BP measurement at railway stations- How useful?
The first step in correct BP measurement is to let the subject
whose BP is to be measured rest for a few minutes on a comfortable chair in a
quiet place.
Intuitively, a railway station with all its hustle and
bustle can hardly be considered a place to take blood pressure of passengers.
However, the advantage at a railway station is in the
quantity (large number) as well as quality (cross section of a diverse
population) of subjects.
But certain precautions must be observed to lend credibility
and legitimacy to the whole exercise, which we did that day to our
satisfaction.
1.
Let the subject rest for a few minutes before
checking his or her BP
2.
If the reading is less than 120/80, the person
is reassured and asked to recheck at 6 monthly intervals.
3.
If the first reading is above 120/80 mm Hg, it
is checked again after few minutes. If again high, the person is sent to an
enclosure with some privacy where the BP is checked with an AOBP. This
automated office BP instrument takes BP thrice at intervals and gives an
average of 3 readings automatically. World over, this has been advocated as the
most accurate way of BP measurement. Fortunately, we had 2 such instruments
(being used for the first time probably on a railway station).
4.
If the BP is persistently high after using all
above methods, we direct the subject to his or her primary physician to confirm
readings with multiple measurements over a few days’ period and further medical
advice.
5.
NO DRUG is PRESCRIBED, but ALL subjects,
irrespective of their BP are advised about life style changes as the first and
permanent step.
So, our experience at Andheri railway station on 12th
November 2019 of checking BP of about 153 people with the above precautions, on
behalf of Rotary District 3141 and Rotary club of Bombay Airport was quite
rewarding.
High blood pressure or hypertension problem world over has
been described to have what is known as the “rule of halves”.
According to this rule based on a common observation, ‘half
the people with high blood pressure are not known (“rule 1”), half of those
known are not treated (“rule 2”) and half of those treated are not controlled
(“rule 3”)’
Thus, more than 75% of high blood pressure people either do
not know they have hypertension or are not optimally treated, exposing them to
the risks of heart attacks, brain strokes and kidney failure.
If one considers that hypertension is prevalent in almost 30
to 50 % of our population, the above percentages imply a large burden of
unknown, uncontrolled hypertension in the country.
Obviously, the first step is to diagnose as many people as
possible correctly so that they can be given correct advice and saved.
The availability of large cross section of population at
railway stations presents a unique opportunity to tackle this problem and save
millions of people from the complications of hypertension by early detection
and advice
Indeed, many subjects were happy at the availability of such
a facility at a railway station in contrast to spending lot of time waiting for
their turn at a family doctor’s clinic to get BP checked.
Hope our railway authorities take note and help us achieve
this goal by giving permissions to set up booths and kiosks for measuring BP
with modern, internationally validated and user- friendly BP instruments which
well-trained para medics can use.
We at Rotary clubs are ready.
