血圧測定は毎日しよう。知っておきたい血圧の事

高齢者の血圧には様々な特徴がある事をご存じですか?
高齢だし仕方ない」と放置していたりしてしまうと、脳卒中や心筋梗塞などの重大な病気を引き起こす可能性があります。

実際に65歳以上の高齢者の高血圧の割合を調べると、なんと3人に1人が高血圧になっているデータもあるほどです。
少しでも「いつもと違う」と思った時はすぐに血圧を測るようにしましょう。
そして普段の血圧がどの程度なのかを把握しておくためにも、血圧は毎日測って記録しておくに越したことはありません。
今回は高齢者の血圧の特徴について、説明したいと思います。

目次

最高血圧が高くなりやすい⁉︎

心臓に血液を送り出すときに、血管壁にかかる圧力が最高血圧です。
高齢者では最高血圧が高く、最低血圧との差が大きくなる傾向が見られます。
最高血圧が高くなるのは、老化によって血管の弾力性が低下し血流が悪くなるためです。
高齢になると自律神経の働きも悪くなり、血管の収縮や拡張がうまくできなくなることも原因の一つです。 

高齢者の場合、最高血圧が少し高めでも病院では、薬での治療はすぐに行わず、まず生活指導を優先するケースが多く見られています。
急激に血圧が下がると危険な場合がある為です。
しかし、油断をしていると動脈硬化が進み、脳卒中や心筋梗塞などを起こす可能性がある為、血圧が高めだとわかったら、食事や運動等、医師の生活指導をよく守り、リスクを減らすようにしましょう。

脳の血流量が少ない⁉︎

血圧が高いのに対し、脳を流れる血液の量が減少しやすいのも高齢者の特徴の一つです。
脳はもともと血圧の影響をあまり受けず、一定の血液量を維持する機能を持っています。
高齢になるにつれ、この機能も低下する為、脳に血液を送る圧力が必要になります。 

そこで突然薬を使い血圧を低下させてしまうと、脳の血液量も減ってしまうことがあり、その結果、めまいや立ち眩みを起こしてしまう場合があります。
高齢者の中には症状に気づかないケースもありますが、もし、めまい等の症状が出た場合は医師に相談しましょう。
また、食後30分~1時間は胃や腸などの消化器系へ血液を多く要するため、一時的に脳への血液量が減り、低血圧の症状がみられる場合も高血圧症の方に多く見られます。

血圧変動のリズムが崩れやすい⁉︎

血圧は一般的に朝から日中は高めで、夜間には低くなります。
高齢者の場合、自律神経機能が低下していたり、動脈硬化がみられると、血圧変動のリズムが乱れ、夜間や就寝中に血圧が下がらないことがあります。 

逆に早朝に血圧が一定以上に高くなる場合もあります。
こうした状態を放置していると心臓などに負担がかかり、脳卒中や心臓病などのリスクが高くなります。

温度差などの影響から、脳卒中や心筋梗塞を起こしやすい⁉︎

加齢に伴い、血管は硬くなり(動脈硬化)伸展性がなくなっていきます。
そのため急激な温度の変化や季節の変わり目では特に注意が必要です。 

脳卒中や心筋梗塞のような血管の疾患は一度発症してしまうと生活の質(QOL)を著しく低下させてしまう恐れがあります。
日々の生活の中でもできるだけ温度差を少なくするように心がけましょう。それだけでもリスクを下げる事ができます。

日常生活において気を付ける事‼︎

日常生活では以下の事に気を付けることで、高血圧による病気を予防する事ができます。

1.   冬の入浴やトイレに気を付ける。
冬の夜間や早朝などに、温かい場所から寒い場所に移動した際に、血管が収縮して血圧が上昇します。
お風呂に入ったり、いきなり熱いお湯をかけた際も血圧が上昇し、身体が温まると今度は血圧が低下します。
血圧の急激な変化は、血管や心臓に大きな負担を掛けます。
寒い場所はあらかじめ温めておくと良いでしょう。 

2.   脱水症状に気を付ける。
高齢になるにつれ喉の渇きに気づきにくくなります。
夏や冬、又喉の渇きに関係なく1~2時間程度でお茶や水などの水分補給をする癖をつけましょう。
睡眠中も汗をかくので、寝る前や起床時も水分を摂る様に心がけて下さい。 

3.   ゆっくり行動する。
急激な動きをすることで血圧が上昇し眩暈を起こす危険があります。
特に血圧が上がり始めている朝は、ゆっくり行動することがもっとも大切なことです。 
起床時に血圧を測定する場合は、食事前に安静の状態で測定します。
またストレスも血圧を上昇する要因なので、イライラしたりすると血圧が上昇し、脳卒中などの原因になります。
できるだけ平穏な気持ちで生活することを心がけ、イライラした際は読書やテレビを見て意識的に気分転換をするようにしましょう。

正しい血圧の測り方

血圧は一日の中で時々刻々と変化しています。ここでは測定する時のポイントを紹介します。

①リラックスして測りましょう
血圧は身体や精神状態の影響を受けやすいもの
です。
イライラしていたり、緊張していたりすると、正確な血圧値を知ることはできません。
血圧を測る前には、1~2分の安静時間を設け、深呼吸を5~6回ほど行いましょう。 

②排泄は済ませておきましょう
排尿や排便は済ませて、数分経ってから測定しましょう。
尿意や便意がある時は、やや緊張状態にあり、血圧にも影響があります。

③同じ時間帯に測りましょう
目安となる血圧は長期的なデータにこそ意味があります。
一日の上で最も安定した状態になる時間帯を選んで、毎日できるだけ同じ時間に測定するようにしましょう。

④室温はできるだけ整えましょう
血圧測定に最適な温度は20℃前後といわれています。
暑すぎず寒すぎない程度に気温を整えて測定するようにしましょう。 

⑤正しい姿勢で測定しましょう
血圧計には手首で測るものと上腕で測るのもがあります。
椅子に座ってテーブルに手を置き、測定部分をできるだけ心臓と同じ高さになるようにし、測定部は素肌か薄い肌着などの上から、力を抜いた状態で測定しましょう。

まとめ

血圧は健康状態のバロメーターともいわれています。

そのため毎日測定する事で安心感を得られるかもしれませんが、これが「毎日測定しなければならない」となると、ストレスがたまり、本末転倒になってしまいます。
まずは毎日測る習慣をつける事が、健康への第一歩かもしれません。
毎日でなくても週に2~3回からでもいいと思います。

2014年以降の高血圧の治療ガイドラインでは、病院の診察室で測る血圧よりも家庭で毎日測る血圧を重視すると規定され、家庭で測る血圧の重要性はいっそう高まりました

毎日測る血圧を記録しておき、正確な血圧情報によって、お医者さんもより正確な診断ができるのではないでしょうか。
健康管理のためにも、できるだけ毎日、血圧を測ってみませんか?

介護の相談窓口
  • 「今後の生活環境が変わる事への不安」や「介護を使って生活をどうデザインをしていったら良いか」など介護は協力体制で成り立っております。 ちょっとでも解決できる、ストレス軽減できる記事を目指し、一つの相談場所のメディアを目指しております。

病気高齢者

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