Wikipedia

Blood pressure

(Redirected fromDiastolic pressure)
For other uses, seeBlood pressure (disambiguation).

Blood pressure(BP) is thepressureofcirculating bloodagainst the walls ofblood vessels.Most of this pressure results from theheartpumping blood through thecirculatory system.When used without qualification, the term "blood pressure" refers to the pressure in abrachial artery,where it is most commonly measured. Blood pressure is usually expressed in terms of thesystolic pressure(maximum pressure during oneheartbeat) overdiastolic pressure(minimum pressure between two heartbeats) in thecardiac cycle.It is measured inmillimeters of mercury (mmHg)above the surroundingatmospheric pressure,or inkilopascals(kPa). The difference between the systolic and diastolic pressures is known aspulse pressure,[1]while the average pressure during a cardiac cycle is known asmean arterial pressure.[2]

Blood pressure
A healthcare worker measuring blood pressure using asphygmomanometer.
MeSHD001795
MedlinePlus007490
LOINC35094-2

Blood pressure is one of thevital signs—together withrespiratory rate,heart rate,oxygen saturation,andbody temperature—that healthcare professionals use in evaluating a patient's health. Normal resting blood pressure in an adult is approximately 120 millimetres of mercury (16 kPa) systolic over 80 millimetres of mercury (11 kPa) diastolic, denoted as "120/80 mmHg". Globally, the average blood pressure, age standardized, has remained about the same since 1975 to the present, at approximately 127/79 mmHg in men and 122/77 mmHg in women, although these average data mask significantly diverging regional trends.[3]

Traditionally, a health-care worker measured blood pressure non-invasively byauscultation(listening) through astethoscopefor sounds in one arm'sarteryas the artery is squeezed, closer to the heart, by ananeroid gaugeor amercury-tubesphygmomanometer.[4]Auscultation is still generally considered to be the gold standard of accuracy for non-invasive blood pressure readings in clinic.[5]However, semi-automated methods have become common, largely due to concerns about potential mercury toxicity,[6]although cost, ease of use and applicability toambulatory blood pressureor home blood pressure measurements have also influenced this trend.[7]Early automated alternatives to mercury-tube sphygmomanometers were often seriously inaccurate, but modern devices validated to international standards achieve an average difference between two standardized reading methods of 5 mm Hg or less, and astandard deviationof less than 8 mm Hg.[7]Most of these semi-automated methods measure blood pressure using oscillometry (measurement by a pressure transducer in the cuff of the device of small oscillations of intra-cuff pressure accompanying heartbeat-induced changes in the volume of each pulse).[8]

Blood pressure is influenced bycardiac output,systemic vascular resistance,blood volume andarterial stiffness,and varies depending on person's situation, emotional state, activity and relative health or disease state. In the short term, blood pressure isregulatedbybaroreceptors,which act via the brain to influence thenervousand theendocrinesystems.

Blood pressure that is too low is calledhypotension,pressure that is consistently too high is calledhypertension,and normal pressure is called normotension.[9]Both hypertension and hypotension have many causes and may be of sudden onset or of long duration. Long-term hypertension is a risk factor for many diseases, includingstroke,heart disease,andkidney failure.Long-term hypertension is more common than long-term hypotension.

Classification, normal and abnormal values

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Systemic arterial pressure

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Blood pressure measurements can be influenced by circumstances of measurement.[10]Guidelines use different thresholds for office (also known as clinic), home (when the person measures their own blood pressure at home), andambulatory blood pressure(using an automated device over a 24-hour period).[10]

Blood pressure classifications
Categories Systolic blood pressure,mmHg and/or Diastolic blood pressure,mmHg
Method Office Home 24hambulatory Office Home 24h ambulatory
American College of Cardiology/American Heart Association(2017)[11]
Normal <120 <120 <115 and <80 <80 <75
Elevated 120–129 120–129 115–124 and <80 <80 <75
Hypertension, stage 1 130–139 130–134 125–129 or 80–89 80–84 75–79
Hypertension, stage 2 ≥140 ≥135 ≥130 or ≥90 ≥85 ≥80
European Society of Cardiology(2024)[10]
Non-elevated <120 <120 <115 and <70 <70 <65
Elevated 120–139 120–134 115–129 and 70–89 70–84 65–79
Hypertension ≥140 ≥135 ≥130 or ≥90 ≥85 ≥80
European Society of Hypertension/International Society of Hypertension(2023)[12]
Optimal <120 — — and <80 — —
Normal 120–129 — — and/or 80–84 — —
High normal 130–139 — — and/or 85–89 — —
Hypertension, grade 1 140–159 ≥135 ≥130 and/or 90–99 ≥85 ≥80
Hypertension, grade 2 160–179 — — and/or 100–109 — —
Hypertension, grade 3 ≥180 — — and/or ≥110 — —

The risk of cardiovascular disease increases progressively above 90 mmHg, especially among women.[10]

Observational studies demonstrate that people who maintain arterial pressures at the low end of these pressure ranges have much better long-term cardiovascular health. There is an ongoing medical debate over what is the optimal level of blood pressure to target when using drugs to lower blood pressure with hypertension, particularly in older people.[13]

Blood pressure fluctuates from minute to minute and normally shows a circadian rhythm over a 24-hour period,[14]with highest readings in the early morning and evenings and lowest readings at night.[15][16]Loss of the normal fall in blood pressure at night is associated with a greater future risk of cardiovascular disease and there is evidence that night-time blood pressure is a stronger predictor of cardiovascular events than day-time blood pressure.[17]Blood pressure varies over longer time periods (months to years) and this variability predicts adverse outcomes.[18]Blood pressure also changes in response to temperature, noise, emotionalstress,consumption of food or liquid, dietary factors, physical activity, changes in posture (such asstanding-up),drugs,and disease.[19]The variability in blood pressure and the better predictive value of ambulatory blood pressure measurements has led some authorities, such as the National Institute for Health and Care Excellence (NICE) in the UK, to advocate for the use of ambulatory blood pressure as the preferred method for diagnosis of hypertension.[20]

A digitalsphygmomanometerused for measuring blood pressure

Various other factors, such as age andsex,also influence a person's blood pressure. Differences between left-arm and right-arm blood pressure measurements tend to be small. However, occasionally there is a consistent difference greater than 10 mmHg which may need further investigation, e.g. forperipheral arterial disease,obstructive arterial diseaseoraortic dissection.[21][22][23][24]

There is no accepted diagnostic standard for hypotension, although pressures less than 90/60 are commonly regarded as hypotensive.[25]In practice blood pressure is considered too low only ifsymptomsare present.[26]

Systemic arterial pressure and age

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Fetal blood pressure

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Further information:Fetal circulation § Blood pressure

Inpregnancy,it is the fetal heart and not the mother's heart that builds up the fetal blood pressure to drive blood through the fetal circulation. The blood pressure in the fetal aorta is approximately 30 mmHg at 20 weeks of gestation, and increases to approximately 45 mmHg at 40 weeks of gestation.[27]

The average blood pressure for full-term infants:[28]

  • Systolic 65–95 mmHg
  • Diastolic 30–60 mmHg

Childhood

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Reference rangesfor blood pressure (BP) in children[29]
Stage Approximate age Systolic BP,
mmHg 		Diastolic BP,
mmHg
Infants 0–12 months 75–100 50–70
Toddlers and preschoolers 1–5 years 80–110 50–80
School age 6–12 years 85–120 50–80
Adolescents 13–18 years 95–140 60–90

In children the normal ranges for blood pressure are lower than for adults and depend on height.[30]Reference blood pressure values have been developed for children in different countries, based on the distribution of blood pressure in children of these countries.[31]

Aging adults

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In adults in most societies, systolic blood pressure tends to rise from early adulthood onward, up to at least age 70;[32][33]diastolic pressure tends to begin to rise at the same time but start to fall earlier in mid-life, approximately age 55.[33]Mean blood pressure rises from early adulthood, plateauing in mid-life, while pulse pressure rises quite markedly after the age of 40. Consequently, in many older people, systolic blood pressure often exceeds the normal adult range,[33]if the diastolic pressure is in the normal range this is termedisolated systolic hypertension.The rise in pulse pressure with age is attributed to increasedstiffness of the arteries.[34]An age-related rise in blood pressure is not considered healthy and is not observed in some isolated unacculturated communities.[35]

Systemic venous pressure

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Site Normal
pressure range
(inmmHg)[36]
Central venous pressure 3–8
Right ventricular pressure systolic 15–30
diastolic 3–8
Pulmonary artery pressure systolic 15–30
diastolic 4–12
Pulmonary vein/

Pulmonary capillary wedge pressure

2–15
Left ventricular pressure systolic 100–140
diastolic 3–12

Blood pressure generally refers to the arterial pressure in thesystemic circulation.However, measurement of pressures in the venous system and thepulmonary vesselsplays an important role inintensive care medicinebut requires invasive measurement of pressure using acatheter.

Venous pressure is the vascular pressure in aveinor in theatria of the heart.It is much lower than arterial pressure, with common values of 5 mmHg in theright atriumand 8 mmHg in the left atrium.

Variants of venous pressure include:

Pulmonary pressure

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Main article:Pulmonary artery pressure

Normally, the pressure in thepulmonary arteryis about 15 mmHg at rest.[40]

Increased blood pressure in thecapillariesof the lung causespulmonary hypertension,leading to interstitialedemaif the pressure increases to above 20 mmHg, and topulmonary edemaat pressures above 25 mmHg.[41]

Aortic pressure

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Main article:Aortic pressure

Aortic pressure,also called central aortic blood pressure, or central blood pressure, is the blood pressure at the root of theaorta.Elevated aortic pressure has been found to be a more accurate predictor of both cardiovascular events and mortality, as well as structural changes in the heart, than has peripheral blood pressure (such as measured through thebrachial artery).[42][43]Traditionally it involved an invasive procedure to measure aortic pressure, but now there are non-invasive methods of measuring it indirectly without a significant margin of error.[44][45]

Certain researchers have argued for physicians to begin using aortic pressure, as opposed to peripheral blood pressure, as a guide for clinical decisions.[46][43]The way antihypertensive drugs impact peripheral blood pressure can often be very different from the way they impact central aortic pressure.[47]

Mean systemic pressure

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Main article:Mean systemic pressure

If the heart is stopped, blood pressure falls, but it does not fall to zero. The remaining pressure measured after cessation of the heart beat and redistribution of blood throughout the circulation is termed the mean systemic pressure or mean circulatory filling pressure;[48]typically this is proximally ~7 mmHg.[48]

Disorders of blood pressure

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Disorders of blood pressure control includehigh blood pressure,low blood pressure,and blood pressure that shows excessive or maladaptive fluctuation.

High blood pressure

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Main article:Hypertension
Overview of main complications of persistent high blood pressure.[49]

Arterial hypertensioncan be an indicator of other problems and may have long-term adverse effects. Sometimes it can be an acute problem, such as in ahypertensive emergencywhen blood pressure is more than 180/120 mmHg.[49]

Levels of arterial pressure put mechanical stress on the arterial walls. Higher pressures increase heart workload and progression of unhealthy tissue growth (atheroma) that develops within the walls of arteries. The higher the pressure, the more stress that is present and the more atheroma tend to progress and theheart muscletends to thicken, enlarge and become weaker over time.

Persistenthypertensionis one of the risk factors forstrokes,heart attacks,heart failure,andarterial aneurysms,and is the leading cause ofchronic kidney failure.[49]Even moderate elevation of arterial pressure leads to shortenedlife expectancy.[49]At severely high pressures, mean arterial pressures 50% or more above average, a person can expect to live no more than a few years unless appropriately treated.[50]For people with high blood pressure, higherheart rate variability(HRV) is a risk factor foratrial fibrillation.[51]

Both highsystolicpressure and highpulse pressure(the numerical difference between systolic and diastolic pressures) are risk factors.[49]Elevated pulse pressure has been found to be a stronger independent predictor of cardiovascular events, especially in older populations, than has systolic, diastolic, or mean arterial pressure.[52][53][54][55]In some cases, it appears that a decrease in excessive diastolic pressure can actually increase risk, probably due to the increased difference between systolic and diastolic pressures (ie. widened pulse pressure). If systolic blood pressure is elevated (>140 mmHg) with a normal diastolic blood pressure (<90 mmHg), it is calledisolated systolic hypertensionand may present a health concern.[49][56]According to the 2017[57]American Heart Association blood pressure guidelines state that a systolic blood pressure of 130–139 mmHg with a diastolic pressure of 80–89 mmHg is "stage one hypertension".[49]

For those withheart valveregurgitation, a change in its severity may be associated with a change in diastolic pressure. In a study of people with heart valve regurgitation that compared measurements two weeks apart for each person, there was an increased severity ofaorticandmitral regurgitationwhen diastolic blood pressure increased, whereas when diastolic blood pressure decreased, there was a decreased severity.[58]

Low blood pressure

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Main article:Hypotension

Blood pressure that is too low is known ashypotension.This is a medical concern if it causes signs or symptoms, such as dizziness, fainting, or in extreme cases in medical emergencies,circulatory shock.[59]Causes of low arterial pressure includesepsis,hypovolemia,bleeding,cardiogenic shock,reflex syncope,hormonalabnormalities such asAddison's disease,eating disorders– particularlyanorexia nervosaandbulimia.[60]

Orthostatic hypotension

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Main article:Orthostatic hypotension

A large fall in blood pressure upon standing (typically a systolic/diastolic blood pressure decrease of >20/10 mmHg) is termedorthostatic hypotension(postural hypotension) and represents a failure of the body to compensate for the effect ofgravityon the circulation. Standing results in an increasedhydrostaticpressure in the blood vessels of the lower limbs. The consequent distension of the veins below thediaphragm(venous pooling) causes ~500 ml of blood to be relocated from the chest and upper body. This results in a rapid decrease in central blood volume and a reduction of ventricularpreloadwhich in turn reduces stroke volume, and mean arterial pressure. Normally this is compensated for by multiple mechanisms, including activation of theautonomic nervous systemwhich increasesheart rate,myocardial contractilityand systemic arterialvasoconstrictionto preserve blood pressure and elicitsvenousvasoconstriction to decrease venouscompliance.Decreased venous compliance also results from an intrinsicmyogenicincrease in venoussmooth muscletone in response to the elevated pressure in the veins of the lower body.

Other compensatory mechanisms include the veno-arteriolaraxon reflex,the 'skeletal muscle pump' and 'respiratory pump'. Together these mechanisms normally stabilize blood pressure within a minute or less.[61]If these compensatory mechanisms fail and arterial pressure and bloodflowdecrease beyond a certain point, theperfusionof the brain becomes critically compromised (i.e., the blood supply is not sufficient), causinglightheadedness,dizziness,weakness orfainting.[62]Usually this failure of compensation is due to disease, or drugs that affect thesympathetic nervous system.[61]A similar effect is observed following the experience of excessive gravitational forces (G-loading), such as routinely experienced by aerobatic or combat pilots 'pulling Gs' where the extreme hydrostatic pressures exceed the ability of the body's compensatory mechanisms.

Variable or fluctuating blood pressure

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Main article:Labile hypertension

Some fluctuation or variation in blood pressure is normal. Variation in blood pressure that is significantly greater than the norm is known aslabile hypertensionand is associated with increased risk of cardiovascular disease[63]brain small vessel disease,[64]and dementia[65]independent of the average blood pressure level. Recent evidence fromclinical trialshas also linked variation in blood pressure to mortality,[66][67]stroke,[68]heart failure,[69]and cardiac changes that may give rise to heart failure.[70]These data have prompted discussion of whether excessive variation in blood pressure should be treated, even among normotensive older adults.[71]

Older individuals and those who had received blood pressure medications are more likely to exhibit larger fluctuations in pressure,[72]and there is some evidence that different antihypertensive agents have different effects on blood pressure variability;[65]whether these differences translate to benefits in outcome is uncertain.[65]

Physiology

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Cardiac systole and diastole
Blood flow velocity waveforms in the central retinal artery (red) and vein (blue), measured bylaser Doppler imagingin the eye fundus of a healthy volunteer.
Schematic of pressures in the circulation

During each heartbeat, blood pressure varies between a maximum (systolic) and a minimum (diastolic) pressure.[73][unreliable medical source]The blood pressure in the circulation is principally due to the pumping action of the heart.[74]However, blood pressure is also regulated by neural regulation from the brain (seeHypertension and the brain), as well as osmotic regulation from the kidney. Differences in mean blood pressure drive the flow of blood around the circulation. The rate of mean blood flow depends on both blood pressure and the resistance to flow presented by the blood vessels. In the absence ofhydrostaticeffects (e.g. standing), mean blood pressure decreases as thecirculating bloodmoves away from the heart through arteries andcapillariesdue toviscouslosses of energy. Mean blood pressure drops over the whole circulation, although most of the fall occurs along the small arteries andarterioles.[75]Pulsatility also diminishes in the smaller elements of the arterial circulation, although some transmitted pulsatility is observed in capillaries.[76]Gravity affects blood pressure via hydrostatic forces (e.g., during standing), and valves in veins,breathing,and pumping from contraction of skeletal muscles also influence blood pressure, particularly in veins.[74]

Hemodynamics

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Main article:Hemodynamics

A simple view of thehemodynamicsof systemic arterial pressure is based aroundmean arterial pressure(MAP) and pulse pressure. Most influences on blood pressure can be understood in terms of their effect oncardiac output,[77]systemic vascular resistance,orarterial stiffness(the inverse of arterial compliance). Cardiac output is the product of stroke volume and heart rate. Stroke volume is influenced by 1) theend-diastolic volumeor filling pressure of the ventricle acting via theFrank–Starling mechanism—this is influenced byblood volume;2)cardiac contractility;and 3)afterload,the impedance to blood flow presented by the circulation.[78]In the short-term, the greater the blood volume, the higher the cardiac output. This has been proposed as an explanation of the relationship between high dietary salt intake and increased blood pressure; however, responses to increased dietary sodium intake vary between individuals and are highly dependent on autonomic nervous system responses and therenin–angiotensin system,[79][80][81]changes inplasma osmolaritymay also be important.[82]In the longer-term the relationship between volume and blood pressure is more complex.[83]In simple terms, systemic vascular resistance is mainly determined by the caliber of small arteries and arterioles. The resistance attributable to a blood vessel depends on its radius as described by theHagen-Poiseuille's equation(resistance∝1/radius4). Hence, the smaller the radius, the higher the resistance. Other physical factors that affect resistance include: vessel length (the longer the vessel, the higher the resistance), blood viscosity (the higher the viscosity, the higher the resistance)[84]and the number of vessels, particularly the smaller numerous, arterioles and capillaries. The presence of a severe arterialstenosisincreases resistance to flow, however this increase in resistance rarely increases systemic blood pressure because its contribution to total systemic resistance is small, although it may profoundly decrease downstream flow.[85]Substances calledvasoconstrictorsreduce the caliber of blood vessels, thereby increasing blood pressure.Vasodilators(such asnitroglycerin) increase the caliber of blood vessels, thereby decreasing arterial pressure. In the longer term a process termed remodeling also contributes to changing the caliber of small blood vessels and influencing resistance and reactivity to vasoactive agents.[86][87]Reductions in capillary density, termed capillary rarefaction, may also contribute to increased resistance in some circumstances.[88]

In practice, each individual's autonomic nervous system and other systems regulating blood pressure, notably the kidney,[89]respond to and regulate all these factors so that, although the above issues are important, they rarely act in isolation and the actual arterial pressure response of a given individual can vary widely in the short and long term.

Pulse pressure

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Main article:Pulse pressure
A schematic representation of the arterial pressure waveform over one cardiac cycle. The notch in the curve is associated with closing of the aortic valve.

The pulse pressure is the difference between the measured systolic and diastolic pressures,[90]

The pulse pressure is a consequence of the pulsatile nature of thecardiac output,i.e. the heartbeat. The magnitude of the pulse pressure is usually attributed to the interaction of thestroke volumeof the heart, the compliance (ability to expand) of the arterial system—largely attributable to theaortaand large elastic arteries—and theresistanceto flow in thearterial tree.[90]

Clinical significance of pulse pressure

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A healthy pulse pressure is around 40 mmHg.[1]A pulse pressure that is consistently 60 mmHg or greater is likely to be associated with disease, and a pulse pressure of 50 mmHg or more increases the risk ofcardiovascular diseaseas well as other complications such as eye and kidney disease.[52]Pulse pressure is considered low if it is less than 25% of the systolic. (For example, if the systolic pressure is 120 mmHg, then the pulse pressure would be considered low if it is less than 30 mmHg, since 30 is 25% of 120.)[91]A very low pulse pressure can be a symptom of disorders such ascongestive heart failure.[52]

Elevated pulse pressure has been found to be a stronger independent predictor of cardiovascular events, especially in older populations, than has systolic, diastolic, or mean arterial pressure.[52][53]This increased risk exists for both men and women and even when no other cardiovascular risk factors are present. The increased risk also exists even in cases in which diastolic pressure decreases over time while systolic remains steady.[55][54]

Ameta-analysisin 2000 showed that a 10 mmHg increase in pulse pressure was associated with a 20% increased risk of cardiovascular mortality, and a 13% increase in risk for all coronary end points. The study authors also noted that, while risks of cardiovascular end points do increase with higher systolic pressures, at any given systolic blood pressure the risk of major cardiovascular end points increases, rather than decreases, with lower diastolic levels. This suggests that interventions that lower diastolic pressure without also lowering systolic pressure (and thus lowering pulse pressure) could actually be counterproductive.[92]There are no drugs currently approved to lower pulse pressure, although some antihypertensive drugs may modestly lower pulse pressure, while in some cases a drug that lowers overall blood pressure may actually have the counterproductive side effect of raising pulse pressure.[93]

Pulse pressure can both widen or narrow in people withsepsisdepending on the degree ofhemodynamiccompromise. A pulse pressure of over 70 mmHg in sepsis is correlated with an increased chance of survival and a more positive response toIV fluids.[94][95]

Mean arterial pressure

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Main article:Mean arterial pressure

Mean arterial pressure(MAP) is the average of blood pressure over acardiac cycleand is determined by thecardiac output(CO),systemic vascular resistance(SVR), andcentral venous pressure(CVP):[2][96][97]

In practice, the contribution of CVP (which is small) is generally ignored and so

MAP is often estimated from measurements of the systolic pressure,and the diastolic pressure,[97]using the equation:

wherek= 0.333 although other values forkhave been advocated.[98][99]

Regulation of blood pressure

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See also:Renin–angiotensin system

Theendogenous,homeostaticregulation of arterial pressure is not completely understood, but the following mechanisms of regulating arterial pressure have been well-characterized:

These different mechanisms are not necessarily independent of each other, as indicated by the link between the RAS and aldosterone release. When blood pressure falls many physiological cascades commence in order to return the blood pressure to a more appropriate level.

  1. The blood pressure fall is detected by a decrease in blood flow and thus a decrease inglomerular filtration rate(GFR).
  2. Decrease in GFR is sensed as a decrease in Na+levels by themacula densa.
  3. The macula densa causes an increase in Na+reabsorption, which causes water to follow in viaosmosisand leads to an ultimate increase inplasmavolume. Further, the macula densa releases adenosine which causes constriction of the afferent arterioles.
  4. At the same time, thejuxtaglomerular cellssense the decrease in blood pressure and releaserenin.
  5. Renin convertsangiotensinogen(inactive form) toangiotensin I(active form).
  6. Angiotensin I flows in the bloodstream until it reaches the capillaries of the lungs whereangiotensin-converting enzyme(ACE) acts on it to convert it intoangiotensin II.
  7. Angiotensin II is a vasoconstrictor that will increase blood flow to the heart and subsequently the preload, ultimately increasing thecardiac output.
  8. Angiotensin II also causes an increase in the release ofaldosteronefrom theadrenal glands.
  9. Aldosterone further increases the Na+and H2O reabsorption in thedistal convoluted tubuleof thenephron.

The RAS is targeted pharmacologically byACE inhibitorsandangiotensin II receptor antagonists(also known as angiotensin receptor blockers; ARB). The aldosterone system is directly targeted byaldosterone antagonists.The fluid retention may be targeted bydiuretics;the antihypertensive effect of diuretics is due to its effect on blood volume. Generally, the baroreceptor reflex is not targeted inhypertensionbecause if blocked, individuals may experienceorthostatic hypotensionandfainting.

Measurement

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Main article:Blood pressure measurement
Taking blood pressure with a sphygmomanometer
Measuring systolic and diastolic blood pressure using a mercury sphygmomanometer

Arterial pressure is most commonly measured via asphygmomanometer,which uses the height of a column of mercury, or ananeroid gauge,to reflect the blood pressure by auscultation.[4]The most common automated blood pressure measurement technique is based on theoscillometricmethod.[103]Fully automated oscillometric measurement has been available since 1981.[104]This principle has recently been used to measure blood pressure with a smartphone.[105]Measuring pressureinvasively,by penetrating the arterial wall to take the measurement, is much less common and usually restricted to a hospital setting. Novel methods to measure blood pressure without penetrating the arterial wall, and without applying any pressure on patient's body are being explored,[106]for example, cuffless measurements that uses only optical sensors.[107]

In office blood pressure measurement,terminal digit preferenceis common. According to one study, approximately 40% of recorded measurements ended with the digit zero, whereas "without bias, 10%–20% of measurements are expected to end in zero"[108]

In animals

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Blood pressure levels in non-human mammals may vary depending on the species. Heart rate differs markedly, largely depending on the size of the animal (larger animals have slower heart rates).[109]The giraffe has a distinctly high arterial pressure of about 190 mm Hg, enabling blood perfusion through the 2 metres (6 ft 7 in)-long neck to the head.[110]In other species subjected to orthostatic blood pressure, such asarborealsnakes, blood pressure is higher than in non-arboreal snakes.[111]A heart near to the head (short heart-to-head distance) and a long tail with tightintegumentfavor blood perfusion to the head.[112][113]

As in humans, blood pressure in animals differs by age, sex, time of day, and environmental circumstances:[114][115]measurements made in laboratories or under anesthesia may not be representative of values under free-living conditions. Rats, mice, dogs and rabbits have been used extensively to study the regulation of blood pressure.[116]

Blood pressure and heart rate of various mammals[114]
Species Blood pressure
mm Hg 		Heart rate
beats per minute
Systolic Diastolic
Calves 140 70 75–146
Cats 155 68 100–259
Dogs 161 51 62–170
Goats 140 90 80–120
Guinea-pigs 140 90 240–300
Mice 120 75 580–680
Pigs 169 55 74–116
Rabbits 118 67 205–306
Rats 153 51 305–500
Rhesus monkeys 160 125 180–210
Sheep 140 80 63–210

Hypertension in cats and dogs

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Hypertension in cats and dogs is generally diagnosed if the blood pressure is greater than 150 mm Hg (systolic),[117]althoughsight houndshave higher blood pressures than most other dog breeds; a systolic pressure greater than 180 mmHg is considered abnormal in these dogs.[118]

See also

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Wikimedia Commons has media related toBlood pressure.

References

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