BLOOD PRESSURE AND PULSE RATE

Group Experiment
Introduction:
Santorio Santorio (29 March 1561 22 February 1636) The first person to accurately measure
the pulse rate, was the first to use a wind gauge, a water current meter, the pulsilogium (a device
used to measure the pulse rate), an early waterbed and a thermoscope. The pulsilogium was
probably the first machine of precision in medical history. A century later another physician, de
Lacroix, used the pulsilogium to test cardiac function
In medicine, a pulse represents the tactile arterial palpation of the heartbeat by trained fingertips.
The pulse may be palpated in any place that allows an artery to be compressed against a bone,
such as at the neck (carotid artery), on the inside of the elbow (brachial artery), at the wrist
(radial artery), at the groin (femoral artery), behind the knee (popliteal artery), near the ankle
joint (posterior tibial artery), and on foot (dorsalis pedis artery). Pulse is equivalent to measuring
the heart rate.
The normal resting adult human heart rate range from 60100 bpm. Tachycardia is a fast heart
rate, defined as above 100 bpm at rest. Bradycardia is a slow heart rate, defined as below 60 bpm
at rest. Several studies, as well as expert consensus indicates that the normal resting adult heart
rate is probably closer to a range between 5090 bpm.

Characteristics of pulse rate

Normal pulse rates at rest, in beats per minute (BPM)
newborn infants Infants children children over well-trained
(03 months (3 6 (6 12 (1 10 10 years adult athletes
old) months) months) years) & adults,
including
seniors

80-120 70130 60100 4060

100-150 90120

Rhythm
A normal pulse is regular in rhythm and force. An irregular pulse may be due to sinus
arrhythmia, ectopic beats, atrial fibrillation, paroxysmal atrial tachycardia, atrial flutter, partial
heart block etc. Intermittent dropping out of beats at pulse is called "intermittent pulse".
Volume
The degree of expansion displayed by artery during diastolic and systolic state is called volume.
It is also known as amplitude, expansion or size of pulse.
CAUSES:
Causes of tachycardia include:
Heart-related conditions such as high blood pressure (hypertension)
Poor blood supply to the heart muscle due to coronary artery disease (atherosclerosis),
heart valve disease, heart failure, heart muscle disease (cardiomyopathy), tumors, or
infections
Other medical conditions such as thyroid disease, certain lung diseases, electrolyte
imbalance, and alcohol or drug abuse
Emotional stress or drinking large amounts of alcoholic or caffeinated beverage.

Common bradycardia causes include:

A hereditary heart defect
Certain illnesses or heart medications
The natural aging process
Scar tissue from a heart attack
Sick sinus syndrome
The heart's natural pacemaker is not functioning correctly
Heart block
The electrical impulse that travels from the upper to the lower chamber of the heart is
irregular or blocked

BLOOD PRESSURE
Blood pressure is a measurement used in medicine. In the body, the arteries carry blood away
from the heart. As blood travels through the arteries, it presses against the walls of the arteries.
Blood pressure measures how hard the blood is pushing against the walls of the arteries. Usually,
"blood pressure" measures the pressure in larger arteries delivering blood to body parts other
than the lungs, like the brachial artery in the arm. Blood pressure is usually measured in
millimeters of mercury (mmHg).There are two numbers in a blood pressure. The first is the
systolic pressure. It measures how hard the blood pushes against the walls of the arteries when
the heart is in systole (beating and pushing out blood). This is when the pressure against the
walls of the arteries is highest. The second number is the diastolic blood pressure. It measures
how hard the blood pushes against the walls of the arteries when the heart is in diastole (resting
between beats and not pushing out any blood).
Normal Blood Pressure
Blood pressure is usually lower for children and gets higher as a person gets older. For healthy
adult humans, the systolic blood pressure should be below 120, and the diastolic blood pressure
should be below 80. However, blood pressure can be very different for each person. Blood
pressure also changes naturally during the day (in a circadian rhythm). It gets lower during sleep
and gets higher when a person gets up. It is lower when a person is resting and higher during
activity. Many other things - like stress, disease, drugs, and what a person eats - can change
blood pressure. Even the stress of having blood pressure taken can make it higher. This is called
"white coat hypertension.
This view has led the American Heart Association (AHA), for example, to define the following
ranges of blood pressure (in mmHg):
Normal blood pressure is below 120 systolic and below 80 diastolic
Prehypertension is 120-139 systolic or 80-89 diastolic
Stage 1 high blood pressure (hypertension) is 140-159 systolic or 90-99 diastolic
Stage 2 high blood pressure (hypertension) is 160 or higher systolic or 100 or higher
diastolic
Hypertensive crisis (a medical emergency) is when blood pressure is above 180 systolic
or above 110 diastolic.

High blood pressure (Hypertension)

Hypertension or high blood pressure, is a chronic medical condition in which the blood pressure
in the arteries is higher than it should be. This requires the heart to work harder than normal to
circulate blood through the blood vessels. The pressure in the arteries changes depending on
what the heart is doing. When the heart squeezes, pumping blood into the arteries, the pressure
increases. When the heart relaxes, the pressure decreases. When blood pressure is measured, the
highest pressure (when the heart is squeezing) is called the systolic blood pressure. The lowest
pressure (when the heart is relaxing) is called the diastolic blood pressure.

Causes of high blood pressure:

Physical inactivity
A salt-rich diet associated with processed and fatty foods
Alcohol and tobacco use.
chronic kidney disease
Diabetes (both due to kidney problems and nerve damage)
Pheochromocytoma (a cancer)
Congenital adrenal hyperplasia (disorder of the adrenal glands, which secrete the
hormone cortisol)
 Hyperthyroidism (overactive thyroid gland).
Hyperparathyroidism
Pregnancy
Sleep apnea
Obesity

Intervention for hypertension

drug therapy
relaxation and medication
biofeedback technique
individualized behavioral psychotherapy
pharmacotherapy with hydrochlorothiazide
CBT

Low blood pressure (Hypotension)

Hypotension is low blood pressure. A person with low blood pressure is called
hypotensive.Everybody's blood pressure is different. Some people have naturally low blood
pressure. However, for most adults, a systolic blood pressure of under 90, or a diastolic blood
pressure of under 60, is low blood pressure.

Causes of low blood pressure

Pregnancy
Hormonal problems such as an underactive thyroid (hypothyroidism), diabetes, or low
blood sugar (hypoglycemia)
Some over-the-counter medications
Some prescription medicines such as for high blood pressure, depression or Parkinsons
disease
Heart failure
Heart arrhythmias (abnormal heart rhythms)
Widening, or dilation, of the blood vessels
Heat exhaustion or heat stroke
Liver disease

Intervention for hypotension

Yoga Breathing
Sit up
 Side Bending
Back bending
Asanas
Viparit-karani A positive theurapeutic treatment for low blood pressure.
Ardhakurmasana Provides maximum relaxation and checks blood pressure.

Procedure :
Measuring Blood Pressure
Step 1 - Choose the right equipment:
What you will need:
1. A quality stethoscope
2. An appropriately sized blood pressure cuff
3. A blood pressure measurement instrument such as an aneroid or mercury column
sphygmomanometer or an automated device with a manual inflate mode.

Step 2 - Prepare the patient: Make sure the patient is relaxed by allowing 5 minutes to relax
before the first reading. The patient should sit upright with their upper arm positioned so it is
level with their heart and feet flat on the floor. Remove excess clothing that might interfere with
the BP cuff or constrict blood flow in the arm. Be sure you and the patient refrain from talking
during the reading.

Step 3 - Choose the proper BP cuff size: Most measurement errors occur by not taking the time
to choose the proper cuff size. Wrap the cuff around the patient's arm and use the INDEX line to
determine if the patient's arm circumference falls within the RANGE area. Otherwise, choose the
appropriate smaller or larger cuff.

Step 4 - Place the BP cuff on the patient's arm: Palpate/locate the brachial artery and position the
BP cuff so that the ARTERY marker points to the brachial artery. Wrap the BP cuff snugly
around the arm.

Step 5 - Position the stethoscope: On the same arm that you placed the BP cuff, palpate the arm
at the crease of the arm to locate the strongest pulse sounds and place the bell of the stethoscope
over the brachial artery at this location.
Step 6 - Inflate the BP cuff: Begin pumping the cuff bulb as you listen to the pulse sounds. When
the BP cuff has inflated enough to stop blood flow you should hear no sounds through the
stethoscope. The gauge should read 30 to 40 mmHg above the person's normal BP reading. If
this value is unknown you can inflate the cuff to 160 - 180 mmHg. (If pulse sounds are heard
right away, inflate to a higher pressure.)

Step 7 - Slowly Deflate the BP cuff: Begin deflation. The AHA recommends that the pressure
should fall at 2 - 3 mmHg per second, anything faster may likely result in an inaccurate
measurement.

Step 8 - Listen for the Systolic Reading: The first occurrence of rhythmic sounds heard as blood
begins to flow through the artery is the patient's systolic pressure. This may resemble a tapping
noise at first.

Step 9 - Listen for the Diastolic Reading: Continue to listen as the BP cuff pressure drops and the
sounds fade. Note the gauge reading when the rhythmic sounds stop. This will be the diastolic
reading.

Step 10 - Double Check for Accuracy: The AHA recommends taking a reading with both arms
and averaging the readings. To check the pressure again for accuracy wait about five minutes
between readings. Typically, blood pressure is higher in the mornings and lower in the evenings.
If the blood pressure reading is a concern or masked or white coat hypertension is suspected, a
24 hour blood pressure study may be required to assess the patient's overall blood pressure
profile.

Measuring Heart Rate

Your heart rate can be taken at any spot on the body at which an artery is close to the surface and
a pulse can be felt. The most common places to measure heart rate using the palpation method is
at the wrist (radial artery) and the neck (carotid artery).
Manual Method
Radial Pulse (wrist) - place your index and middle fingers together on the opposite wrist, about
1/2 inch on the inside of the joint, in line with the index finger. Once you find a pulse, count the
number of beats you feel within a one minute period.
Carotid Pulse (neck) - To take your heart rate at the neck, place your first two fingers on either
side of the neck. Be careful not too press to hard, then count the number of beats for a minute.

Reference:
"Pulse Rate Measurement". Healthwise. WebMD. Retrieved 14 March 2011
https://en.wikipedia.org/wiki/BP