Diagnosis and measurement of adult hypertension

Diagnosis and measurement of adult hypertension

Normally, we use the upper arm cuff to measure blood pressure. Recent studies have shown that if the upper limbs are thickened (especially obese patients with a BMI > 35), measurement accuracy may be affected. The main reason is that conventional cuff airbags are not suitable for this group of people and may be too small or too narrow. The guide comments are as follows:

1. Under certain conditions, it is necessary for medical staff to measure blood pressure for patients to determine the risk of cardiovascular disease and to monitor the efficacy of antihypertensive therapy. (Class D)

2. When automating blood pressure measurement (AOBP), non-automatic outpatient blood pressure measurement, home blood pressure measurement, and ambulatory blood pressure monitoring, it is recommended to use some standardized techniques and equipment to measure blood pressure (D level). Electronic equipment (Class C) is preferred over auscultation blood pressure measurement tools.

3. For patients with thick upper arms, if the normal upper arm measurement method cannot be used, the wrist device can be used to measure blood pressure (the wrist should also be placed at the heart level) (Class D).

4. Four ways to assess blood pressure:

i. Outpatient blood pressure measurement is preferred AOBP (Class D). In this case, the diagnosis of hypertension is: systolic blood pressure ≥ 135 mmHg or diastolic blood pressure ≥ 85 mmHg (Grade D).

Ii. When the measurement method is non-AOBP, the diagnostic criteria for hypertension are: systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, normal high value: systolic blood pressure is 130-139 mmHg and / or diastolic blood pressure is 85-89 mmHg (Class C).

Iii. In the case of ambulatory blood pressure monitoring, hypertension is diagnosed as: systolic blood pressure ≥ 135 mmHg or diastolic blood pressure ≥ 85 mmHg, or average 24-hour systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg (Grade C).

Iv. At home blood pressure monitoring, mean systolic blood pressure ≥ 135 mmHg or diastolic blood pressure ≥ 85 mmHg (Grade C). If outpatient blood pressure is high but the average home blood pressure is <135/85 mmHg, it is recommended to repeat home blood pressure monitoring to confirm home blood pressure <135/85 mmHg or 24-hour ambulatory blood pressure monitoring to confirm 24-hour mean ambulatory blood pressure <130/80 mmHg and mean Awakening dynamic blood pressure <135/85 mmHg (excluding white coat hypertension) (Grade D).