Health and Wellness Leads : Blood Pressure (BP) Measurement and Education

Appropriate health care or allied health professional trained in measurement of Blood Pressure (BP), referral protocols, and delivering educational messages to participant delivering Blood Pressure (BP) programs. These programs are necessitated to follow national instructions.

• National standard procedures for Blood Pressure (BP) protocols:
   o Calibration of Blood Pressure measuring equipment
   be done at least annually.
   o Two or more measurements of attendant’s Blood Pressure ought to be taken.
   o Referral of participants with high Blood Pressure readings to personal physician for further assessment.

• Systolic/Diastolic Follow-Up:
   o Normal:   <130 / <85
      Action: Recheck in 2 years
   o High Normal:   130-139 / 85-90
      Action: Recheck in 1 year

• Hypertension:
   o Stage 1 (Mild):   140-159 / 90-99
      Action: Confirm within 2 Months.
   o Stage 2 (Moderate):   160-179 / 100-109
      Action: Refer to source of care within 1 month.
   o Stage 3 (Severe):   180-209 / 110-119
      Action: Refer to source of care within 1 week.
   o Stage 4 (Very Severe):   >210 / >120
      Action: Refer to source of care immediately.

• Appropriate educational messages:
   o Normal:   <130 systolic and <85 diastolic
      Action: No referral. If on treatment, then inform attendant that Blood Pressure (BP) is under good control today and must continue seeing and following treatment program.
   o High Normal:   130-139 systolic and/or 85-89 diastolic
      Action: Recommend that participant have Blood Pressure 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 cut Blood Pressure is to bring weight into normal range and to exercise.
   o High:   >140 systolic and/or >90 diastolic
      Action: Refer to physician for further assessment within 2 months unless the level is within urgent, emergency, or isolated systolic hypertension levels. If already on treatment, advise colleague of readings and need to get Blood Pressure (BP) to a objective of 140/90 or less.
   o Isolated Systolic Hypertension:   140-159 systolic and < 90 diastolic in a participant 65 years of age or older.
      Action: Advise attendant to inform physician of readings at next visit and consider advice regarding weight loss and exercise if appropriate.
   o Urgent:   180-209 systolic and/or 110-119 diastolic
      Action: Recommend obtaining healthcare assessment within 1 week.
   o Emergency:   >210 systolic and/or >120 diastolic
      Action: Get immediate medical care attention.

• Provides the following:
   o Written results, referral guidelines, 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 ought to be checked again.
   o Utilizes the recommendations in The Fifth Report Of The Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure, March 1994.
   o Written and audiovisual materials that are informative, easy to be aware of, and useful while containing scientifically accurate information.
   o Relationship of elevated Blood Pressure and other risk factors, such as family history, smoking, high fat and unhealthy diet, lack of exercise, in the development of cardiovascular disease, including stroke, kidney disease, heart attack, and other diseases.
   o Definition and causes of high Blood Pressure (BP).
   o Importance of following prescribed treatment.