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  • So recently I went into my doctor's office,

    最近私は

  • and I was told that my blood pressure was 115/75.

    血圧を測ってもらいました。

  • So I thought we would talk about exactly what this means and try

    115と75でした。

  • to figure out how to think about blood pressure in general,

    これにはどういう意味があるのでしょう。

  • using these numbers and this experience

    血圧とは何なのか、

  • as kind of a launching point.

    これからこの数字と

  • So the way I think about blood pressure

    血圧の測定を例にとって説明します。

  • is I always imagine kind of a tube

    さて、

  • and I imagine blood going through that tube.

    血圧を考えるときは

  • And this tube is like a blood vessel.

    管の中を

  • So there's blood trying to get its way

    血液が流れるところを想像します。

  • from one side to the other.

    これを血管としましょう。

  • And on its way, the neat thing that it's doing

    血液はこちらから

  • is as it flows, it's pushing out.

    こちらへ流れます。

  • So it's forcing against these walls,

    そして流れるときには

  • and specifically what I mean by that is there are cells

    外の方に向かって圧力がかかります。

  • and there's plasma, and all that stuff is pushing out

    血管の壁を押すわけです。

  • against the walls of the blood vessels.

    血液は

  • So you've got a force, and that force

    赤血球と血漿からできていますが、

  • is being exerted on the surface area of the blood vessel.

    これが血管の壁を

  • So it's force over a surface area.

    押すのです。

  • And any time you see force over an area,

    血液の押す力が、

  • you know that equals a pressure.

    血管の表面に

  • And in this case, it's a blood pressure

    かかるのです。

  • because it's the blood that's doing that work.

    押す力/表面 ですね。

  • So this is how I think of blood pressure, specifically

    それが

  • as those little blue arrows.

    圧力であり、

  • And the two questions that kind of pop into my mind anytime

    つまり血圧です。

  • I'm thinking about blood pressure

    血液が圧力をかけているからです。

  • are where is the blood pressure being taken,

    血圧を想像すると

  • and when are you taking it?

    この青い矢印です。

  • So let's start with the first question, where?

    さて、血圧を考えるとき

  • And by that I mean where in the circulatory system.

    いつも問題になるのは

  • So you've got the heart-- and this is my Valentine's Day

    どこで血圧測るか、

  • heart-- and you've got the aorta coming off of the heart.

    そしていつ測るか、です。

  • And it's got lots of branches, but I'm

    まず測る場所から。

  • going to just draw one branch, which

    つまり体の循環系のどこで測るかです。

  • is the artery leading off to my arms.

    これが心臓。

  • This is called the brachial artery going off to my arm.

    バレンタインのハートです。

  • And usually, I'd say 90% of the time,

    ここから大動脈が出ていて

  • maybe even more, the blood pressure that you're

    枝分かれします。

  • getting recorded, or the number that's being told to you,

    ここでは一つだけ、

  • is being checked at this point.

    腕に伸びる動脈を描きます。

  • I marked it with a little x because that's

    上腕動脈

  • kind of the upper arm.

    腕の方に伸びています。

  • So that's usually where they're checking the blood pressure.

    さて、血圧を測るとき、

  • And again, they're checking the force

    殆どの場合

  • that the blood is putting on the vessel walls.

    この部分で測った数字が

  • So these little blue arrows.

    使われます。

  • So that answers the where question.

    Xとしましょう。

  • And certainly, you can imagine if I checked

    場所は上腕です。

  • blood pressure let's say at some other spot, let's say over here

    ここで血圧が測定されます。

  • or over here, you might get a different blood pressure

    血管にかかる

  • reading than if I checked it at the yellow x.

    血液の圧力が測定されます。

  • So really were just talking about that one spot.

    青の矢印です。

  • Now the other question is when are you checking it?

    どこで測るかの答えが、

  • So for this, let me show you a little table or a figure,

    これです。

  • rather.

    他の場所でも測れます。

  • So imagine that over time, time is this way,

    こことか、こことか。

  • you have different recordings for blood pressure.

    当然違った値が

  • So this will be blood pressure.

    得られます。

  • And blood pressure is usually measured

    普通はこの黄色いところで測ります。

  • in millimeters of mercury.

    それではいつ測るのでしょう?

  • So I'll write millimeters of mercury here.

    ここでグラフを

  • And let's go from 200 all the way down to 0.

    描いてみます。

  • And I'll use my numbers that I got from the doctor

    これが時間軸

  • the other day to illustrate what I'm trying to say.

    です。

  • So right at that yellow x, at the bottom,

    測る時間が違えば、

  • let's say of my reading I've got 75.

    血圧も違います。

  • So let's start at 75, which is about here.

    血圧は普通

  • As the heart is pumping, the pressure starts building up.

    ミリメートル水銀柱で測定します。

  • And it gets up to about 115.

    ここに書きましょう。

  • So really what is happening is blood

    200から

  • is making its way from the heart as it squeezes towards that x.

    0まで。

  • And as it gets there, the force that it's putting on the walls

    私が医者に測ってもらった

  • is going up, up, up.

    血圧を例に

  • And as it goes up, it goes from 75 all the way to 115.

    説明します。

  • So that all happens during the squeezing part

    この黄色のXで

  • of the heart cycle.

    測った血圧は75

  • We call that systole.

    このあたりです。

  • So this is all happening during systole,

    心臓が鼓動すると

  • which is when the heart is squeezing down,

    血圧は上がります。

  • and we know the heart is a pump.

    私の場合は115に

  • Now from that point forward, the heart begins to relax.

    つまり

  • So at this point, at 115, the heart is now relaxing slowly.

    血液が心臓から

  • And as it relaxes, the pressure begins to fall.

    押し出されてXのところへ行くのです。

  • And it continues to fall all the way out here.

    この段階で

  • And the pressure gets down to about 75 again.

    血液の押す力がどんどん上がります。

  • And this is diastole.

    そして75から115に上がるのです。

  • So this is when the heart is actually

    心臓が収縮するときに

  • taking a break from squeezing and is now refilling,

    こういうことが起こるのです。

  • and we call that diastole.

    これが収縮期です。

  • So I'll call that refilling.

    心臓が血液を絞り出したいる

  • And so during systole, you spend about 1/3 of the time.

    時に起こるのです。

  • And in diastole, you spend about 2/3 of the time.

    心臓はポンプのようなものです。

  • And I'm talking about one heartbeat here.

    血液を押し出した後は

  • So this would be one heartbeat.

    ゆるみます。

  • So it's not 50-50.

    115まで上昇した圧力は

  • And the easy way to remember this

    心臓が緩むに連れて下がります。

  • is in a given day, 24 hour day, I

    どんどん下がって

  • spend about 8 hours working and about 16 hours relaxing,

    また75に戻るのです。

  • or not working.

    これが拡張期です。

  • And so I think of the heart doing its squeezing,

    心臓は収縮した後

  • its work, for eight out of 24 would be about 1/3.

    拡張し、血液を再び取り込みます。

  • Kind of the same as me.

    これが拡張期です。

  • About 1/3 of the time, the heart is squeezing.

    血液が心臓に入ってくるのです。

  • So that's how the heart is spending its time,

    心臓の鼓動の1/3は収縮期、

  • in systole and diastole.

    約2/3は拡張期です。

  • And the pressure is ranging between 115 and 75.

    これが一回の鼓動です。

  • So really it's never just 115 or just 75.

    1ドキというわけです。

  • It's somewhere between the two.

    半分ずつと言うわけではありません。

  • And for example, if I checked right here in time,

    これは私たちの一日に似ています。

  • it might be let's say 85, or here it might be 102,

    8時間働いて、

  • or here it might be 87.

    16時間休む。

  • So it's somewhere between 115 and 75.

    心臓も同じです。

  • So this number I wrote up here becomes the range.

    1つのサイクルの1/3を収縮に、

  • This is the range of blood pressure.

    つまり私と同様、

  • So when I talk about when, it really

    仕事に使っているのです。

  • depends on when in the cycle you're at

    心臓の収縮期と拡張期は

  • and you're somewhere in that range.

    こんな割合です。

  • And when I talk about the where, we

    この運動の中で血圧が

  • know that we're talking about a reading that's

    115だったり、75だったりします。

  • taken in the upper arm.

    単に2つの数字というわけでなく、幅なのです。

  • So those are the two thoughts that

    今この位置で測れば

  • should cross your mind every time you hear a blood pressure

    85かもしれません、102かも、あるいは87かもしれません。

  • recording.

    つまり75から115までのどこかなのです。

  • And of course, the top number, 115 again,

    この数字[115/75] はしたがって

  • is the systolic blood pressure.

    1つの幅を表しています。

  • And 75 is the diastolic blood pressure.

    これが血圧の範囲です。

So recently I went into my doctor's office,

最近私は

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