Arteriosclerosis and Hypertension, with Chapters on Blood Pressure: 3rd Edition. — John Shaqi
Arteriosclerosis and Hypertension, with Chapters on Blood Pressure: 3rd Edition.Warfield, Louis M. (Louis Marshall)
Science
Arteriosclerosis and Hypertension, with Chapters on Blood Pressure: 3rd Edition.
Warfield, Louis M. (Louis Marshall)
Arteries -- Diseases; Blood pressure
Blood pressure is the expression used for a series of phenomena
resulting from the action of the heart. As every heart beat is actual
work done by the heart in overcoming resistance to the outflow of blood,
this force is approximately measurable in a large artery such as the
brachial. It has been determined that the pressure in the brachial
artery is almost equal to the intraventricular pressure in the left
ventricle. In animals it is easy to attach manometers to the carotid
artery and to measure the blood pressure accurately. Formerly the method
consisted in attaching a tube and allowing the blood to rise in the
tube. The height to which the blood rose measured the maximum pressure.
This is a crude method and has been replaced by the U-tube of mercury
with connection made to the artery by saline or Ringer's solution. This
apparatus is familiar to all physiologists.
In man the measurement is most conveniently made from the brachial
artery. There is some difference in the pressure in the femoral and the
brachial and some use both arteries. However, the difficulty of
adjusting instruments to the upper leg, the great force which must be
used to compress the femoral artery and the relative inaccessibility of
the leg as compared to the arm, make the leg an inconvenient part for
use in blood pressure determinations. It is not to be recommended.
Blood pressure is a valuable aid in diagnosis and of material help in
many cases in prognosis, but it is not infallible neither can it be used
alone to diagnose a case. Blood pressure is only one of many links in a
chain of evidence leading to diagnosis. It has been badly used and much
abused. It has been condemned unjustly when it did not furnish _all_ the
evidence. It has been made a fetish and worshipped by both doctors and
patients. A sane conception of blood pressure must be widely
disseminated lest we find it being discarded altogether.
Blood pressure consists of more than the estimation of the systolic
pressure. The blood pressure picture consists of (1) the systolic
pressure, (2) the diastolic pressure, (3) the pulse pressure which is
the difference between the systolic and diastolic pressure, (4) the
pulse rate. Expressed in the literature it should read thus: 120-80-40;
72. That tells the whole story in a brief, accurate form. This is
recommended in history reporting. It must be ever kept in mind that a
blood pressure reading represents the work of the heart at the _moment
when it was taken_. Within a few minutes the pressure may vary up or
down. There is no normal pressure as such, but an average pressure for
any group of people of the same age living under similar conditions. The
habit of speaking of any systolic figure as normal should be broken. A
pressure picture may be normal but a systolic reading, whatever it may
be, is not accurately designated as normal. This distinction is worth
insisting upon.
=Blood Pressure Instruments=
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