BLOOD PRESSURE AND PULSE RATE

A SHORT HISTORY:

It is Galen in ancient Greece who first proposed the existence of a circulatory system in
the human body. However, building on ideas conceived by Hippocrates and because the arteries
stopped bleeding when death occurred, Galen believed that this circulatory system was
composed of an interconnected set of arteries filled with “pneuma” (life giving force) or air. He
maintained that the human body was comprised of three systems. Nerves and the brain were
responsible for sensation and thought, the heart filled the body with life-giving energy (pneuma)
and the liver provided the body with nourishment and growth. Galen believed that the heart was
like a fountain, constantly giving the needed pneuma and blood to the system.

Harvey
In 1616 William Harvey announced that Galen was wrong in his assertion that the heart
constantly produced blood, like a fountain. Harvey proposed that there was a finite amount of
blood that circulated the body in one direction only. Harvey's views were initially met with a lot
of skepticism and resistance. The idea that blood was not constantly produced in the body raised
doubts about the benefit of bloodletting, a popular medical practice at the time. As a matter of
routine, bloodletting was used as a universal panacea for just about every symptom known to
man.

First blood pressure

The first recorded instance of the measurement of blood pressure was in 1711 by the
Reverend Stephen Hales. Hales inserted a glass tube into an artery of a horse and observed the
rise and fall of blood in the tube and concluded that this must be due to fluctuating pressure in
the arteries of the horse. However, Hales’ technique was not suitable for testing with humans, as
it was very invasive and highly inappropriate for clinical use. The horse died every time...

Human blood pressure measurement

In 1856, Faivre recorded human blood pressure for the first time during a limb
amputation. Faivre used Carl Ludwig's recently invented kymograph with catheters inserted
directly into an artery. Ludwig's kymograph consisted of a U-shaped manometer tube connected
to a brass pipe canula plugged directly into the artery. The manometer tube had an ivory float
onto which a rod with a quill was attached. This quill would sketch onto a rotating drum.
However, at this time, blood pressure could still only be measured by invasive means. The race
was now on to find a suitable way to measure blood pressure non-invasively.
In 1855, Karl Vierordt discovered that with enough pressure the arterial pulse could be
obliterated. Vierordt introduced the sphygmograph, based on this principle of obliteration.
Vierordt used an inflatable cuff around the arm to constrict the artery. However, Vierordt’s
device was huge and unwieldy (168 cm tall) and produced very uneven results.

The Sphymogragh
Etienne Jules Marey, a French physician (also a cinematographer who is considered to
be the father of modern photography) developed this idea further in 1860. His sphygmograph
could accurately measure the pulse rate, but was very unreliable in determining the blood
pressure. Yet this design was the first that could be used clinically was some degree of success.
In 1882, Robert Ellis Dudgeon simplified and refined the Marey sphygmograph, rendering it
eminently portable and easy to use.

The Sphygmomanometer
In 1881, Samuel Siegfried Karl Ritter von Basch invented the sphygmomanometer. His
device consisted of a water or mercury-filled rubber ball connected to a manometer. The rubber
ball was then pressed against the radial artery until the pulse was obliterated and the blood
pressure was then estimated using the manometer However von Basch's design never had the
success it deserved, many physicians of the time being skeptical of this new technology,
claiming that it sought to replace traditional ideas of diagnosis based on palpation. The real
problem was however that most doctors questioned the medical usefulness of blood pressure.
This did not stop some from attempting to produce a more useful device, such as the
sphygmometer by Bloch, which was essentially a spring-loaded tire-gage that was applied to an
artery to see how much pressure was necessary to obliterate the pulse.
In 1889, Potain improved all of the compression devices available by replacing water and
mercury in the devices with air, thus substantially improving their accuracy.
Riva-Rocci
1896 was a decisive year in the history of blood pressure. Scipione Riva-Rocci developed
his first mercury sphygmomanometer. This design was the forerunner of the modern mercury
sphygmomanometer. An inflatable cuff was placed over the upper arm to constrict the brachial
artery. This cuff was connected to a glass manometer filled with mercury to measure the pressure
exerted onto the arm. Riva-Rocci's sphygmomanometer was then spotted by the American
neurosurgeon Harvey Cushing while he was traveling through Italy. Seeing the potential benefit
of this device, he returned to the US with the design in 1901. After the design was modified to be
more adapted for clinical use, the sphygmomanometer became commonplace.

Korotkoff
However, it is useful to remember that this sphygmomanometer was then only used to
determine the systolic blood pressure. The importance of the diastolic pressure had not yet been
clearly defined at this time. In 1905, a young Russian surgeon, Nikolai Korotkoff, observed the
sounds made by the constriction of the artery, using a stethoscope. Korotkoff found that there
were characteristic sounds at certain points in the inflation and deflation of the cuff. These
Korotkoff sounds were caused by the passage of blood through the artery, corresponding to the
systolic and diastolic blood pressures. The technique that we still use today to measure systolic
and diastolic blood pressure was born. A crucial difference in Korotkoff's technique was the use
of a stethoscope to listen for the sounds of blood flowing through the artery. This auscultatory
method proved to be more reliable than the previous palpation techniques

Modern blood pressure

In 1974, Panasonic released the first digital oscillometric device. These
sphygmomanometers measure the pressure imparted onto the cuff by the blood pushing through
the constricted artery over a range of cuff pressures. This data is used to estimate the systolic and
diastolic blood pressures. In the 1980's, home monitoring of blood pressure becomes
commonplace.

IT’S IMPORTANCE FOR PSYCHOLOGISTS:

Wellness and Illness of the human being is based on both body and mind condition.
Anxiety, Stress, Depression, Panic attack, etc., changes the level of blood pressure and pulse rate
in one's body and vice versa. Depending upon one's Blood pressure level and pulse rate,
Psychologists initiate and continue the counseling and therapies for the betterment of their
clients. Infact, certain therapies like biofeedback helps to manage the level of blood pressure and
pulse rate of a person when they experience severe anxiety, migraine, etc., So there is a
significant need for Psychologists to learn and have knowledge about the blood pressure and
pulse rate of the human being.
CONSEQUENCES OF HIGH BLOOD PRESSURE:
High blood pressure can damage health in many ways. It can seriously hurt important
organs like heart and brain. Fortunately, we can control our blood pressure to lower your risk for
serious health problems. Decreased Blood Flow to the Heart, High blood pressure can harden the
arteries, which decreases the flow of blood and oxygen to heart and lead to heart disease. In
addition, decreased blood flow to the heart can cause:

 Chest pain, also called angina.

 Heart failure, a condition when your heart can’t pump enough blood and oxygen to
your other organs.
 Heart attack, which occurs when the blood supply to your heart is blocked and heart
muscle begins to die without enough oxygen. The longer the blood flow is blocked,
the greater the damage to the heart.

 The Brain, High blood pressure can burst or block arteries that supply blood and
oxygen to the brain, causing a stroke. Brain cells die during a stroke because they do
not get enough oxygen. Stroke can cause serious disabilities in speech, movement,
and other basic activities, and a stroke can kill you.
 The Kidneys, Adults with diabetes, high blood pressure, or both have a higher risk of
developing chronic kidney disease than those without these diseases. Approximately
1 of 3 adults with diabetes and 1 of 5 adults with high blood pressure have chronic
kidney disease.

CONSEQUENCES OF LOW BLOOD PRESSURE:

It has varied effects on the body, one important effect being that the heart rate is lower
than normal.

 Heart/Kidney Problems: The kidney does not eliminate wastes from the body efficiently.
This malfunction then results in a build-up of toxins in the body, which can lead to any
related sickness. This condition also adversely affects the heart and tends to cause various
heart diseases, and can ultimately also result in a heart attack.
 Brain/Nerve Damage: A lower blood pressure can lead to nerve damage. It will also
damage the brain due to insufficient oxygen, thus causing a stroke.
 Dizziness: This is experienced by many people suffering from low blood pressure. It occurs
when a person suddenly stands up, or gets out from the bed after sleeping very soon. It also
tends to affects people more with advancement in age.
CONSEQUENCES OF SLOW PULSE RATE:

Bradycardia: Slow Heart Rate

Bradycardia is a heart rate that’s too slow. It can depend on our age and physical
condition. Elderly people, for example, are more prone to bradycardia. In general, for adults, a
resting heart rate of fewer than 60 beats per minute (BPM) qualifies as bradycardia. But there are
exceptions. Our heart rate may fall below 60 BPM during deep sleep. And physically active
adults (and athletes) often have a resting heart rate slower than 60 BPM.
Complications of bradycardia

Left untreated, severe or prolonged bradycardia can cause:

 Heart failure
 Fainting (syncope)
 Chest pain (angina pectoris)
 Low blood pressure (hypotension)
 High blood pressure (hypertension)

CONSEQUENCES OF FAST PULSE RATE:

Tachycardia: Fast Heart Rate

Tachycardia refers to a heart rate that’s too fast. How that’s defined may depend on our age and
physical condition.Generally speaking, for adults, a heart rate of more than 100 beats per minute
(BPM) is considered too fast.

Symptoms and complications

Some people with atrial or supraventricular tachycardia may have no discernible symptoms.
Others may experience:

 Fainting (syncope)
 Lightheadedness or dizziness
 Rapid heartbeat or palpitations
 Fluttering in the chest
 Bounding pulse
 Chest pressure, tightness or pain (angina)
 Shortness of breath
 Fatigue

In extreme cases, those suffering with atrial or SVT may also experience:
  Unconsciousness
 Cardiac arrest

Range of symptoms
Symptoms for ventricular tachycardia vary. Common symptoms include:

 Dizziness
 Palpitations
 Shortness of breath
 Nausea
 Lightheadedness
 Falling unconscious
 Cardiac arrest, in extreme cases

REFERENCES:

Uwe Diegel, 2018, History of Blood Pressure, HealthWorks, Paris, France.

American Heart Association, retrieved from https://www.heart.org/en/health-

topics/arrhythmia/about-arrhythmia/tachycardia--fast-heart-rate