Centre of Global Professional and

Social Development

Foundation in Science
( Cohort 20 )

Biology Practical 2
FIS 2102

Case Study 2

Name: Riyashini Ram Mahendran

Matric Number: 6031213013
Date of Submission: 27th March 2022
Lecturer’s Name: Mr. Mohd Shamen Mohd Yazam
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TABLE OF CONTENT

Title 3
Objective 4
Introduction 5-6
Materials 7
Method 8-10
Results 11
Discussion 12-14
Conclusion 15
Question 16-18
References 19-20

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TITLE

An Unusual Case of Hypertension

A case study by

Riyashini Ram Mahendran

March 2022
Foundation in Science ( Cohort 20 )
KPJUC Healthcare College

This case study discusses on the normal and abnormalities on blood pressures,
along with the factors which plays a major role in regulating the blood pressure.

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OBJECTIVES

1. To determine the pulse rate of male patients and family members per
minute.

2. To determine the blood pressure of the male patients and family

members.

3. To determine the factors which cause different blood pressure readings.

4
INTRODUCTION

The pressure or the force exerted by the blood when it is pushing against the
walls of arteries is known as the blood pressure. Blood pressure is measured by
using a common medical instrument known as the sphygmomanometer.
Alternatively, blood pressure can also be measured by using the fingers. Placing
both the middle and index fingers on the brachial nerve in the inner arm and
count the number of taps in ten seconds to obtain the blood pressure. (Warren,
2018) Blood pressure consists of its own importance. For instance, blood
pressure is vital as it ensures that the blood flows to each part of the body. Apart
from that, blood pressure also plays a dominant role in exchange of nutrients
and respiratory gases between capillaries. Moreover, blood pressure is required
in the formation of both urine and lymph. (MacGregor, 2016)

The reading of the blood pressure consists of two numbers. The first number
shows the systolic pressure, while the second number shows the diastolic
pressure. The systolic pressure occurs when the ventricles in the heart is
contracted, while the diastolic pressure occurs when the ventricles of the heart is
relaxed. The value of systolic pressure is always higher than the value of
diastolic pressure because the value of systolic pressure is taken when it is in the
highest and the diastolic pressure is taken when it is in the lowest. The blood
pressure normal range varies with the age. Normal adults should have a blood
pressure below 120/80 mmHg in order to be classified as a normal and healthy
person. (Charles, 2020)

While some experience having a normal blood pressure range, others might
have an elevated blood pressure reading or a low blood pressure reading.
Hypotension means low blood pressure. A reading of blood pressure below
90/60 mmHg is considered as hypotension. On the other hand, hypertension
means that the blood pressure is high and usually provides a reading above
140/90 mmHg. (John, 2014) The common signs of hypotension include feeling
sick, light-headedness, and having blurred vision. The typical signs that one
may experience when they have hypertension is nosebleed, severe headaches,
and chest pain. (Jenkin, 2018) The most general factors which causes the
abnormalities in blood pressure is the increased amount of salt intake in diets,

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lack of exercising, being obese, pregnancy, blood loss, endocrine problems, and
so on. (Hazelwood, 2019)

There are several ways in order to overcome or avoid getting a blood pressure
reading which is not normal. For instance, exercising at least an hour a day will
help to reduce weight. In addition to that, limiting or reducing the intake of
sodium in the diet will also bring a huge difference in the readings of blood
pressure. Furthermore, staying hydrated will also lift up the blood pressure
reading into a normal range. Most importantly, monitoring and regularly
checking on the readings of blood pressure will also help to detect any
abnormalities in the early stages so that hypotension and hypertension can be
overcome in the early stage. (Stephen, 2020)

Thus, there are various of ways on how one can maintain their blood pressure
readings. However, the true cure lays in our own hands and we must take great
care of our bodies.

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MATERIALS AND APPARATUS

1. A piece of paper
2. Stopwatch
3. Sphygmomanometer
4. Stethoscope

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METHODOLOGY

A. Blood Pressure Measurement using a Mercurial Sphygmomanometer

1. A sphygmomanometer and a stethoscope were prepared.

2. The earpieces and the diaphragm of the stethoscope were cleaned by
using alcohol wipes.
3. The subject was ensured to be sitting quietly with a bare arm resting on a
table at heart level. The person was made sure to remain as calm and
relaxed as possible.
4. The brachial artery was located at the above of the elbow. The cuff of the
sphygmomanometer was wrapped around the arm so that its lower border
is about 2.5 cm above the end of the elbow. The tube of the cuff was
centred in line with the brachial pulse.
5. The radial pulse was palpated. The valve on the neck of the rubber bulb
connected to the cuff was closed. The air was pumped from the bulb into
the cuff.
6. The cuff was inflated while observing the sphygmomanometer. The
pressure when the pulse disappeared was noted, as the rough estimation
of systolic pressure. The cuff was then deflated immediately.
7. The stethoscope was positioned over the brachial artery. The cuff was
reinflated to a level of 30 mmHg, higher than the point where the pulse
disappeared during palpation.
8. The valve of the bulb was slowly opened until the pressure in the cuff
dropped at a rate of about two to three mmHg per second.
9. The Korotkoff sounds from the brachial artery were listened to. The
reading was recorded as the systolic pressure when the first loud ‘ lub ‘
sound was heard. The ‘ lub ‘ sound indicated the pressure exerted against
the arterial wall during systole.
10. The sound was listened to continuously as the pressure dropped until the
sound ‘ dub ‘ was heard. The reading was observed and jotted down on a
piece of paper, indicating that the reading was diastolic pressure.
Diastolic pressure means the constant arterial resistance.
11. All the pressure from the cuff were released.
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 12. The procedure was repeated on other patients and family members by
measuring two additional times when the subjects’ pressures were
elevated, by waiting a few minutes between measurements. The readings
were observed and recorded in a table.

Figure 1: An image of mercurial sphygmomanometer

Source: www.linkedin.com/pulse/sphygmomanometer-
%E1%97%B4%E1%96%87-%E2%84%AD-

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Figure 2: An image of stethoscope
Source: https://www.medilogbiohealth.com/2021/03/parts-of-stethoscope.html
B. Measurement of Pulse Rate

1. The subject was ensured to be remain calmly seated.

2. The pulse was located by placing the index and middle finger over the
radial artery on the anterior surface of the wrist. The thumb was not used
in sending the pulse as the pulse coming from the artery in the thumb
itself may be sensed.
3. The characteristics, regular, irregular, hard, soft or strong and weak, were
noted.
4. The number of pulses in one minute was counted and recorded in order to
obtain the pulse rate. This was accomplished by counting pulses in 15
seconds and multiplying the number of pulses obtained by four.
5. The procedure was repeated on the other patients and family members.
6. The pulse rate, which is the beats per minute, was counted and recorded
in a table.

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 RESULTS

Name Age, Year Systolic, mmHg Diastolic, mmHg Pulse, beats/min

Mr. Jamal 50 190 110 90
Patient A 52 110 79 60
Patient B 60 140 99 88
Patient C 29 160 109 88
Mahendran 46 110 70 89
Vinoshan 16 108 67 80
Riyashini 19 109 68 72

Table 1: Blood pressure and pulse results of male patients and family members

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DISCUSSION

The main objectives of this experiment were to determine the pulse rate, blood
pressure of the male patients and family members, and also to determine the
factors that causes the abnormalities in blood pressure readings.

The reading of blood pressure obtained consisted of two numbers. The first
value represents systolic pressure, while the second value represents diastolic
pressure. The systolic pressure indicates the contractions of ventricles in the
heart, while the diastolic pressure occurs when the ventricles of the heart is
relaxed. (Noah, 2018) Furthermore, pulse rate can be defined as the total beats
produced by the heart in one minute. Pulse rate can be determined by simply
placing both the index and middle finger on the radial artery and count the beats
produced in ten seconds. (Weasley, 2019)

According to Table 1, Mr. Jamal has the highest systolic and diastolic pressure,
that is 190/110 mmHg, with a pulse rate of 90 beats per minute. The lowest
systolic and diastolic pressure holder is Vinoshan, with the reading of 108/67
mmHg ad a pulse rate of 80 beats per minute. Mr. Jamal’s blood pressure
reading is not normal for a man of his age. A blood pressure reading of 190/110
mmHg is considered to be extremely high and he might be facing hypertensive
crisis. Hypertensive crisis occurs when the blood pressure reading is above
180/110 mmHg. (James, 2020) Mr. Jamal should seek medical care
immediately before health problems such as stroke and heart attack strikes him.
Next, Patient A’s blood pressure reading is 110/79 mmHg, which is considered
normal for a man at his age. Although Patient A is 52 years old, his blood
pressure reading is far more normal. This might be because Patient A exercises
regularly, constantly monitoring any changes in his blood pressure reading, or
even consume a balanced diet. Then, Patient B is a male of 60 years old with a
blood pressure reading of 140/99 mmHg. Patient B is not in a good health
condition. This is said so because Patient B’s blood pressure reading is 140/99
mmHg. The normal blood pressure for someone who is 60 years should be
below 150/90 mmHg. Although the systolic blood pressure is below 150
mmHg, the diastolic blood pressure is above 90 mmHg, which is considered

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high. Thus, Patient B is diagnosed with isolated diastolic hypertension ( IDH ).
Isolated diastolic hypertension ( IDH ) occurs when the diastolic pressure is
high, while the systolic pressure is normal. (Beatty, 2015) Furthermore, Patient
C has a blood pressure of 160/109 mmHg. It is considered very high for a man
of 29 years old. Patient A is still considered as an adult and his blood pressure
should be below 120/80 mmHg, however, his blood pressure is extremely high
and he should be in Stage I hypertension. It can be cured if he seeks
professional’s help in the early stage to keep his blood pressure readings on
track. Other than that, my family members and I are having a normal blood
pressure reading. Mahendran, my dad, has a blood pressure reading of 110/70
mmHg. My brother, Vinoshan, has a blood pressure reading of 108/67 mmHg,
while myself has a blood pressure reading of 109/68 mmHg. Three of us are
considered as having a normal blood pressure as we all have blood pressure
reading below 120/80 mmHg.

Abnormalities of blood pressure can be seen from Table 1 above. There are two
main types of abnormalities present for blood pressure. The first one is
hypotension, while the other one is hypertension. Hypotension occurs when the
blood pressure reading is below the normal range, while hypertension occurs
when the reading of blood pressure is higher than then normal range. The blood
pressure reading for hypotension is usually lower than 90/60 mmHg. The
reading for hypertension is usually above 140/90 mmHg. Hypotension is
usually caused by emotional stress, pressure, fear, dehydration, which will
reduce the blood’s volume, internal bleeding or even blood donations. (Jr.,
2018) On the other hand, hypertension is commonly caused by being
overweight ( obese ), inactive in physical activities, excessive consumption of
sodium in diets, and also stress. (Yanet, 2012)

Some suggested ways to overcome hypotension is to increase the intake of

sodium in diets. This is said so because sodium can increase the blood pressure,
which might help to bring the blood pressure within a normal range. Next,
drinking more water can also help body to increase its blood volume and stay
hydrated. Lastly, wearing compression stockings can help to relieve pain and
swelling of varicose veins so that the blood will not be poling in the leg area
only. (Rivera, 2021) In addition to that, hypertension can also be treated by
losing some weight. It is because the breathing might be disrupted during sleep,
which can increase the blood pressure. Next, exercising for at least an hour a
day will keep hypertension at bay. Next, consuming a healthy diet is very vital

13
to keep blood pressure within a normal range. The Dietary Approaches to Stop
Hypertension (DASH) diet is a diet which consists of grains, fruits, vegetables,
and low-fat dairy products that does not contain much sodium. (Rivera, 2021)
Thus, these are some ways to prevent the risk of getting hypotension and
hypertension.
Some precautionary steps in this experiment are to avoid drinking and eating 30
minutes before taking the blood pressure measurement. This is said so because
the digestion process might lower the actual blood pressure. In addition to that,
the subject must be sitting with the feet on the ground and with a good back
support to avoid increasing the blood pressure reading by six to ten points. (DR.
Janet and DR. Richard, 2019)

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CONCLUSION

The main objectives of this experiment were to determine the pulse rate of male
patients and family members per minute, the blood pressure of the male patients
and family members, and also the factors which cause different blood pressure
readings.

Blood pressure measurement is a common process done in clinics and hospitals

to determine the pressure exerted in the arteries as the heart pumps blood
throughout the body. The blood pressure is taken seriously as it shows whether
a person is diagnosed with hypotension or hypertension or having a normal
blood pressure. The blood pressure usually comes with two numbers. The first
number represents the systolic pressure which occurs when the ventricles of
heart is contracted. The second number represents the diastolic pressure, that
will occur when the ventricles of the heart is relaxed.

It can be concluded from the Table 1 above that the normal range of blood
pressure varies with one’s age. For instance, adults are classified into the
healthy category if they have a blood pressure range between 120/80 mmHg,
while older people should have a blood pressure ranging from 150/90 mmHg to
be considered as normal, and infants must have a blood pressure range of 80/45
mmHg to be classified as having a normal blood pressure.

Apart from having a normal blood pressure reading, there are also some special
cases at where the blood pressure might seem too low or too high. Hypertension
is having a high blood pressure, while hypotension means having low blood
pressure reading. Typically, the blood pressure range for both hypotension and
hypertension are more than 140/90 mmHg and less than 120/70 mmHg
respectively.

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Various of treatments are out there to treat both hypotension and hypertension
cases. However, we should be obligated to take an enormous amount of effort to
always monitor the blood pressure readings and immediately seek
professional’s help if there were any abnormalities spotted.

QUESTIONS
1. What is the normal blood pressure value range and what do the
numbers mean?
The blood pressure range varies as one is getting older. For a young adult, the
normal blood range is 120/80 mmHg, where the systolic pressure is 120 mmHg,
while diastolic pressure is 80 mmHg. Next, the blood pressure range for older
pressure is usually 140/95 mmHg. Furthermore, the blood pressure range for
infants are systolic pressure of 80 and diastolic pressure of 45 mmHg, which
makes 80/45 mmHg. There are two numbers that will appear in a blood pressure
measurement. The first number is the systolic pressure, which occurs during
contractions of ventricles in the heart. The second number is diastolic, which
occurs due to the relaxation of ventricles in the heart.

2. List some risk factors of hypertension.

Some risk factors of hypertension include age, family history, being an obese or
overweight, inactive physically, and also too many sodium intakes in the diet.

3. What are some lifestyles change recommendations for a person with

hypertension?
Some lifestyle changes recommendations for a person with hypertension
include losing down some weight as being overweight might cause disrupted
breathing. Next, reducing the intakes of sodium in the foods consumed will also
help to reduce the blood pressure. Besides that, person with hypertension should
also be persistent in exercising for at least an hour each day to keep the blood
pressure within a normal range.

4. Name two different target organs which may be used to treat

hypertension.

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Two different target organs which may be used to treat hypertension include
heart and brain.

5. What would you classify the health condition for Mr Jamal?

The health condition of Mr. Jamal can be considered as hypertension. It is said
so because Mr. Jamal’s blood pressure reading is 190/110 mmHg, which is
considered as very high for a man in his age.

6. What would you classify the health condition for Patient B?

The health condition of Patient B is not healthy. This is said so because Patient
B’s blood pressure reading is 140/99 mmHg. The normal blood pressure for
someone who is 60 years should be below 150/90 mmHg. Although the systolic
blood pressure is below 150 mmHg, the diastolic blood pressure is 90 mmHg,
which is considered high. Thus, Patient B is diagnosed with isolated diastolic
hypertension ( IDH ).

7. What would you classify the health condition for Patient C?

The health condition of Patient C is bad as the blood pressure reading is
160/109 mmHg for someone at the age of 29. Patient C is experiencing Stage 1
Hypertension as his blood pressure reading is far more than normal.

8. From Table 1, which patient is showing the most critical state of

health condition? Explain.
From Table 1, the patient that shows the most critical state of health condition is
Patient C. This is said so because the patient is experiencing a stage 1
hypertension even though he is only 29 years old. This might lead to death in a
young age if it is left untreated.

9. From Table 1, which patient is showing a healthy blood pressure?

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From Table 1, the patient that shows a healthy blood pressure is Patient A, with
a blood pressure reading of 110/79 mmHg.

10.Complete the data in Table 1. Explain your observations on the blood

pressure and pulse readings of your family members (you can use
smartphone applications to determine the readings required to
substitute the standard method).

First of all, my dad, brother and my blood pressure reading obtained were in a
normal range of blood pressure. For my dad, Mahendran, his blood pressure
reading was 110/70 mmHg and his heart beats 89 times per minute, which is
considered healthy and normal. Next, my brother, Vinoshan’s blood pressure
reading and pulse rate were 108/69 mmHg and 70 respectively. He is also
considered to have a normal blood pressure reading. Lastly, my own blood
pressure reading obtained was 109/68 mmHg and my pulse rate is 72. I am also
considered to be healthy and having a normal blood pressure reading. Three of
us have a normal blood pressure reading as a normal blood pressure reading
should be lower than 120/80 mmHg to be classified as healthy.

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