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The Process of Reading Blood Pressure

With each heartbeat, your blood pressure goes up. And with each pause between beats, it drops a little. In other words, you really don’t have a constant flow of blood, like water through a garden hose. It’s more like an air pump that pushes bursts of air into a tire, pauses to create more pressure, and then shoots in the air again.

A blood pressure reading measures both the pressure when the heart pumps and the pressure when it relaxes and reloads. The higher reading, when the heart pumps, is called systolic pressure. The lower reading, when the heart is at rest, is called diastolic pressure. These numbers are usually written with a slash between them, like 110/70 or 140/90. You’d read them as “110 over 70? or “140 over 90.”

The most common device that measures blood pressure is called a sphygmomanometer. You’ve probably seen one in your doctor’s office. It consists of an inflatable cuff, an air pump, and a gauge. The gauge may be electronic, may be a circular dial (termed aneroid}, or it may be a column that looks like a giant thermometer. Like a thermometer, the column is filled with mercury. The higher the pressure goes the higher the mercury rises in its tube.

Here’s how the process works: Your doctor or nurse wraps the cuff snugly around your upper arm. She then places a stethoscope on the inside of your elbow. The stethoscope is a listening device that lets the person doing the measurement hears the pulse and blood flow in your arm. It’s the same instrument that your doctor uses to listen to your lungs and heart.

The cuff is slowly inflated. As it tightens around your arm, it starts to temporarily cut off the flow of blood to your lower arm. The tighter the cuff, the more restricted the blood flow. Finally, it stops altogether. This happens when the main artery in your arm, the brachial artery, gets squeezed so tightly that it collapses momentarily.

Now the readings begin. The doctor or nurse slowly releases the pressure in the cuff. Blood keeps trying to squeeze back through the brachial artery. Finally, the artery refills partway and shoots blood back into your lower arm. The person doing the measurement hears the rush of blood and a thumping sound through the stethoscope. She then looks at the pressure gauge and notices the level of mercury. The point at which blood pushes back through the artery is the systolic blood pressure reading. Remember, it’s the higher of the two readings.

The cuff keeps slowly deflating, and more and more blood flows through the brachial artery. But because there’s still some air left in the cuff, the artery remains partially collapsed. The doctor or nurse can still hear the blood pumping. Eventually, the artery refills completely. That’s when there’s no more noise in the stethoscope. The doctor or nurse then checks the gauge again. The number she sees is the diastolic blood pressure reading. This shows what your blood pressure is when your heart is at rest between beats. Again, it’s read in millimeters of mercury. So a typical diastolic reading might be 80 mm Hg.

Using Nicotine Gums to Ward off Smoking

Nicotine gums can help you stop smoking, thereby reducing the ill effects that cigarettes have on high blood pressure. These gums come in different strengths. The two-milligram version is for people who smoke fewer than 25 cigarettes a day. The four-milligram version is for those who smoke that many or more. Both types are now available without a prescription. Nicotine gum is not a permanent solution. You’ll need to taper off the gum as your cigarette cravings disappear.