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Blood Pressure Monitoring during COVID19 Posted on 23 Sep 2020

This is a worrying time for a lot of people with long-term health conditions such as high blood pressure. It is more important than ever to be in the best health we can while coronavirus is at large, to reduce our risk of having to go into hospital. Your doctor will want to help you get good control of your blood pressure, but they will want to monitor you without you having to come into the surgery, to reduce the risk of the infection spreading.

Guide to Blood Pressure Monitoring

Keeping your blood pressure under control during Covid 19

This is a worrying time for a lot of people with long-term health conditions such as high blood pressure. It is more important than ever to be in the best health we can while coronavirus is at large, to reduce our risk of having to go into hospital. Your doctor will want to help you get good control of your blood pressure, but they will want to monitor you without you having to come into the surgery, to reduce the risk of the infection spreading. This guide explains how to monitor your blood pressure without having to leave the house.

High blood pressure is the biggest risk factor for heart attack and stroke. High blood pressure does not usually make you feelill, or any different to usual, so the only way to know whether your blood pressure is too high is to measure it with a machine. Blood pressure medications will not make you feel any better in yourself,but will reduce your risk of getting a heart attack or stroke.

Measuring your blood pressure

You may already have a blood pressure machine at home. If not, now is the time to buy or borrow one.You can buy themover the internet or from many pharmacies. The best type is one that wraps around your arm rather than your wrist.

The British Heart Foundation website has a useful video showing how to measure blood pressure: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/tests/blood-pressure-measuring-at-home

Blood pressure readings are made up of two numbers – a ‘top’ number and a ‘bottom’ number – which are both important. If either of them are too high, the heart attack and stroke risk is increased.

You can use either arm to measure your blood pressure. However if the difference between your two arms is more than 15, measurethe blood pressure again. If the difference is still more than 15, remember which arm had the higher reading and use this arm for all readings in future.

What numbers to aim for?

The blood pressure number you should aim for depends whether you have any other health conditions. Individual circumstances varybut in general: (1)

  • If you are under 80 with no other health conditions, aim for 135/85 or lower
  • If you have type 2 diabetes, aim for 135/80 or lower*
  • If you have kidney disease you may have to aim for 130/80 or lower*–this depends on how bad your kidney damage is so you may need to discuss this with your doctor
  • If you are over 80, aim for 145/85 or lower**
  • There is no minimum blood pressure target. If your blood pressure is too low, you will get symptoms of feeling faint and dizzy, especially when you stand up. If you are feeling like this your blood pressure medications are probably too strong and you should speak to your doctor as soon as you can.

The readings you take at home will be just as good as the ones your doctor or nurse takes in the surgery – probably better because you will be more relaxed. Our blood pressure naturally goes up and down throughout the day and is altered by stress, exercise and lots of other things. One high blood pressure reading may not be anything to worry about, but it is important to do some more measurements to see whether it’s just a one-off or whether it’s always high. To get a good idea of the general trend of your blood pressure, check it twice a day (morning and evening) for a week and write down the readings. You can then book a telephone appointment with your doctor to tell them the readings. They will want to find out your average blood pressure, and to discuss your treatment, which may involve lifestyle changes or medication.

There is no minimum blood pressure target. If your blood pressure is too low, you will get symptoms of feeling faint and dizzy, especially when you stand up. If you are feeling like this your blood pressure medications are probably too strong and you should speak to your doctor as soon as you can.

* These two conditions increase your risk of heart attack or stroke even further, so the blood pressure targets have been made more strict to counteract this

** When we stand up, our blood pressure naturally gets higher so that enough blood can still get to our brains. As we get older the body finds it more difficult to do this and the blood pressure may even start to drop when we stand up. This can lead to dizziness and falls, which are more dangerous than the high blood pressure, and being too strict with blood pressure treatments can make this effect worse, so the targets are less strict for this age group. If you are in this category it is a good idea to measure you blood pressure while you are standing rather than sitting.

How often to check?

If your blood pressure was on target at your last check, we would recommend checking it aboutevery 6 months. If you are above your target, speak to your doctor on the phone to discuss what changesto make and when to check it again .

(1.) National Institute for Health and Care Excellence Clinical Knowledge Summary on Hypertension, accessed at https://cks.nice.org.uk/hypertension-not-diabetic#!scenarioRecommendation:2

Blood pressure flowchart (.pdf, 142KB)

How to measure your blood pressure at home

HOW CAN WE MONITOR IT DURING COVID19? By doing HOME BLOOD PRESSURE monitoring.

Step 1: BUY OR BORROW A BLOOD PRESSURE MACHIN

Step 2: CHECK YOUR BLOOD PRESSURE MORNING AND EVENING

RECORD IT FOR 7DAYS IN THE CHART PROVIDED

Step 3: WHAT BLOOD PRESSURE TO AIM FOR?

  • Less than 80YRS AND no other health conditions
    BP below 135/85
  • Less than 80YRS WITH any other health condition
    BP below 135/80
  • More than 80YRS
    BP below 145/85

Step 4: WHAT IF YOUR AVERAGE BLOOD PRESSUREIS HIGHER THAN THE TARGET?

HIGHER Blood Pressure LEVEL

  • 150/95or higher and NO symptoms-CONTACT YOUR GP (telephone/ video consultation). Follow the ‘useful tips’ on making important lifestyle changes.
  • 150/95or higher and symptoms(headache, changes in vision, nose bleeds, dizziness, confusion) – could be dangerous-URGENTLY CONTACT 111/999
  • if you are ensure what your level means then contact your GP

Useful Tips

Stop smoking and have less

  • Salt
  • Alcohol
  • Stress
  • Weight

Do more:

  • Exercise
  • Fruit/veg
  • Medication adherence

 

Recording Chart

Recording Chart (PDF, 108KB)

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