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To minimize the fluctuation of blood pressure caused by negative influences such as stress and environment, the diagnosis of high blood pressure usually requires at least two measurements at two different times after the first initial screening.
Before the screening, those being tested should relax and should not consume coffee or any drink that contains caffeine before the measurement. Caffeine can transiently elevate your blood pressure, although there is no evidence that suggests caffeine contributes to long-term hypertension. Smokers should refrain from smoking before their blood pressure is measured .
Blood pressure is measured with an instrument called a sphygmomanometer and is counted in millimeters of mercury (mm Hg). A rubber cuff is wrapped around the upper arm and then inflated. This compresses a large artery in the arm, momentarily stopping the blood flow. The air in the cuff is then released and the health care provider measuring the blood pressure listens with a stethoscope. When the blood pressure starts to pulse through the artery, it makes a sound. While the physician listens and watches the gauge, two measurements are recorded. The first number is the systolic pressure, which is the amount of pressure in your arteries when your heart is pumping or the pressure when the first sound is heard. The second number, known as diastolic pressure, is the amount of pressure when your heart is resting between beats and the pressure when the last sound is heard. As follows with medical custom, the systolic pressure is always reported first and the diastolic pressure second.
Hypertension is defined as systolic blood pressure (SBP) of 140 mm Hg or greater, diastolic blood pressure (DBP) of 90 mm Hg or greater. Normal blood pressure is in the range of 120/80 mm Hg.
Hypertension is further classified into different stages. These stages, along with other risk factors, help determine the degree and type of treatment. Table 1 shows the classification of blood pressure in adults over 18 years of age not currently taking any medications for high blood pressure.
Click here to see the Table 1 |
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Nowadays, hypertension is largely diagnosed by above normal readings of blood pressure measured on three separate occasions. (Please see western medicine diagnosis section for reference).
TCM practitioners will diagnosis hypertension according to its clinical symptoms and further characterizes it by the disharmony patterns displayed by individuals. (See below)
TCM Examination Techniques:
Diagnosis in TCM is based on four examination techniques. The first is "questioning." The TCM practitioner will want to know what the individual's current complaints are, and their family's medical history. The second technique is "observation." Physical features of the body such as the face, tongue, hair, nails, sputum (mucus that is coughed up) and examining the area of pain all offer clues to the problem. Examining the tongue is particularly useful as a gage to assess illness because it is seen as a window to look at the functioning of internal organs. The third technique is "hearing and smelling." Smelling the sputum and breath and listening to the sounds coming from the chest offer additional clues. The last technique used in examination is "touching." Feeling the pulse is a cornerstone of TCM diagnosis and gives the TCM practitioner a lot of information about the body's imbalance.
Note: If a TCM practitioner suspects there might be a serious problem that Chinese medicine alone cannot treat, he or she will recommend the individual see a western doctor for further follow up.
The Four Types of Disharmony Patterns The information gathered from the TCM examination is used to determine which type of disharmony pattern an individual has. This is important because at the various stages of a disease, varieties of disharmony patterns are present which require different types of therapy. This is the reason two individuals with the same disease may be treated very differently by their TCM practitioners.
1. Hyperactivity of liver-yang
According to the "five elements theory," liver and wind evils belong to the element wood, which have ascending motion properties. Those physiological functions of the liver are considered to be yang. Excessive yang and stirring up wind evils will affect the brain, and cause dizziness and headache symptoms because it interferes with the ascending motion of the liver.
2. Yin Deficiency and Yang Hyperactivity
The body's physiological functions (yang) and physical forms (yin) are maintained in dynamic balance to achieve health. When the body is injured internally (yin deficiency), physiological hyper-function occurs and reveals heat symptoms like headache, fever and sweating.
3. Liver-Wind and Turbid Phlegm
Phlegm evil results from the impaired function of the spleen and stomach. These organs are affected by liver-wind evil that goes to the head, and obscures the meridian and orifices that eventually leads to severe hypertension with symptoms of facial distortion, and paralysis.
4. Deficiency in Yin and Yang
Both internal injury (yin) and dysfunction of organs (yang) will cause the body to lose harmony, and suffer worse manifestations such as low body temperature and a soft pulse sign, which means the vital signs are weak.
Hypertension should be differentiated from conditions where hypertension is caused by a specific disease process.
Secondary hypertension is more common, and therefore more frequently seen in:
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Individuals with clinical or biochemical features of a specific disorder. For example, blood hormone levels (catecholamines) that are above normal range suggest an endocrine disease of pheochromocytoma. |
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Young patients (30-years-old and under) |
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Accelerated hypertension (severe cases of hypertension) suggests cardiovascular causes like aneurysm. |
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Troublesome hypertension (hypertension that does not respond to medication) suggests renal causes like congenital polycystic kidneys. |
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