Blood pressure is the pressure created when blood is forced out of the heart and comes into contact with the walls of the arteries which transport blood around the body. The pressure of blood flowing in the arteries changes according to the different phases of the heartbeat cycle. The pressure in the arteries will be at its highest when the heart is ‘contracting’ and pumping blood out, and at its lowest as the heart relaxes before it pumps again.
Blood pressure is recorded as two numbers: the systolic pressure (as the heart beats) and the diastolic (as the heart relaxes between beats). The numbers are written one above or before the other, the systolic number on top and the diastolic on the bottom.
Your target blood pressure should be less than 140/90 unless you have been told otherwise. If you have any coronary heart disease such as angina or have had a heart attack or stroke, or have diabetes or kidney disease, it is better for your target blood pressure to be less than 130/80.
High blood pressure – hypertension – means that your blood pressure is constantly higher than the recommended target blood pressure. Over time if this is not treated, you become more at risk of heart disease or having a stroke.
You may be asked to come to see a nurse for a blood pressure check and if it is found to be above the recommended target, you may also be asked to have a number of tests – blood tests, an electrocardiogram (ECG), a painless procedure which records the electrical activity of the heart, ambulatory blood pressure (ABP) which records your blood pressure over a 12 hour period during the day – to help your doctor decide if treatment is necessary.
Home Blood Pressure Monitoring
Surgery blood pressure measurements do not always give a true picture of what your blood pressure is doing over your normal day. Some people are found to have a higher blood pressure when at the surgery or when they are not relaxed.
It is now recommended that a better way to check your blood pressure is to measure it yourself twice each morning and evening when you are at home, relaxed and comfortable. This will then give us an idea as to what your blood pressure really is, and whether the measurements we take in the surgery are similar to those you record at home.
If you have your own blood pressure monitor, you may be asked to record a series of readings over a week to be averaged and recorded in your note. You can then submit these readings via our eConsult review page – click here.
Faecal Immunochemical Test (FIT)
The Faecal Immunochemical Test (FIT) checks for tiny amounts of blood in your faeces. Blood can be a sign of polyps (non-cancerous growths) or bowel cancer. It is now being used as the primary test in the NHS Bowel Cancer Screening Programme for patients aged 60-74 years old.
Your GP may organise a FIT test outside of the bowel screening programme if you have symptoms such as a change in bowel habits and/or rectal bleeding. The test can be easily done at home by following the step-by-step instructions in the leaflet below.
There are a number of chest conditions, which may cause breathing difficulties. Sometimes it is helpful to see how well you breathe out to help diagnose any condition or to see if the treatment you are having is working well. This may involve you blowing into a machine – a spirometer – which measures how well you can breathe out.
There are some requirements necessary before you have the test done, such as withholding use of your usual inhalers for a few hours, or usual tablets relating to any chest condition for 24 hours and avoiding vigorous exercise prior to the test.
Sometimes you will be asked to undertake a spirometry test with reversibility. This means you will be asked to blow into the machine without using your inhalers first and then again after you have used your inhalers.
A Doppler test is undertaken to help measure the flow of blood through the arteries in your arms or legs using sound waves to make a noise when blood flow is detected. The Doppler is used in place of the stethoscope normally used when taking blood pressures. The test is to detect if there are any abnormalities in the flow of blood in your vessels.
A Doppler assessment is a painless procedure and often undertaken as part of any overall assessment of whether provision of support or compression hosiery (full length or knee high stockings or socks) may be helpful to you.
Helicobacter Pylori Stool Test
Helicobacter pylori is a germ which can infect the lining of the stomach and can cause a range of stomach problems for some people. Once identified, it can be easily treated with a course of antibiotics and acid suppressing medicines.
Infection with helicobacter pylori can be confirmed with a stool test which is sent to the hospital laboratory.
There are some requirements necessary before you take the test such as withholding any regularly taken antibiotics or stomach medications for a few weeks.
Hearing Tests (Audiometry)
Damage to any part of the ear can cause a hearing loss. Problems may occur in the ear canal or the middle ear and hearing loss can be temporary or permanent. A hearing test checks whether there is a problem with any of the different mechanisms that allow a person to hear.
The test involves the use of a special machine called an audiometer, which plays a series of tones through headphones, which you will be asked to wear. The tones vary in pitch and loudness and the nurse conducting the hearing test will control the volume and tone of the sounds relayed through the machine. You will be asked to respond to each sound you hear even if very faint.
The results of a hearing test will form a graph called an audiogram. This will show if there is any pattern to the hearing loss you may be experiencing and help your doctor assess the most appropriate management.