggressive treatment of high blood pressure has shown effectiveness in mitigating risk of mild cognitive impairment. Mild cognitive impairment is viewed as a potential precursor to Alzheimer’s and dementia. A study showed that when treating patients to reduce systolic blood pressure below 120, as opposed to below 140, the past standard target, the risk of mild cognitive impairment was reduced by 19% comparatively.
Gone are the days where your cardiovascular health could be summed up in two numbers. Systolic and diastolic blood pressure, measured at the brachial artery, were the key tools for staving off heart attack, stroke and other cardiovascular disease (CVD). Have a BP of under 140/90? Great! You are going to live a long and healthy life. Over 140/90? Time to watch your salt and medicate away. While lowering BP in hypertensive patients has been proven to be an effective intervention, it may not be so simple any more. Research, such as the SPRINT study, are finding benefits for managing BP in pre-hypertensive patients. With that, a new series of indices and measurements are offering more tools for doctors to measure and treat hypertension.
On recognizing the fact that fifty percent of the world hypertensive population did not realize they had the condition, the World Hypertension League (WHL) dedicated May 17th to the promotion of hypertension awareness. Since that day in 2005, World Hypertension Day has been celebrated by offering free blood pressure readings through the volunteered efforts of numerous affiliated organizations across the globe.
Ambulatory blood pressure monitoring (ABPM) - a procedure in which a patient wears an automatic blood pressure device for 24 hours as readings are taken every 30-60 minutes - is a widely used hypertension diagnostic tool in many countries, but not the US.
Traditionally, blood pressure (BP) measurement is largely confined to the doctor's office, using manual measurements to provide a snapshot of a patient's blood pressure and cardiovascular risk.
Anyone who has had a stress test knows that stress tests are not easy and can even be painful! The commonly-used Bruce protocol for treadmill exercise tests includes 7 stages of 3 minutes each. The first stage starts at a 10% grade at a speed of 1.7 miles per hour. Each stage increases by 2% and between 5-9 miles per hour. Even though a stress test can last for over 20 minutes, most people don't last longer than seven minutes on the treadmill. However, it is important to keep going as long as possible to collect lots of data and be sure to reach the target heart rate. Each additional minute of a stress test could yield important information about the heart's condition.
Blood Pressure experts offer new advice based on a recent study conducted by the ACP/AAFP, which shows that the threshold for hypertension in healthy patients may not be as low as what the SPRINT study of 2015 concluded.
Just like humans, dogs can have hypertension, which is higher than normal blood pressure. The best way to prevent hypertension in your pet is through a healthy diet and exercise. The risk of high blood pressure increases as the animal ages. One study found that up to 10% of dogs may suffer from high blood pressure1!
Blood Pressure Basics
Taking a patient’s blood pressure has become a routine practice for medical staff. Unfortunately, training in this area is often met with a very high-level overview and is sometimes neglected in regards to the overall mechanics of manual or automated methods in accurate blood pressure measurement techniques.
Research has proven that ambulatory blood pressure monitoring (ABPM) is the best way to determine true blood pressure available to physicians today. Results from an ABPM device will always 1 provide a level of insight unavailable with other forms of blood pressure measurement. However, there are eight situations in which ABPM is especially useful in providing accurate readings to properly diagnose hypertension.
A blood pressure check is one of the first procedures done when you go to the doctor. So it should be no surprise that your veterinarian will likely check your pet’s blood pressure, too!
It is becoming more and more common for vets to regularly check blood pressure at every checkup. However, many pet owners do not realize that their pet’s blood pressure is constantly changing in response to many factors. Being aware of these factors and ensuring that your pet is comfortable in its environment will help the vet to get the most accurate blood pressure reading. Here is a list of 5 factors that may cause significant changes in your pet’s blood pressure:
According to the Centers for Disease Control and Prevention (CDC), nearly 70 million American adults have high blood pressure—that’s 1 in every 3 adults. More alarming is that only about half (52%) of people with high blood pressure have their condition under control.
With those overwhelming numbers, it goes without saying that raising awareness about how to reduce hypertension – with or without medication – is critical.
How Low Should Blood Pressure Go?
When it comes to blood pressure guidelines, it’s a question cardiologists have puzzled over for years – just how low should blood pressure go? Well, according to articles released by nearly every major news outlet, including The New York Times, US News & World Report, FOX News and NBC News, federal health officials have declared they have “potentially lifesaving information” as a result of a recent major study – one that they are ending a year early because it has already conclusively answered this question.
The April 2015 edition of Cardiology Today includes an interesting article – “New Hypertension Recommendations Anticipated in 2016” - stating that the American Heart Association (AHA) and the American College of Cardiology (ACC), in collaboration with nine other medical societies, will be releasing new hypertension guidelines that will serve as an update to those released by the Seventh Joint National Committee (JNC 7) in 2003.
But, wait…weren’t updated guidelines already published back in 2013? As a matter of fact, they were!
According to the Centers for Disease Control and Prevention, 67 million American adults (31%) have high blood pressure – that’s 1 out of every 3 adults. Depending upon the severity of the condition, typically diagnosed by in-office BP measurements, blood pressure medication and/or lifestyle modifications may be prescribed.
Although in-office BP measurements are typically used to diagnose hypertension, several studies have shown that other diagnostic options are far more reliable - specifically, the use of a 24-hour, ambulatory blood pressure monitoring device (ABPM).
A vast amount of physicians are diagnosing hypertension without properly assessing a patient’s blood pressure during the course of a 24-hour period using Ambulatory Blood Pressure Monitoring. Simply put, ABPM provides valuable diagnostic information that in-clinic and home blood pressure monitoring systems are incapable of measuring including:
Believe it or not, your pet can have high blood pressure too! That being said, the significance of this is a bit different than it would be for you and me. Hypertension in cats and dogs is almost always secondary, which means it is caused by an underlying condition or disease. Because secondary hypertension is a signal that something else is wrong, blood pressure screening is a great way to discover other health issues in your pet such as acute kidney disease or hyperthyroidism. BP screening can help to prevent serious organ damage if a condition or disease is caught in its early stages.