Video 3 - Blood Pressure Measurement
‘All information contained in these videos is taken from the ACSM’s Guidelines for Exercise Testing and Prescription, 10th Edition’
Elevated blood pressure indicates a higher risk of cardiovascular events. For adults aged 40-70 years old, the risk of Cardiovascular Disease is doubled for every 20 mm of mercury increase in Systolic Blood Pressure, or 10 mm of mercury increase in diastolic blood pressure.
A blood pressure reading of greater than 140/90 mmHg is deemed as Stage 1 hypertension, and 160/100 mmHg is classed as stage 2 hypertension. Normal blood pressure is classed as below 120/80. The classification and management of blood pressure is detailed in table (table 3.2 p55).
Although automated blood pressure monitors are available, for a reliable and valid measurement, the use of a sphygmomanometer and stethoscope by a skilled tester is recommended. If using an automated monitor, please refer to the manufacturer’s guidelines.
- Client should be seated quietly for at least 5 minutes in a chair with back support with their feet on the floor and their arms supported at heart level. Patients should refrain from smoking cigarettes or ingesting caffeine for at least 30 minutes preceding the measurement.
- Wrap cuff firmly around upper arm at heart level; align cuff with brachial artery.
- The appropriate cuff size must be used to ensure accurate measurement. The bladder within the cuff should encircle at least 80% of the upper arm. Many adults require a large adult cuff.
- Place stethoscope chest piece below the antecubital space over the brachial artery.
- After ensuring the air release valve on the bulb is closed, quickly inflate cuff pressure to 20mmHg above the first Korotkoff sound (Korotkoff sounds are the sounds made by the pressure of blood exerted on the artery walls, and are described as tapping sounds similar to that of gently tapping the head of the stethoscope with a finger)
- Slowly release the pressure at a rate equal to 2-3 mmHg per second. Pressure is released by slowly opening the air release valve on the bulb.
- Systolic Blood Pressure is the point at which the first of two or more Korotkoff sounds are heard, and Diastolic Blood Pressure is the point before the disappearance of Korotkoff sounds.
- At least two measurements should be made a minimum of 1 minute apart, and the average should be taken.
- Blood Pressure should be measured in both arms during the first examination, and the higher pressure should be used if there is a difference between arms.
- Compare results to the ‘Classification and Management of Blood Pressure for Adults table’ (table 3.2) in order to determine whether the client is hypertensive.
- Provide clients, verbally and in writing, their specific blood pressure numbers and goals.