Level 2 Anatomy and Physiology

Unit 3 – Circulation and respiration

Lesson 3.4 – Blood pressure and the pulse

Level 2 Anatomy and Physiology
Lesson 3.4 Blood pressure and the pulse

Step 1 – Blood pressure

Measurement of blood pressure is an important indicator of health, particularly of

the circulatory function. By blood pressure, we mean the hydrostatic pressure
exerted by the blood on the walls of the blood vessels, measured in millimetres of
mercury (mm Hg).

As we have discussed, the heart pumps blood into the large arteries, from which it
makes its way into the arterioles and capillaries. However, the volume of blood
entering the arteries is greater than can immediately be absorbed by the smaller
blood vessels, and a back pressure is therefore exerted against the arteries.

The elasticity of the arteries and the pumping power of the heart are liable to
deteriorate with age, with certain illnesses, and as a result of lack of exercise. This
will affect blood pressure.

As pressure varies during the beat cycle, two levels of pressure are actually
measured:

 The higher blood pressure occurs during systole (contraction) and is called
systolic pressure
 The pressure at the end of diastole (relaxation) is less and is known as
diastolic pressure

During a single heartbeat cycle, the blood pressure varies from a maximum during
systole to a minimum during diastole.

Step 2 – Measuring blood pressure

Arterial pressure can be measured by a sphygmomanometer. (A manometer is a

pressure gauge; 'sphygmo' is from the Greek, meaning 'force of pulse'.)

This instrument consists of a canvas cuff surrounded by a wide rubber bag, which
is connected to a pressure gauge and a syringe bulb.

The cuff is strapped round the upper arm and air is pumped into the bag. This
raises the pressure and distends the bag but as the canvas bag is designed not to
stretch, the bag pressure is exerted on the blood vessels of the arm.

The person taking the measurement listens with a stethoscope applied to an artery
in the lower arm. As the cuff expands, it gradually compresses the artery, and
eventually stops circulation in the arm so that no pulses can be heard. The cuff is
slowly deflated, and at the point when the circulation is restored, you can hear the
blood hitting the artery walls with a thump, or bump sound as the heart contraction
forces blood through the artery. The reading at this point is noted as the systolic
pressure.

May 2015 © Future Fit Training, 2015 Page 1 of 3

Level 2 Anatomy and Physiology
Lesson 3.4 Blood pressure and the pulse

Step 3 – Measuring blood pressure

The cuff pressure is then allowed to gradually deflate further, until blood is flowing
normally again and no sound can be heard. A reading is taken at this point and
indicates the diastolic pressure.

Blood pressure is usually expressed as a ratio expression of the higher reading

over the lower, that is the systolic pressure over the diastolic pressure.

A healthy person will have a blood pressure in the order of:

 80/45 (in infants)

 120/80 (age 30)
 140/85 (age 40 and over)

However, blood pressure varies between individuals, and in the same individual at
different times. Men typically have higher pressure than women and children due
to a higher volume of blood. Pressure is lowest during sleep.

Step 4 – High and low blood pressure

High blood pressure

High blood pressure is called hypertension, and is a common complaint. It is
defined as systolic pressure being in excess of 140mmHg and diastolic pressure
being in excess of 90mmHg. Hypertension is a major cause of heart failure, kidney
disease and stroke. It has been proved that excess weight, smoking and stress
can all contribute to raised blood pressure.

Low blood pressure

Low blood pressure (called hypotension) is a less serious condition, but usually
results in poor circulation, indicated by cold hands and feet.

Below is a table showing the British Hypertension Society Classification of Blood

Pressure Levels

Category Systolic BP Diastolic

(mmHg) BP (mmHg)
Optimal BP <120 <80
Normal BP <130 <85
High-normal BP 130-139 85-89
Grade1 hypertension (mild) 140-159 90-99
Grade 2 hypertension (moderate) 160-179 100-109
Grade 3 hypertension (severe) 180+ 110+
Isolated systolic hypertension (ISH) Grade 1 140-159 <90
Isolated systolic hypertension (Grade 2) 160+ <90

If diastolic and systolic measurements fall into different categories, the higher
value is used to classify blood pressure. (McInnes et al, 2004)

May 2015 © Future Fit Training, 2015 Page 2 of 3

Level 2 Anatomy and Physiology
Lesson 3.4 Blood pressure and the pulse

Step 5 – The pulse

The rate of the pulse can be a useful fitness indicator.

The most common way to take the pulse is over the radial artery in the wrist. The
first three fingers should be used - not the thumb, as it has its own pulse. You can
take the pulse for 15 seconds and then multiply by 4 to calculate the rate per
minute.

Step 6 – The pulse

An average, untrained adult who is relaxed and sitting down, and has not recently
taken part in exercise, should have a pulse rate of approximately 70-80 beats per
minute (bpm). Anything over 90 bpm is high.

Children have naturally higher rates of around 90 bpm.

Step 7 – The pulse

Factors affecting pulse rate include:

 Age: it is quicker in infants and becomes slower throughout life

 Gender: females have quicker pulses than males
 Whether the individual is at rest, rather than having been exercising or
feeling agitated
 Fitness levels
 Size: smaller people tend to have higher pulse rates than larger people
 Emotion and excitement
 Temperature: the pulse tends to quicken when the person is hot
 Temperament: placid people generally have slower beats than energetic
ones
 Disease and illness
 Drugs and alcohol

Step 8 – Summary
Because pressure varies during the beat cycle, two levels of pressure are actually
measured: the higher blood pressure occurs during systole (contraction) and is
called systolic pressure; the pressure at the end of diastole (relaxation) is less and
is known as diastolic pressure.

Blood pressure is usually expressed as a ratio expression of the higher reading

over the lower (the systolic pressure over the diastolic pressure).

High blood pressure is called hypertension and is a common and serious

complaint.

The rate of the pulse can be a useful fitness indicator.

May 2015 © Future Fit Training, 2015 Page 3 of 3