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Systolic BP is a measurement of the
maximal pressure exerted against
arterial walls during systole,
primarily a reflection of cardiac
output.
Diastolic BP is a measurement of
pressure remaining in arterial system
during diastole (period of relaxation
that reflects the pressure remaining in
blood vessels after heart has pumped),
a reflection of peripheral vascular
resistance.
Pulse Pressure Measurement of the
ratio of stroke volume to
compliance (total distensibility) of
the arterial system.
BP normal limits
120/80 mmHg (adults)
Determinants of BP
Cardiac output
Peripheral vascular
resistance
Blood volume
Blood viscosity (Hct. >
60-65%)
Factors affecting BP
 Age (elasticity of the
arteries)
 Exercise
 Stress
 Race: African,
European American
males over 35 years
have higher BP.
 Gender
 medications
 Obesity
 Diurnal variations
 Disease process
(complications)
Assessing BP
Sphygmomanometer &
stethoscope
Electronic
Sphygmomanometer
Doppler US
Arterial lines
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Assessing BP
Sites:
Brachial
Radial
Popliteal
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Assessing BP
Contraindications For Brachial Artery BP
Measurement
Venous access devices, as IV infusion or AV fistula
for renal dialysis
Surgery in breast, axilla, shoulder, arm, hand
Injury or disease to shoulder, arm, or hand, such
as trauma, burns, or cast or bandage
Assessing BP
Hypertension
Primary hypertension
Secondary hypertension
Assessing BP (Hypertension)
Associated factors include:
Smoking
Obesity
Alcohol
Arteriosclerosis
Lack of physical activity
High blood cholesterol
Stress
Assessing BP (Hypertension)
Diagnostic measures: >140/90 mmHg in
multiple readings
Rx. : treatment of secondary causes, life
style changes and monitoring.
Assessing BP (Hypotension)
Orthostatic hypotension
Assessment of: drugs, bleeding, severe
burn and dehydration
Management: supine position 2-3min.,
V/s, prevent falls, Rx of the cause.
Orthostatic Postural Hypotension
Postural or orthostatic hypotension
(sudden; temporary drop in BP when rising
from a reclining position)
Most common in those with circulatory
problems, dehydrated, or those who take
diuretics or other drugs that lower BP
Category Systolic
(mmhg)
Diastolic
(mmhg)
Follow-up
recommended
Optimal <120 <80 / 2 years
Normal <130 <85 2 years
High normal 130139 8589 1 year
Hypertension
Stage 1 140159 9099 In 2 months
Stage 2 160179 100109 In 1 month
Stage 3 180 or higher 110 or
higher
immediately or
in 1 week

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