Do the “4 Sets” to measure blood pressure more accurately

  Everyone knows that blood pressure monitoring is the main method for evaluating blood pressure levels, diagnosing hypertension, and observing the effect of lowering blood pressure. At present, in clinical and prevention work, three methods are mainly used: office blood pressure, ambulatory blood pressure and home blood pressure measurement. Among them, home blood pressure monitoring has become an indispensable means to effectively improve the awareness and control rate of hypertension. Many recent national or regional hypertension guidelines, including the “2019 Chinese Family Blood Pressure Monitoring Guidelines”, strongly recommend family blood pressure monitoring. So, what are the precautions for measuring blood pressure at home? How to ensure the accuracy of the measurement?
Recommend upper arm type electronic blood pressure monitor

  First of all, we have to choose a blood pressure measurement device suitable for home use. At present, common household sphygmomanometers include spring-loaded sphygmomanometers, pressure column sphygmomanometers, light display sphygmomanometers, and liquid crystal sphygmomanometers. General doctors preferentially recommend the upper arm type automatic oscillometric electronic sphygmomanometer. In the course of long-term clinical use, the accuracy and repeatability of this sphygmomanometer have been fully verified, and the patient can basically master the correct measurement method after a brief study according to the instructions or the guidance of relevant professionals.
  When purchasing, you should first choose sphygmomanometers from well-known brands at home and abroad. These manufacturers are relatively large in scale, relatively reliable in product quality, and have a relatively complete after-sales service system, which is convenient for patients to perform regular calibration during the use of sphygmomanometers to ensure the accuracy of self-test blood pressure. When purchasing blood pressure monitors, you should also pay attention to requiring the seller to provide a cuff of a suitable size that matches the circumference of the upper arm of the main user of the blood pressure monitor. At present, most electronic sphygmomanometers are equipped with standard cuffs (upper arm circumference <32cm) suitable for most measurers and large cuffs (upper arm circumference ≥32cm) for those with larger upper arm arm circumferences. If you are measuring blood pressure in children, adolescents, or other people with thin upper arms, you should choose a small cuff. The measurement must be done well   Prepare the measuring equipment, let's talk about how to measure. First of all, do not exercise vigorously, empty your bladder, do not smoke, and keep your mood stable within 30 minutes before the measurement. Then, choose a comfortable seat, lean the body back against the back of the chair, relax your legs, land your feet naturally, expose your arms and place them on the table in a relaxed state, tie the blood pressure monitor cuff, and the cuff should not be too loose Or too tight, the center point of the cuff should be roughly at the same level as the position of the heart. Finally, the blood pressure can be measured 2 to 3 times each time, with an interval of 1 minute. Finally, take the average value and record it. At the same time, record the measurement date and time, pulse and other information. For the first visit, early treatment, or the blood pressure that has not reached the target despite treatment, the blood pressure should be measured continuously for 5 to 7 days before seeing the doctor; when the blood pressure is well controlled, the blood pressure should be measured at least 1 day a week.   In order to ensure the accuracy of the measurement results, the following "4 fixes" should be implemented-   the blood pressure of the human body will be slightly different at a given time, generally the lowest in the morning, the peak in the evening, and then fall back. Therefore, only when blood pressure measurements are performed at the same time period can they be comparable. It is generally recommended to measure the blood pressure in the morning and evening each day, in order to understand the blood pressure in the morning and the blood pressure in the evening. One hour after waking up in the morning, measure before eating breakfast, taking antihypertensive drugs, morning exercises and other activities; measure blood pressure at night after dinner and before going to bed.   The fixed position is affected by the anatomical position of the brachial artery. Generally speaking, the blood pressure of the right upper limb is higher than that of the left upper limb, and the blood pressure difference is about 5-10mmHg. Therefore, if you choose the left upper limb for blood pressure measurement, you will always choose the left upper limb instead of today. The upper left limb will choose the upper right limb tomorrow, causing human error.   The fixed position blood pressure will change with the body position. For example, there will be a 10mmHg difference between sitting and lying position. China's hypertension guidelines recommend that sitting posture is recommended to measure blood pressure. Of course, if the patient cannot maintain a sitting posture due to illness, he can also choose lying posture or other postures, but it should be noted that the same posture should be maintained for each measurement.   Regardless of the sphygmomanometer you choose, it is not recommended to replace it frequently, because there are differences between different sphygmomanometers. Of course, if the blood pressure monitor at home is not accurate enough, it should be replaced in time. How to judge whether the sphygmomanometer is accurate? You can take the home sphygmomanometer to the hospital and compare the measurement results with the hospital's sphygmomanometer, and measure them 3 times. If the difference is less than 7mmHg, you can continue to use it.