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VITAL SIGNS. Do you know what vital signs are for?

01/06/2023 General Medicine

BMI

This vital sign helps us understand our weight status initially and whether we have any overweight or underweight issues.

To determine BMI, two data points are considered: weight and height, and the number indicates the proportion between the two. Here's an interpretation table for you:

  • BMI below 18.5: Underweight.
  • BMI between 18.5 and 24.9: Normal weight.
  • BMI between 25-30: Overweight.
  • BMI between 30.1-35: Mild obesity.
  • BMI between 35.1-40: Moderate obesity.
  • BMI over 40.1: Severe obesity.

As mentioned earlier, this is just an initial indicator, as we are unaware of other factors that may better explain our weight situation. For example, even with similar BMIs:

  • Women tend to have more body fat.
  • A larger person may have a higher fat accumulation.
  • Athletes often have more muscle (which weighs more than fat) and therefore may have a higher BMI.

 

BLOOD PRESSURE

Blood pressure indicates the force of blood against the walls of the arteries, similar to water coming out of a hose. It needs to be at an optimal level to be strong enough to properly irrigate the body, but not too high to damage the blood vessels in the long term.

Blood pressure is measured using two numbers: the first one is the "systolic pressure," which is usually the higher number and reflects the moment when the heart contracts; the second one is the "diastolic pressure," which is typically the lower number and reflects the moment when the heart relaxes. Both pressures are measured in millimeters of mercury (mmHg).

Here's an interpretation table for you:

  • Low pressure: below 100/70 mmHg.
  • Normal pressure: up to 120/80 mmHg.
  • Elevated pressure: 10-129 / less than 80 mmHg.
  • High blood pressure (Hypertension stage 1): 130-139 / 80-89 mmHg.
  • High blood pressure (Hypertension stage 2): 140-180 / 90-120 mmHg.
  • Hypertensive crisis (severe condition): higher than 180/120 mmHg.

There are many factors that can elevate blood pressure, such as:

  • Inadequate water intake.
  • Overall condition of the kidneys, nervous system (stress or anxiety), and blood vessels.
  • Hormonal levels.
  • Age (blood pressure tends to increase with age due to the stiffness of blood vessels).
  • Obesity.
  • Excessive consumption of salt or cigarettes.
  • Diseases like diabetes or a family history of hypertension.
  • Pregnancy (preeclampsia).
  • Consumption of medications such as birth control pills, weight loss pills, corticosteroids, etc.
  • Obstructive sleep apnea.

It's highly likely to have no symptoms of high blood pressure, but there's a risk of experiencing cerebrocardiovascular events, heart attacks, heart failure, kidney disease, or premature death. Therefore, it's extremely important to regularly measure blood pressure.

Regarding sudden attacks, there are moments when the following symptoms may occur. If that's the case for you, we encourage you to see a doctor as soon as possible:

  • Severe headache.
  • Seeing flashing lights.
  • Nausea or vomiting.
  • Confusion.
  • Nosebleeds.

 

HEART RATE

As the name suggests, this vital sign measures the number of heartbeats per minute, which reflects the pumping effort of the heart.

A normal resting heart rate for adults ranges between 60 and 100 beats per minute.

Contrary to popular belief, a low heart rate doesn't necessarily indicate decompensation; it can indicate efficient cardiac function and better cardiovascular fitness. This situation is seen in athletes with a certain level of training, whose heart rate can range around 40 beats per minute.

To better understand heart rate management, it's necessary to monitor it for at least 5 consecutive days and consider other factors that may influence a low or high heart rate, such as:

  • Time of day when measured (preferably at rest, without prior activity).
  • Body position (sitting is recommended).
  • Age.
  • Physical condition.
  • Smoking status.
  • Cardiovascular diseases, high cholesterol, or diabetes.
  • Strong emotions (measure it in the calmest/relaxed state possible).
  • Medication use.

Only by considering these key factors can we determine if a high/low heart rate is relatively "normal" or at least consistent with the overall picture. Remember that an unusually high or low heart rate, consistently measured for 5 days, may indicate an underlying health issue.

 

OXYGEN SATURATION

After the COVID-19 pandemic, it's easier for all of us to understand the concept of oxygen saturation in our bodies and the devastating effects of having a saturation below 95%, which could indicate lung diseases such as COPD or pneumonia.

We refer to hypoxia, which means lack of oxygen, when saturation is below 90%, and severe hypoxia when it's below 80%.

In addition to lung problems, low oxygen saturation can also indicate an issue with the blood flow to transport the necessary amount of oxygen to the body.

The most frequent causes of hypoxia include:

  • Anemia.
  • Respiratory insufficiency like asthma and COPD (chronic obstructive pulmonary disease).
  • Pneumonia.
  • Pulmonary emphysema.
  • Acute respiratory distress syndrome.
  • Lung diseases.
  • Congenital heart diseases.
  • Pneumothorax (collapsed lung).
  • Pulmonary edema (fluid in the lungs).
  • Pulmonary embolism (blood clot in a lung artery).
  • Cystic fibrosis (lung scarring or injury).
  • Sleep apnea.

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