Take control of your Blood Pressure

Blood pressure:

(Strictly speaking: vascular pressure) refers to the force exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs. The pressure of the circulating blood decreases as blood moves through arteries, arterioles, capillaries, and veins; the term blood pressure generally refers to arterial pressure, i.e., the pressure in the larger arteries, arteries being the blood vessels which take blood away from the heart. Arterial pressure is most commonly measured via a sphygmomanometer, which uses the height of a column of mercury to reflect the circulating pressure. Although many modern vascular pressure devices no longer use mercury, vascular pressure values are still universally reported in millimetres of mercury (mmHg).

The systolic arterial pressure is defined as the peak pressure in the arteries, which occurs near the beginning of the cardiac cycle; the diastolic arterial pressure is the lowest pressure (at the resting phase of the cardiac cycle). The average pressure throughout the cardiac cycle is reported as mean arterial pressure; the pulse pressure reflects the difference between the maximum and minimum pressures measured.Our health is directly influenced by our immune system. A balanced and healthy immune system is central to the body's ability to defend against infections. "It is our ability to create a healthy immune system that represents the greatest potential for gains in human health."

Today, however, many factors contribute to the general weakening of the body's defenses. Antibiotics have begun to fail as the resistance of many infectious strains multiplies. Due to the failure of government control of health codes, deterioration of water quality, and frequent international travel diseases now spread more easily than ever before.

Fortunately, recent research has uncovered a natural agent that can increase our ability to fight disease and improve the quality of life for many people. Transfer factor is the name given to this relatively new agent. It is found in colostrum and other sources and is a natural way of strengthening our immune systems against disease.

HOW IS YOUR BLOOD PRESSURE?

Typical values for a resting, healthy adult human are approximately 120 mmHg (16 kPa) systolic and 80 mmHg (11 kPa) diastolic (written as 120/80 mmHg, and spoken as "one twenty over eighty") with large individual variations. These measures of arterial pressure are not static, but undergo natural variations from one heartbeat to another and throughout the day (in a circadian rhythm); they also change in response to stress, nutritional factors, drugs, or disease. Hypertension refers to arterial pressure being abnormally high, as opposed to hypotension, when it is abnormally low. Along with body temperature, blood pressure measurements are the most commonly measured physiological parameters

Hypertension

Hypertension, most commonly referred to as "high blood pressure" or HTN, is a medical condition in which the blood pressure is chronically elevated. It was previously referred to as arterial hypertension, but in current usage, the word "hypertension" without a qualifier normally refers to arterial hypertension.

Hypertension can be classified as either essential (primary) or secondary. Essential hypertension indicates that no specific medical cause can be found to explain a patient's condition. Secondary hypertension indicates that the high blood pressure is a result of (i.e. secondary to) another condition, such as kidney disease or certain tumors (especially of the adrenal gland). Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure. Even moderate elevation of arterial blood pressure leads to shortened life expectancy. At severely high pressures, defined as mean arterial pressures 50% or more above average, a person can expect to live no more than a few years unless appropriately treated.

Hypertension is considered to be present when a person's systolic blood pressure is consistently 140 mmHg or greater, and/or their diastolic blood pressure is consistently 90 mmHg or greater. Recently, as of 2003, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has defined blood pressure 120/80 mmHg to 139/89 mmHg as "prehypertension." Prehypertension is not a disease category; rather, it is a designation chosen to identify individuals at high risk of developing hypertension. The Mayo Clinic website specifies blood pressure is "normal if it's below 120/80" but that "some data indicate that 115/75 mm Hg should be the gold standard." In patients with diabetes mellitus or kidney disease studies have shown that blood pressure over 130/80 mmHg should be considered high and warrants further treatment. Even higher numbers are considered diagnostic using home blood pressure monitoring devices.

(click here for help with your blood pressure)

ARE YOU TAKING CARE OF YOUR BLOOD PRESSURE?

Up to 25% of patients diagnosed with hypertension do not suffer from it, but rather from white coat hypertension (elevated arterial pressure specifically during medical exams, probably as a result of anxiety). Thus, well-performed, accurate home arterial pressure monitoring can prevent unnecessary anxiety, as well as costly and potentially dangerous therapy in many millions of people worldwide. Home arterial pressure monitoring provides a measurement of a person's arterial pressure at different times and in different environments, such as at home and at work, throughout the day. Home arterial pressure monitoring may assist in the diagnosis of high or low arterial pressure. It may also be used to monitor the effects of medication or lifestyle changes taken to lower or regulate arterial pressure levels.

Automatic self-contained blood pressure monitors are available at reasonable prices, some of which are capable of Korotov's measurement in addition to oscillometric methods, enabling irregular heartbeat patients to accurately measure their blood pressure at home, which was not possible using the traditional devices.

The 2003 US Joint National Committee recommends the use of self monitoring of arterial pressure, before considering the more expensive ambulatory monitoring of arterial pressure, to improve hypertension management. Both the Joint National Committee and the 2003 guidelines from the European Society of Hypertension and the European Society of Cardiology suggest that self monitoring might also be used as an alternative to ambulatory monitoring for the diagnosis of white coat hypertension.

A study published in the May 2006 American Journal of Hypertension compared home and ambulatory blood pressure monitoring methods in the adjustment of antihypertensive treatment. The study showed home arterial pressure monitoring is as accurate as a 24 hour ambulatory monitoring in determining arterial pressure levels. Researchers at the University of Turku, Finland studied 98 patients with untreated hypertension. They compared patients using a home arterial pressure device and those wearing a 24hr ambulatory monitor. Researcher Dr. Niiranen said that, "home blood pressure measurement can be used effectively for guiding anti-hypertensive treatment". Dr. Stergiou added that home tracking of arterial pressure, "is more convenient and also less costly than ambulatory blood pressure monitoring".

A clinical study published in the May 2007 edition of The American Journal of Hypertension compared the accuracy of 3 different methods of taking arterial pressure in indicating cardiovascular health. The study aim was to assess the accuracy of home blood pressure monitoring (HBP), 24hr ambulatory blood pressure monitoring (ABP) and arterial pressure readings taken in a doctor’s office (OBP). The arterial pressure tests were compared to the left-ventricular mass index (LVMI). The LVMI was calculated from an echocardiogram of the heart and indicates cardiovascular organ damage, an indicator of arterial pressure. Researchers at The Columbia University Medical Center, New York found that home arterial pressure monitoring, over a 10 week period was a significant independent predictor of LVMI even after adjusting for age, sex and BMI (body mass index). They found that home monitoring over time is a better indicator of cardiovascular health than ambulatory readings or readings taken at the doctors’ office. The value of home monitoring increases over time with a number of measurements taken.

The June 2007 AMNews; Newspaper for America's Physicians released a study which showed arterial pressure readings taken in a doctors office are often unreliable. The American Medical Association newspaper quoted Prof Norman Kaplan from the University of Texas Southwestern Medical Center who said, "Of all the procedures done in a doctor's office, measurement of blood pressure is usually the least well performed but has the most important implications for the care of the patient." The paper explained that arterial pressure readings taken in a Doctors office can be falsely raised or lowered. This can be due to the presence of a Doctor or clinician which results in the patient experiencing white coat hypertension.

The American Heart Association website states, "You may have what's called 'white coat hypertension'; that means your blood pressure goes up when you're at the doctor's office. Monitoring at home will help you measure your true blood pressure and can provide your doctor with a log of blood pressure measurements over time. This is helpful in diagnosing and preventing potential health problems."

Those using home arterial pressure monitoring devices are increasingly also making use of arterial pressure charting software. These charting methods provide print outs for the patients physician and reminders on how often to check arterial pressure

While statistically normal values for arterial pressure could be computed for any given population, there is often a large variability from person to person and it also varies in individuals from moment to moment. Additionally, since there's no guarantee the norm of the population in question should even be considered healthy, the relevance of such statistical values would be questionable. In a study of 100 subjects with no known history of hypertension, an average systolic blood pressure of 112.4 mm Hg and an average diastolic pressure of about 64.0 mm Hg was found.

In children the observed normal ranges are lower; in the elderly, they are often higher, largely because of reduced flexibility of the arteries. Factors such as age, gender and race influence blood pressure values. Pressure also varies with exercise, emotional reactions, sleep, digestion and time of the day.

In the U.S., the optimal arterial pressure (sometimes referred to as the ‘gold standard’) targets are:

Systolic: less than 120 mmHg (16 kPa or 2.32 psi)

Diastolic: less than 80 mmHg (10 kPa or 1.55 psi)

Levels above 120 mmHg (16 kPa) but below 140 mmHg (19 kPa) in systolic pressure, or above 80 (11 kPa) but below 95 mmHg (13 kPa) in diastolic pressure, are referred to as "prehypertensive" and often progress to frankly hypertensive levels. However studies already extant reveal that there are fewer complications at, e.g., 115 mmHg (15 kPa) systolic than 120 (16 kPa), and in fact arterial pressure is a continuum with decreasing pathology associated with lower levels to well within the current "optimum" range. The risk of cardiovascular disease increases progressively throughout the range of arterial pressure, beginning at 115/75 mm Hg. "Some data indicates that 115/75 mm Hg should be the gold standard. Once arterial pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase. Prehypertension is now considered to be a systolic pressure ranging from 120 to 139 or a diastolic pressure ranging from 80 to 89." (Excerpts from Mayo Clinic website). In the past, hypertension was only diagnosed if secondary signs of high arterial pressure were present, along with a prolonged high systolic pressure reading over several visits. In the U.S., this reactive stance has been soundly rejected in the light of recent evidence.

In the UK, mirroring abandoned earlier U.S. practice, nursing students continue to be taught that their patients’ readings should be considered ‘normal’ if in the range:

Systolic: 110 - 140mmHg

Diastolic: 70 - 90 mmHg:

Clinical trials demonstrate that people who maintain arterial pressures at the low end of these pressure ranges have much better long term cardiovascular health. The principal medical debate is the aggressiveness and relative value of methods used to lower pressures into this range for those who don't maintain such pressure on their own. Elevations, more commonly seen in older people, though often considered normal, are associated with increased morbidity and mortality. The clear trend from double blind clinical trials (for the better strategies and agents) has increasingly been that lower arterial pressure is found to result in less disease.