Health Promotion : Blood Pressure Measurement and Education.

Appropriate medical or allied health specialist trained in measurement of blood pressure, referral protocols, and delivering educational messages to participant conducting blood pressure programs. These programs are required to follow national guidelines.

National guidelines for blood pressure (BP) protocols -     

• Calibration of blood pressure (BP) measuring equipment should be done at least yearly .    

• Two or more measurements of participant’s blood pressure should be taken.    

• Referral of participants with high blood pressure readings to personal physician for further evaluation .   

Systolic / Diastolic Follow-Up -     

• Normal -    <130 / <85   

   Action -  Recheck in 2 years

• High Normal -    130-139 / 85-90   

   Action -  Recheck in 1 year

Hypertension -     

• Stage 1 (Mild) -    140-159 / 90-99    

   Action -  Confirm within 2 Months.

• Stage 2 (Moderate) -    160-179 / 100-109    

   Action -  Refer to source of care within 1 month.

• Stage 3 (Severe) -    180-209 / 110-119    

   Action -  Refer to source of care within 1 week.

• Stage 4 (Very Severe) -    >210 / >120    

   Action -  Refer to source of care immediately.

Appropriate educational messages -     

• Normal -    <130 systolic and <85 diastolic   

   Action -  No referral. If on treatment, then inform participant that blood pressure is under good control today and ought to continue seeing and following treatment program.

• High Normal -    130-139 systolic and/or 85-89 diastolic   

   Action -  Recommend that participant have blood pressure (BP) rechecked within 1 year unless under treatment. Advise participant that the readings are in a high normal range that needs rechecking. In the interim, suggest that one of the most effective means to lower blood pressure (BP) is to bring weight into normal range and to exercise.

• High -    >140 systolic and/or >90 diastolic   

   Action -  Refer to doctor for further evaluation within 2 months unless the level is within urgent, emergency, or isolated systolic hypertension levels. When already on treatment, advise participant of readings and need to get blood pressure (BP) to a goal of 140/90 or less.

• Isolated Systolic Hypertension -    140-159 systolic and < 90 diastolic in a participant 65 years of age or older.   

   Action -  Advise participant to inform physician of readings at next visit and consider advice regarding weight loss and exercise if appropriate.

• Urgent -    180-209 systolic and/or 110-119 diastolic   

   Action -  Recommend obtaining medical examination within 1 week.

• Emergency -    >210 systolic and/or >120 diastolic   

   Action -  Obtain immediate medical attention.

Quality health screening programs offer the following:     

• Written results, referral instructions, and an explanation of blood pressure (BP) levels given to each participant with individualized counseling, including advice about the interval of time recommended when the participant should be checked again.

• Utilizes the recommendations in the Fifth Report Of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure, March 1994.

• Written and audiovisual materials that are informative, easy to understand, and useful while containing scientifically accurate information.

• Relationship of high blood pressure and other risk factors, such as family history, smoking, high fat and unhealthy diet, lack of exercise, in the development of cardiovascular illness , including stroke, kidney illness , heart attack, and other diseases .

• Definition and causes of high blood pressure.

• Importance of following prescribed treatment.