Give pressure. How to calculate mean arterial pressure. Subcortical brain structures

In medicine, systolic pressure is the blood pressure in the arteries when the heart muscle contracts, and diastolic pressure is the pressure when the heart muscle relaxes. While both indicators are important in their own right, for certain purposes (for example, to find out how well organs are supplied with blood) it is also important to know the average arterial pressure. This value can be easily calculated using the following formula: (2(DBP)+SBP)/3, where DBP is diastolic pressure, and SBP is systolic pressure.

Steps

Part 1

Measure your blood pressure. In order to calculate your mean arterial pressure, you must know your systolic and diastolic pressure. If you don't already know your blood pressure, take it. There are many different (and sometimes bizarre) ways to define blood pressure, but everything you need to get more or less reliable result measurements are a tonometer and a phonendoscope. As a reminder, systolic pressure is the value on the pressure gauge at which you hear the first beat through the phonendoscope, and diastolic pressure is the value at which you stop hearing the heartbeat.

• If you don't know how to measure your blood pressure, below you will find step by step instructions(or refer to our article on this topic).
• You can also go to a nearby clinic or pharmacy to have your blood pressure measured.

1. Using the formula (2(DBP)+SBP)/3. If you know your diastolic and systolic pressure, determining mean arterial pressure is very simple. Simply multiply your diastolic pressure by two, add your systolic pressure and divide the result by three. Average diastolic pressure is measured in millimeters of mercury, which is the standard for blood pressure measurements.

   As an alternative, the formula 1/3(SBP – DBP) + DBP is used. This simple equation is another way to calculate mean arterial pressure. Subtract the diastolic pressure from the systolic, divide the result by three and add the diastolic pressure. You will get the same result as using the first equation.

   • Using the same blood pressure values ​​as in the first case, we obtain an average blood pressure equal to: 1/3(120 – 87) + 87 = 1/3(33) + 87 = 11 + 87 = 98 mmHg Art.

2. An approximate result of the mean arterial pressure value can be obtained using the following formula: CO × OPSS. In certain situations, this equation, using cardiac output (CO, measured in L/min) and total peripheral vascular resistance (TPVR, measured in mmHg), is used to quickly estimate a patient's mean arterial pressure. Although the results of this equation are not 100% accurate, they are generally useful as a rough estimate. Note that CO and TPR are usually measured in a hospital setting with special equipment (although there are quite a few simple methods and for their determination).

   • In women, normal cardiac output is usually ~5 L/min. If we assume that her peripheral vascular resistance is 20 mmHg. Art. (which lies closer to the upper limit of normal), then her average arterial pressure will correspond to 5 × 20 = 100 mmHg st

3. Use a calculator if necessary. Note that it is not necessary to calculate mean arterial pressure manually. If you're in a hurry, there are plenty of online calculators (like this one) that will allow you to instantly calculate your mean arterial pressure by simply plugging in your blood pressure readings.

   Consult a specialist if your mean arterial or blood pressure readings are abnormal. If your average resting blood pressure is outside the normal range, although you are likely not in danger, you may want to consult your doctor about further testing. The same applies to non-standard resting systolic and diastolic pressure values ​​(which should be 120 and 80 mmHg, respectively). Don't put off visiting your doctor - there are many cardiovascular diseases respond well to treatment if they are noticed before they become a serious problem.

   Conditions affecting mean arterial pressure. It is important to know that for some diseases and when taking certain medical supplies the perception of what is considered "normal" mean arterial pressure changes. In these cases, the doctor will ensure that the mean arterial pressure does not go beyond the new limits and lead to serious complications. If you are unsure how a medical condition you have or the medications you are taking affects your normal blood pressure range, contact your doctor right away:

   • Patients with head injuries
   • Patients with certain types of aneurysms
   • Patients suffering from septic shock and on vasoconstrictor drugs
   • Patients undergoing vasodilator infusion

Part 3

1. Feel your pulse. If you are not sure what your resting systolic and diastolic blood pressure values ​​are, then measuring your pressure with a mechanical tonometer is not at all difficult. All you need is a tonometer and a phonendoscope, which you can easily find at your nearest pharmacy. You should be at rest, sit down and feel the pulse in the area of ​​​​the inside of the elbow or wrist under the base thumb. Put on your phonendoscope to prepare for the next step.

   • If you cannot feel the pulse, try using a phonendoscope. When you hear light, constant beats, you have found the right point.

2. Inflate the cuff that is on your shoulder. Take the blood pressure monitor and place the cuff on the biceps of the same arm on which you found the pulse. Most modern cuffs have Velcro, which is easy to use. When the cuff is well (but not tightly) attached to your arm, use a bulb to pump air into it. Look at the pressure gauge - you want it to show a pressure of about 30 mmHg. Art. higher than your expected systolic blood pressure.

   • As the cuff inflates, bring the head of the phonendoscope to the place where you were able to feel the pulse (if you were unable to do this, then to inside elbow bend). Listen - if you have inflated the cuff sufficiently, you will not hear anything at this stage.

3. Allow the air to gradually escape from the cuff while you watch the pressure gauge. If the air does not come out on its own, then open the valve (the screw next to the bulb), turn it counterclockwise until the air begins to slowly and continuously come out. Watch the pressure gauge as the air leaves the cuff - its needle should show gradually decreasing values.

4. Wait for the first strike. As soon as you hear the first beat in the phonendoscope, write down the value that the pressure gauge needle shows. This is your systolic pressure. In other words, this is the pressure when the arteries are most tense after heart rate.

   • Once the cuff pressure is the same as your systolic pressure, blood can flow under the cuff as the heart beats. Therefore, we use the pressure gauge needle reading at the first audible heartbeat as an indicator of systolic pressure.
   "Normal" blood pressure readings are usually below 80 diastolic and below 120 mmHg. Art. for systolic pressure. If any of these numbers are exceeded, you may not need to worry. Many factors, both major and minor, affect a person's blood pressure. If one of the factors below occurs in your case, then wait until its effect wears off.
   • State of stress and nervous excitement
   • Recent meal
   • Recent exercise
   • Recent use of alcohol, tobacco, drugs
   • Please note that if you have persistently high blood pressure, you should consult a doctor, even though wellness. This may be a sign of hypertension (high blood pressure) or may indicate its development, which can lead to serious complications over time.

Warnings

• DISCLAIMER: ALL CALCULATIONS MUST BE CONFIRMED BY A QUALIFIED MEDICAL PROFESSIONAL BEFORE USE!

Determining blood pressure standards and the limits of extreme fluctuations in children is challenging task, since blood pressure in children and adolescence is closely related to the influence of gender, height-weight and hormonal “jumps”, hereditary characteristics, physical activity, environmental factors, etc. Currently, standards have been developed for the average values ​​of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in children and adolescents with cut-off points for their percentile distribution depending on age and somatotype.

Higher blood pressure was observed in the group with low physical activity. Very big influence the value of blood pressure is influenced by the constitutional features of the vegetative nervous system. With a hyperkinetic type of blood circulation, along with a more frequent heart rhythm, there is also a more high level HELL.

If blood pressure is between the 90th and 95th percentiles, then this condition is regarded as “high normal blood pressure.” Blood pressure values ​​above the 95th percentile of the distribution curve in the pediatric population with a threefold change are taken as “arterial hypertension.”

First- average SBP and/or DBP from those measurements equal to or greater (by less than 10 mm Hg) 95 percentile for a given age group taking into account gender and age.

Second- average SBP and/or DBP from those measurements, equal to or greater than 10 mm Hg. Art. and more than 95 percentiles, for a given age group, taking into account gender and age.

The Pediatric Blood Pressure Working Group, after examining 70,000 children in the United States and Great Britain in 1987, developed criteria for the severity of hypertension for children and adolescents of all age groups.

It has been established that at birth the systolic blood pressure (SBP) of a child is 70-75 mmHg. Art. In the 1st week of life, SBP increases daily by 1-2 mmHg. Art., and then in the next 6 weeks - by 1 - 2 mm Hg. Art. per week and remains stable until approximately 4 years of age. In subsequent years there is gradual increase Blood pressure, the level of which depends on height and body weight. The correlation between body weight and blood pressure is especially pronounced in the 2nd decade of life. Growth directly correlates with blood pressure. Considering the report of the II Commission on the Control of Blood Pressure in Children, age-specific blood pressure standards are given that take into account the growth of children and adolescents, which is currently used in the United States and the European Union. A similar approach is beginning to be used in our country.

If a 10-year-old boy's blood pressure is 120/80 mmHg. Art., then this should be considered normal for a child tall, but at the same time it is increased for a child of short stature. If the height is average, then the normal blood pressure value will be between exact value between normal values ​​for short and tall children of a given age.

Given the wide variation in BP levels considered elevated by researchers, the WHO suggests a BP value of 140/90 mmHg. Art. as a single universal criterion for hypertension in adolescents starting from the age of 13.

We would like to emphasize the following. It would seem that it is very easy to make a diagnosis of hypertension based on determining blood pressure levels, but in practice, due to the lack of sufficient knowledge or haste when measuring blood pressure, incorrect conclusions are often made, which leads to overdiagnosis of this disease. Assessing many situations is also very difficult. For example, in the case of a difference in blood pressure on both arms, the question arises: which indicator is considered “correct”. With several consecutive measurements, different values ​​of blood pressure are determined. Rhythm disturbances deprive blood pressure levels of stability. Because of this, when measuring blood pressure, you must strictly adhere to the following rules:

The study should be carried out in a quiet, calm and comfortable environment, at a comfortable room temperature;

Blood pressure must be measured after the child has rested for 3-5 minutes while sitting on a chair with a straight back next to the table;

On the day of blood pressure measurement, the child should not drink tea or coffee, or smoke during the last hour before the test;

The cuff must have a pneumatic chamber size corresponding to the circumference of the upper arm; use three cuffs standard sizes: width 5-6, 8-9 and 12-14 cm (if you use a cuff that is too small, the measurement results are overestimated, and if you use a cuff that is too large, the results are underestimated); Taking into account the age of the child, WHO recommends the following cuff width: up to 1 year - 2.5 cm, 1-3 years - 5-6 cm, 4-7 years - 8-8.5 cm, 8-9 years - 9 cm, 10 -13 years - 10 cm, 14-17 years - 13 cm;

The cuff is placed on right hand(at the first measurement, sequentially on both arms) and cover at least 40% of the circumference and at least 80% of the length of the shoulder; the lower edge of the cuff should be 2.5 cm above the cubital fossa;

The arm with the cuff applied should be at the level of the heart, i.e. approximately at the level of the fourth intercostal space in a sitting position;

The hand on which the measurement is taken must be bare;

Blood pressure is measured at the radial artery after air is inflated into the cuff until the pulse disappears; deflation of air from the cuff leads to the appearance of tones, which corresponds to SBP, and the complete disappearance of tones corresponds to DBP;

To achieve the greatest measurement accuracy, it is necessary to inflate air into the cuff quickly and release it at a speed of 2 mmHg. Art. in 1 s before the appearance of Korotkoff sounds, and then at the same speed from beat to beat;

Blood pressure is measured again 1-2 minutes after the first measurement; the average value of several measurements taken on one arm reflects the blood pressure level more accurately than a single measurement;

The SBP level can be monitored by the appearance of a pulse wave on the radial artery, the DBP level - by sharp decline fluctuations of the tonometer needle or oscillations of the mercury column.

Often, accurate determination of DBP is associated with some difficulties; Korotkoff sounds in children and adolescents are often heard until the very end of the measurement (the “infinite tone” phenomenon). In this case, you should not press the stethoscope on the brachial artery, but only lightly press it against the skin, which avoids the occurrence of this phenomenon.

It should be borne in mind that the initial measurement of blood pressure, as a rule, gives slightly inflated results, which can only be of approximate value. When re-measuring, the pressure in the cuff should be adjusted to a level slightly higher than that noted during the first measurement. Blood pressure readings are recorded as the pressure in the cuff slowly decreases, sometimes intermittently, re-inflating the cuffs along the way. If it is not possible to accurately record the blood pressure level, a third measurement is taken, adhering to the same rules.

Usually the most low performance Blood pressure is recorded in a lying position, slightly higher in a sitting position and the highest in a standing position. With the opposite ratio of blood pressure, i.e., a decrease in blood pressure after the patient gets up, this indicates orthostatic syndrome, which is observed with autonomic dysfunction.

However, this method of measuring blood pressure is acceptable only for children over 3 years of age. In newborns and children under 3 years of age, oscillometric principles or Doppler are used for measurement. ultrasonic method. During Doppler measurement, SBP is recorded by increasing the intensity of reflected sound waves, and DBP - by the appearance of muffling during deflation of air from the cuff. This method is comparable in accuracy to other non-invasive methods of measuring blood pressure.

IN last decade widely used for diagnosing hypertension daily monitoring BP (ABPM). When using this method in comparison with traditional blood pressure measurement, new opportunities and advantages appear:

Possibility of using the method in areas familiar to children and adolescents living conditions(outpatient);

The ability to analyze blood pressure in parallel with heart rate during both wakefulness and sleep, as well as at various specified time intervals;

Safety, simplicity of the method, the possibility of its repeated repetition;

The ability to determine individual daily (circadian) blood pressure rhythms;

Reducing the effect of “placebo” on blood pressure parameters during antihypertensive therapy (AHT);

The ability to carry out differentiated selection of antihypertensive drugs (AGDs), frequency and time of their administration.

ABPM is currently not a mandatory method of examining patients with hypertension. It is most informative in the following cases:

Marked changes in blood pressure during one or more visits;

Suspicions of “white coat hypertension”;

Symptoms that suggest the presence of episodes of hypotension;

Refractory to drug therapy hypertension;

Violations circadian rhythm HELL.

Along with obvious advantages ABPM before “office” blood pressure measurements, it should be recognized that there are also disadvantages:

High cost of research and, as a result, limited availability;

Discomfort due to frequent blood pressure measurements with the device, which may affect the results of the study;

There is still no generally accepted normal suture indicators for ABPM.

Average values ​​of SBP and DBP per day, as well as individual time periods, more objectively reflect the true level of blood pressure and the severity of hypertension than single measurements. In 1997, M. Soergel et al. determined the proper average values ​​of blood pressure in children and adolescents based on 24-hour monitoring data taking into account height (body length).

An important indicator reflecting the severity of hypertension (as with hypertension in adults) is the time index, calculated by the percentage of measurements that exceed normal values Blood pressure over 24 hours or individual time intervals. IV SBP more than 25% is considered pathological. With labile hypertension, the AI ​​is in the range of 25-50%, and with stable hypertension it exceeds 50%.

The diagnostic criteria for labile forms of hypertension, according to ABPM data, are:

Increasing the average values ​​of SBP and/or DBP from 90 to 95 percentiles of the distributions of these parameters for the corresponding growth indicators;

IV in the daytime and/or night period time from 25 to 50%;

Increased blood pressure variability.

The criteria for diagnosing stable forms of blood pressure, according to ABPM data, are:

An increase in the average values ​​of SBP and/or DBP above the 95th percentile of the distributions of these parameters for the corresponding growth indicators;

AI during the day and/or night is more than 50%.

The diurnal index (CI) gives an idea of ​​the circadian organization of the daily blood pressure profile in both healthy and sick children and adolescents. SI is calculated as the difference between the average blood pressure values ​​during the day and night periods as a percentage of the average daily value. For most children, both with normal blood pressure and with hypertension, the nighttime decrease in blood pressure is 10-20% of the daytime value. In English-language literature, such persons are classified as “dippers”. If the SI is less than 10%, such individuals are designated as “non-dipper”. With an excessive nighttime decrease in blood pressure, SI is more than 20%, and such patients are classified as “over-dipper”. When blood pressure increases at night, SI is less than 0%, and such patients are designated as “night-peaker”. This type of curve occurs most often in patients with symptomatic hypertension. Taking into account the SI index, we can differentiate various shapes hypertension.

Let us dwell on one more aspect of blood pressure measurement. Currently, many recommendations from societies for the study of hypertension contain provisions that provide for the use of self-monitoring of blood pressure (SMB) as an important addition for diagnosing and monitoring the effectiveness of antihypertensive therapy. Involving patients and their relatives in healing process increases “adherence” to treatment. However, along with positive points using home measurement AD some difficulties may arise. These primarily include methodological errors when measuring blood pressure with sphygmomanometers. In this regard, it is advisable to use electronic semi-automatic or automatic devices when measuring blood pressure at home, which is not always possible due to the lack of the required width of the cuff used. These devices are easy to use and require skills in auscultatory determination of blood pressure. It is necessary to use devices in which the cuff is attached to the forearm. The use of devices that allow you to measure blood pressure on the wrist or finger is unacceptable, since the results obtained are not reliable.

To adequately control blood pressure at home, measurements should be taken in the morning (within 1 hour after waking up, before breakfast) and in the evening (before dinner or at least 2 hours after dinner) in a sitting position after a 5-minute rest.

Remember that only a methodically correct determination of blood pressure allows you to make a timely diagnosis of hypertension and prescribe an adequate amount of various rehabilitation measures.

Already in the very name of this phenomenon lies part of the answer. Pulse means it is somehow connected with the pulse. Measuring blood pressure (hereinafter referred to as BP) by determining the pressure in the cuff, when inflated the radial artery is compressed and the pulse disappears, and when the cuff is subsequently deflated, the pulse is detected again. It is the point of restoration of blood flow, when, upon auscultation (listening) of the compressed artery, the first sounds of the pulse are heard and there is systolic blood pressure (hereinafter referred to as SBP).

The moment when sounds (Korotkoff sounds) with further slow deflation of the cuff disappear again will be diastolic blood pressure (DBP), and the difference between them will be pulse pressure. Thus, to know your pulse pressure and how to calculate its value, you just need to take a tonometer, measure your blood pressure, and subtract the lower number (DBP) from the top number (SBP).

Pulse pressure is not just a difference in indicators

The question arises: there are such indicators as SBP and DBP, why do we also need to know about pulse pressure. Until recently, there was an opinion among the scientific medical elite that Negative influence It is the increase in DBP that affects the body. The higher the DBP, the higher the risk of cardiovascular disease (CVD) - and this is a correct opinion. The higher the DBP, the more likely more problems with blood vessels, kidneys, thyroid gland, heart, etc. It is also true that high SBP is no less dangerous for human health, which is also a risk factor for heart failure, damage to target organs (brain, heart, kidneys) and blood vessels.

Both of these quantities (both SBP and DBP) are integral, i.e. depending on many parameters:

• stroke volume;
• heart rate (HR);
• total peripheral vascular resistance (TPVR);
• circulating blood volume (CBV);
• blood viscosity, etc.,

which in turn are also multicomponent. Therefore, the difference between SBP and DBP, i.e. pulse pressure, is an integral indicator that reflects both the condition of the heart and the true age of the arteries and other parameters of the body’s vital activity.

What pulse pressure value is considered normal?

Normally, the indicator is considered to be 40 + 5 mmHg. Art. You can imagine the norm pulse pressure by age in the table (Table 1), but we can say with confidence that in relation to PAD, as in everything that concerns the human body, it is necessary to adhere to the golden rule: the maximum is sufficient and the minimum is necessary. That is, the lower the PBP, but it ensures a comfortable (sufficient in all respects) state of the body, the less its wearing effect on all organs and systems. It is important to understand this rule in its entirety, without in any way detracting from its second part – maximum sufficiency.

Table: Pulse pressure - norm by age

In addition, the calculation of the proper SBP and DBP, adjusted for weight, for each age can be calculated using the formulas:

1. SBP = 109+(0.5*Age (in years))+(0.1*Weight (in kg))
2. DBP = 63+(0.1*Age (in years)+(0.15*Weight (in kg))
3. PAD = GARDEN - PAD

So, for example, for a 53-year-old man weighing 85 kg, these indicators will be as follows:

1. SBP = 109+(0.5*53)+(0.1*85) = 144 mmHg.
2. DBP = 63+(0.1*53)+(0.15*85) = 81 mmHg.
3. PBP = 144 – 81 =63 mmHg.

What does pulse pressure reflect?

When PBP is above 50 mmHg. (high pulse pressure) or below 30 mmHg (low pulse pressure) indicate a deviation from the norm. Both high and low indicators indicate cardiovascular risk. In healthy people, an increase may occur during psycho-emotional or physical stress; a decrease may be observed during sleep. Those. Almost always, when the work of the heart increases (stroke volume, heart rate), the blood pressure increases, and vice versa.

High pulse pressure

A systematic increase in pulse pressure negatively affects the condition of target organs and blood vessels. Accordingly, an increased rate at rest indicates the presence of cardiovascular or other pathology.

Low pulse pressure

A decrease in PBP can occur with aortic diseases, myocardial infarction, kidney diseases, shock of various origins, etc. Low pulse pressure means the heart is not functioning well, while increased value Pulse pressure may indicate insufficient closure of the heart valves and backflow of blood into the left ventricle.

It is important to understand that a decrease or increase can occur with seemingly normal blood pressure, and therefore, if there is discomfort in the heart, general malaise and changes in blood pressure, you should consult a specialist.

In a healthy person, the stroke volume received by the vessels with each contraction of the heart muscle causes stretching of these vessels with subsequent elastic recoil at the end of each cycle. With aging, blood vessels lose elasticity, which leads to their rigidity, an increase in pulse wave speed and, accordingly, an increase in blood pressure.

Of course, this applies to a greater extent to older people and old age. But in last years CVDs have become younger and are becoming relevant for both older and younger people.

Normal blood pressure the indicator is recognized as 120/80, the pressure is measured in mmHg. using a tonometer.

The first number - systolic pressure (so-called upper) - indicates the blood pressure during contraction of the heart muscle. The second number - diastolic pressure (the so-called lower) - indicates the blood pressure when the heart muscle relaxes. The difference between these indicators is called pulse blood pressure(abbreviated as PAD).

Cardiologist numbers human pulse pressurecan talk about:

• condition of blood vessels, the size of their lumen;
• wear or elasticity of artery walls;
• myocardial function;
• condition of the heart opening, aortic valves;
• presence of changes due to atherosclerosis;
• possibility of stenosis, etc.

There is a table for both systolic and diastolic numbers, as well as for pulse blood pressure numbers , where it is indicated which option considered the norm for a certain age. If difference between lower and upper pressure is very different from the norm, the doctor will look for the cause, since this indicates pathology.

How to calculate pulse pressure

Having learned what is pulse pressure, it’s not difficult to calculate it at home if you have a tonometer at hand. If you don’t have such a device in your home yet, you can go to a clinic or pharmacy where they can measure your blood pressure. Already at home you can calculate what difference between top and bottom indicator, having received the currentpulse pressurein numbers. For example, with a pressure of 130/90, the PAP is 40 mm, which is considered normal pulse pressure. pressure.

Patients are interested in doctors, which reflects the pulse blood pressure, if you can use the upper and lower numbers, and they are probably enough to assess the condition of the heart and blood vessels.

The fact is that each of the indicators tells the doctor information about different organs. Previously, doctors believed that the most unfavorable condition was when diastolic pressure was above normal . The higher this indicator, the more obvious the risk of cardiovascular diseases, problems with the kidneys, thyroid gland, heart, blood vessels, etc.

On the other hand, an increase reflecting systolic blood pressure numbers indicate the risk of heart failure, damage to blood vessels, myocardium, brain, and kidneys. Both numbers on the tonometer (upper and lower blood pressure) are considered integral, i.e. depending on many factors.

These are the frequency of contractions of the heart muscle, blood volume and viscosity, peripheral resistance of blood vessels, etc. Each of these factors is also multicomponent, hence the difference between two indicators in the form of pulse pressure will also be integral, using it the doctor determines the condition of the heart muscle, arteries, and other parameters of the health of organs and systems.

Pressure within normal limits

As the special table says, pulse pressure is normal- 40 mm. It must be taken into account thatnorm by ageslightly different. Indicators are considered ok if p difference between them and the numbers indicated table , no more than 10 mm. If pulse blood pressure increases, this indicates problems with the heart and vascular system, and the presence of age-related diseases. Typically, increased pulse pressure is characteristic of the elderly.

Each person by nature has his own “working” pressure, and if from birth normal pulse pressurediffers from the usual parameters, then doctors consider this to be a special physiology and do not classify the case as a pathology. If the pulse pressure is lower than necessary, there is a risk of fainting, anxiety, and respiratory paralysis.

Decreased pulse pressure

As mentioned above, the difference between pulse pressure and the norm, which is indicated by a special table , talking about serious illnesses that have begun to develop or have long been ruining a person’s life. Against the background of low pulse pressure, anemia, drowsiness and weakness, dizziness and headaches, and fainting may occur.

For a parameter such as pulse pressure, the norm is should not have a difference with the current state of more than 10 units. If there is a difference of 30, you need to urgently go to the doctor, since this sign occurs with the following diseases:

• vegetative-vascular dystonia;
• myocardial inflammation;
• renal ischemia;
• stenosis of the mouth of a blood vessel;
• anemia;
• hypovolemic shock;
• sclerosis of the heart.

If too little difference is detected between the upper and lower blood pressure, this indicates that the blood is poorly ejected by the heart, tissues and organs do not fully receive oxygen. Reduced pulse pressure is very dangerous for those who have suffered cardiogenic shock, heart attack.

If a drop in pulse pressure is observed once, this may be the body’s reaction to some irritant, as well as a sign developing disease. Therefore, it is important from now on to monitor your well-being, control your blood pressure, and if the situation repeats, immediately contact a cardiologist.

Increased pulse pressure

If a person is diagnosed high pulse pressure, this may be preceded by recent physical activity. If this is the case, then there is no need to worry - the condition will soon return to normal. From time to time, pulse pressure can increase in all people; this is associated with intense work.

Often such indicators are detected in pregnant women. If the pulse pressure indicators are constantly lower than those indicated in the special table , this may be a signal of disease:

• congenital vascular defect;
• thyrotoxicosis;
• fever;
• iron deficiency in the body;
• hypertension;
• aortic valve disorder;
• atherosclerosis;
• hypertonic disease;
• ischemia;
• inflammation of the endocardium;
• renal failure;
• high intracranial pressure.

How to calm your pulse pressure

So that the pressure is close to the standards indicated in the table , you need to help your body overcome pathological conditions. It is important to remember that medications that helped colleagues and friends can cause harm - self-medication is unacceptable when we're talking about about the health of the heart, brain and blood vessels.

Everyone's pulse pressure can change for various reasons, and it is important to establish this reason, since without solving the problem it will be impossible to normalize blood pressure. For frequent physical activity, doctors may prescribe folic acid to help the heart cope with the task. If a person excess weight, up to obesity, he is prescribed diuretics.

To normalize the condition after atherosclerosis, statins are prescribed, nicotinic acid, ion exchange resins, etc. Stimulators of myocardial tone (digitalis, lily of the valley glycosides) can bring pulse blood pressure closer to normal, and to reduce it, papaverine, Ca-channel blockers, and antispasmodics are prescribed.

All medications will be prescribed by the doctor no earlier than the patient will undergo diagnostics and the cause of the disease will be identified.

• Possible reasons
• Low pulse pressure
• Treatment options

Pulse pressure is the difference between diastolic and... The unit of measurement is usually considered to be millimeters. In medical practice, blood pressure can rise to 120/80 mm Hg. A low pulse pressure is abnormal if it is less than a quarter percent of the systolic value. Today, such an anomaly prevents not only older people from living normally, but also young people. More and more people are going to the hospital with problems unstable pressure. The sources of education can be different factors.

Possible reasons

In most cases, the causes of low pulse pressure are associated with a stroke of the left ventricle, as well as with any trauma that was accompanied big amount blood loss. If the pressure is very low (about 25 mm or less), then the cause may be a small cardiac stroke volume. The same thing happens in acute heart failure. Low heart rate may occur aortic stenosis valve

Usually in healthy people at rest it does not rise above 40 mmHg. Increases during or after physical activity. After 10 minutes it is restored. Pulse pressure must be monitored. The high should be lowered immediately, since this factor contributes to rapid aging organs, especially the heart, brain and kidneys. Therefore, you need to be careful and consult a doctor if symptoms appear.

Today, the main causes of high pulse pressure include the following factors:

• atherosclerosis;
• arteriovenous fistula;
• chronic failure;
• anemia;
• pregnancy;
• heart block;
• intracranial pressure.

The following factors are characteristic of low pulse pressure:

• the heart functions poorly;
• there are features of vegetative-vascular tone;
• the presence of vegetative-vascular dystonia;
• presence of anemia.

High pulse pressure itself indicates heart disease. The harder the blood vessels become. Thus, they are susceptible to atherosclerotic changes. The cause of increased pulse pressure may be a simple lack of iron and failure of activity

Blood pressure problems can occur in absolutely anyone. In order to notice deviations in the functioning of blood vessels and the heart in time, you need to know the exact value of your blood pressure. To check this indicator, a tonometer is used. It can be freely purchased at any pharmacy or store medical equipment. The tonometer makes it possible to find out the current systolic and diastolic pressure. If the data obtained differs from normal, the doctor may suspect the patient has developed vascular or heart disease. For a complete assessment of the condition individual organs and systems require additional calculation of mean arterial pressure. It will help the specialist make the correct diagnosis.

Not only diastolic and systolic, but also pulse and average pressure are considered. Particular attention should be paid to the latter type of blood pressure.

The average blood pressure of the whole is called cardiac cycle. To calculate it, doctors use a special formula. If a person has no health problems, then his SBP should be in the range of 80-95 mmHg. Art.

Pulse pressure is also not difficult to calculate. To do this, it is enough to subtract the diastolic from the systolic indicator. Normally, the resulting number should not exceed 45 units.

Mean pressure is not used to study cardiac function. If a specialist wants to know exactly what condition his patient’s body is in, he must take into account the following values:

• Stroke volume. Lets you know exactly how much blood was ejected during a single contraction of the organ;
• Cardiac index. Describes the work of the heart in the most accurate way;
• Cardiac output. Shows how much blood is ejected from the heart in 1 minute.

Determination of mean arterial pressure

Calculation of average blood pressure cannot be done by finding the average value between the lower and upper BP. This is because during the cardiac cycle the pressure is not systolic, but diastolic. Therefore, we can say that it is 40% correlated with the upper indicator and 60% with the lower one.

What affects the pressure indicator

For an adult who has no health problems, blood pressure should be 120/80 mmHg. Art. If it is slightly higher, then this does not cause any concern among doctors. This phenomenon accepted as normal. Blood pressure is influenced by many external and internal factors. Among them are:

1. Human diet. Regular appointment dishes that contain a large number of salt and spices have a detrimental effect on health. This explains why hypertensive patients are advised to adhere to a gentle diet and give up coffee and other similar drinks that negatively affect blood pressure;
2. Experience stressful situations. Any experience causes an increase in blood pressure. Especially if they last for a long time;
3. Physical activity. After performing exercises, a person's blood pressure increases for a short period of time. This is why you should not take blood pressure measurements after training, as they will turn out to be incorrect;
4. Bad habits. Smoking and frequent use Alcoholic drinks harm the entire body. Tobacco and alcohol have a bad effect on the condition of blood vessels.

Any of these factors may affect pressure measurements. To get more accurate data, a person should temporarily exclude them from his life.

Formulas for calculating average pressure

There are several simple formulas that help calculate CPAD. They are used not only by doctors, but also ordinary people who are interested in their own health.

The first step is to measure your current blood pressure. To calculate the average, you need to know your diastolic and systolic blood pressure. To obtain more accurate results, you should use a working tonometer and phonendoscope. If a person is unable to take measurements on his own, he can make this request to any clinic. This procedure is also carried out in many pharmacies.

Formula No. 1: (2(DBP)+SBP)/3

To find out how to calculate the average pressure value, you must use this formula. It will require systolic and diastolic blood pressure. These measurements should be multiplied and then added. The final result must be divided by 3. The final value is measured in mmHg. Art.

Average blood pressure is calculated using special formulas

It wouldn't hurt to pay attention to one important point. Diastolic blood pressure must be multiplied by 2. This is because the heart spends 2/3 of its time in a state of relaxation.

Formula No. 2: 1/3(SBP - DBP) + DBP

Mean arterial pressure can also be calculated using this alternative formula. This equation is quite simple and understandable. In order to carry out a correct calculation, it is necessary to subtract diastolic pressure from systolic pressure. The result obtained must be divided by 3. Then the lower blood pressure indicator is added to it. If all numerical manipulations were carried out correctly, then the person will get the same result as when using the first formula.

Formula No. 3: SV × OPSS

Not the most popular determining formula, but it also helps to find out the approximate value of ADSR. To calculate this equation, use the value cardiac output. It is measured in l/min. Peripheral vascular resistance is also taken into account. This indicator is measured in mmHg. Art. The calculation formula is used in certain situations when there is a need to quickly estimate a person’s average pressure. But you need to understand that the obtained value is approximate. It is impossible to obtain a 100% correct result using such a calculation.

It is recommended to measure cardiac output and total peripheral vascular resistance in a hospital setting using special equipment.

Average arterial pressure can be calculated using one of the developed formulas without the participation of auxiliary equipment. However, to get more exact result It is recommended to use a calculator when calculating.

If a person does not have time to manually insert the obtained values ​​of blood pressure and other indicators into the formula, then he can use a modern online calculator for this purpose. To see correct result, you just need to enter the required numbers in the cells provided for them. The system itself will carry out the calculation and show the correct answer.

What does average blood pressure mean?

Interpretation of average pressure indicators

For blood pressure, a normal value is indicated. This means that there are certain boundaries within which blood pressure should be completely healthy person. This principle is used to determine the average pressure.

Each specialist is familiar with the generally known values, which help to understand that the blood pressure measured in a person is normal. Small deviations from it are usually not taken into account. You should especially not take them into account if, before measuring blood pressure, the body was influenced by factors that contributed to its increase.

After the average pressure is calculated using one of the special formulas, the resulting value should be compared with the normal one. According to doctors, if it is in the range of 70-110 mm Hg. Art., means a person no problems with functioning cordially- vascular system. If the indicator is lower or higher, then we can safely say that there is a pathology that should be studied and eliminated.

You should not be negligent about the average pressure value if it does not fit within the normal range. A person is recommended to make an appointment with a specialist in order to identify the cause of such a deviation. It is possible that there is no cause for concern, and such pressure is quite natural. However, there is a possibility of developing heart or vascular disease, which can have a very disastrous consequences for individual organs or the whole organism.

Completion

If a person knows exactly what his average pressure is, then he can easily notice even minor deviations from the norm, which are a good reason to visit a doctor. Many people find this indicator at home. To do this, you just need to choose the appropriate formula and carry out simple calculations.

Before you start calculating mean arterial pressure, you must first measure your upper and lower blood pressure. This data will need to be substituted into the formula. It must be remembered that average pressure, unlike diastolic and systolic, does not change over time. It is not affected by a person's age. So this indicator should always remain constant.

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Classmates

It is known that the total amount of blood in the body is 6–8% of body weight. Using a simple calculation, you can easily find out the blood volume of each person. So, with a weight of 75 kilograms, the blood volume is 4.5 - 6 liters. And all of it is enclosed in a system of vessels communicating with each other. So, when the heart contracts, blood moves along blood vessels, puts pressure on the wall of the arteries, and this pressure is called arterial pressure. Blood pressure helps move blood through the vessels.

There are two indicators of blood pressure:

• systolic blood pressure (SBP), also called “upper” - reflects the pressure in the arteries, which is created when the heart contracts and blood is released into the arterial part of the vascular system;
• diastolic blood pressure (DBP), also called “lower” - reflects the pressure in the arteries at the moment the heart relaxes, during which it fills before the next contraction. Both systolic blood pressure and diastolic blood pressure are measured in millimeters of mercury (mmHg).

A blood pressure value of 120/80 means that the systolic (upper) pressure is 120 mmHg. Art., and the value of diastolic (lower) blood pressure is 80 mm Hg. Art.

Why is it necessary to know your blood pressure?

Increase in pressure for every 10 mm Hg. Art. increases the risk of developing cardiovascular diseases by 30%. In people with high blood pressure disorders develop 7 times more often cerebral circulation(stroke), 4 times more often - coronary heart disease, 2 times more often - damage to the blood vessels of the legs. It is from measuring blood pressure that it is necessary to begin the search for the cause of such frequent manifestations of discomfort as headache, weakness, dizziness. In many cases, pressure is necessary constant control, and measurements should be taken several times a day.

You can measure your blood pressure yourself using special devices– so-called “tonometers”. Measuring blood pressure at home provides valuable information. Additional information, as in initial examination the patient, and with further monitoring of the effectiveness of treatment.

Self-monitoring of blood pressure disciplines the patient and improves adherence to treatment. Measuring your blood pressure at home can help you more accurately assess the effectiveness of treatment and potentially reduce its cost. An important factor influencing the quality of self-monitoring of blood pressure is the use of devices that comply international standards accuracy. We do not recommend using blood pressure devices on your finger or wrist. You should strictly follow the instructions for measuring blood pressure when using automatic electronic devices.

Mandatory rules that must be followed when measuring blood pressure:

Situation

The measurement should be carried out in a quiet, calm and comfortable stop at a comfortable temperature. You should sit in a straight-backed chair next to a desk. The height of the table should be such that when measuring blood pressure, the middle of the cuff placed on the shoulder is at the level of the heart.

Preparation for measurement and duration of rest

Blood pressure should be measured 1-2 hours after eating. You should not smoke or drink coffee for 1 hour before measurement. You should not be wearing tight, constricting clothing. The arm on which blood pressure will be measured must be bare. You should sit leaning against the back of a chair with relaxed, uncrossed legs. It is not recommended to talk while taking measurements, as this may affect your blood pressure levels. Blood pressure measurements should be taken after at least 5 minutes of rest.

Cuff size

The cuff width should be sufficient. The use of a narrow or short cuff leads to a significant false increase in blood pressure.

Cuff position

Determine with your fingers the pulsation of the brachial artery at the level of the middle of the shoulder. The center of the cuff balloon should be located exactly above the palpable artery. The bottom edge of the cuff should be 2.5 cm above the cubital fossa. Cuff tightness: a finger should fit between the cuff and the surface of the patient's shoulder.

How much to pump?

Determining the maximum level of air inflation into the cuff is necessary to accurately determine systolic blood pressure with minimal discomfort for the patient:

1. determine the pulsation of the radial artery, the nature and rhythm of the pulse
2. While continuing to palpate the radial artery, quickly inflate the cuff to 60 mmHg. Art., then pump 10 mm Hg. Art. until the pulsation disappears
3. The air from the cuff should be deflated at a speed of 2 mmHg. Art. per second. The level of blood pressure at which the pulse appears again is recorded
4. completely deflate the cuff. To determine the level of maximum air injection into the cuff, the value of systolic blood pressure, determined by palpation, is increased by 30 mm Hg. Art.

Stethoscope position

Using your fingers, you determine the point of maximum pulsation of the brachial artery, which is usually located just above the cubital fossa on the inner surface of the shoulder. The membrane of the stethoscope should be in full contact with the surface of the shoulder. Should be avoided too strong pressure stethoscope, and the head of the stethoscope should not touch the cuff or tubes.

Inflating and deflating the cuff

Inflation of air into the cuff to the maximum level should be carried out quickly. Air is released from the cuff at a rate of 2 mmHg. Art. per second until the appearance of tones (“dull blows”) and then continue to be released at the same speed until the sounds disappear completely. The first sounds correspond to systolic blood pressure, the disappearance of sounds (last sound) corresponds to diastolic blood pressure.

Repeated measurements

Data obtained once are not true: repeated blood pressure measurements must be taken (at least twice with an interval of 3 minutes, then calculated average value). It is necessary to measure blood pressure in both the right and left arms.

Statistics

The largest number of cerebral strokes and myocardial infarctions, many of which end fatal, occurs from 6.00 to 10.00 am. When taking morning measurements, you should pay attention Special attention, since blood pressure values ​​​​obtained in the morning provide invaluable assistance in making a diagnosis and developing the correct treatment tactics.

In addition, often the morning measurement data can be compared with the nighttime blood pressure value, which is extremely important for diagnostics.

Check your blood pressure regularly in the morning!

* If systolic and diastolic blood pressure are found in different categories, the highest category is selected.
** Optimal in relation to the risk of cardiovascular complications and mortality.

The terms “mild”, “borderline”, “severe”, “moderate” given in the classification characterize only the level of blood pressure, and not the severity of the patient’s disease. In everyday life clinical practice classification accepted arterial hypertension World Organization health care, based on damage to the so-called target organs. This is the most frequent complications, occurring in the brain, eyes, heart, kidneys and blood vessels.