Blood Pressure

Blood pressure is vital to life. It is the force that moves blood around the circulatory system. Without it, oxygen and nutrients won’t be delivered to our tissues and organs and toxins and carbon dioxide cannot be removed through our arteries. If your blood pressure is too high or too low, it can cause numerous health problems.

Blood pressure is measured by two numbers: systolic (the top number) and diastolic (bottom number) blood pressure.

Systolic Blood Pressure

The systolic number is the pressure in blood vessels created by the force of blood being pushed through your arteries as your heart beats. A normal reading is below 120. An elevated level is between 120-129. Stage 1 high blood pressure (hypertension) is 130-139. Stage 2 hypertension is a reading of 140 or more. Reading 180 or more is a hypertensive crisis – call 911.

Diastolic Blood Pressure

The diastolic reading is the pressure in the arteries when the heart is at rest between beats. This is the time when the heart fills with blood and gets oxygen. A normal reading is under 80. However, even if your diastolic reading is normal, if your systolic reading is 120-129, then your blood pressure is still elevated. A diastolic reading of 80-89 is stage 1 hypertension. Readings 90 or more is stage 2 hypertension. Any diastolic readings 120 or more is a hypertensive crisis – call 911.

The abbreviation mm Hg means millimeters of mercury. Mercury was used in the first accurate pressure gauges and is still used in medicine today as a standard unit of measurement for pressure.

  • Blood Pressure Stages
  • Risk Factors
  • Signs & Symptoms
  • Consequences Of High Blood Pressure
  • Prevention & Management
  • Which Number Is More Important?
The five blood pressure stages recognized by the American Heart Association are:
 

Normal

Blood pressure readings are less than 120/80 mm Hg. Sticking with heart-healthy habits like balanced diets and regular exercise will help you maintain healthy readings. 

Elevated

Elevated blood pressure is when readings consistently range from 120-129 systolic and less than 80 mm Hg diastolic. People with elevated blood pressure are likely to develop hypertension if left unmanaged.
 

Hypertension Stage 1

Hypertension stage 1 is when blood pressure readings are consistently range from 130-139 systolic and 80-89 mm Hg diastolic. Doctors will likely suggest lifestyle changes and may consider adding blood pressure medication based on your risks of atherosclerotic cardiovascular disease (ASCVD), like heart attack or stroke. 
 

Hypertension Stage 2

Hypertension stage 2 is when blood pressure is consistently 140/90 mm HG or more. At this stage, doctors will prescribe medication and lifestyle changes. 
 

Hypertensive Crisis

This level of high blood pressure needs immediate medial attention. If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and then test your blood pressure again. If your readings are still unusually high, contact your doctor immediately. 

If your blood pressure is higher than 180/120 mm HG and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision of difficulty speaking, do not wait to see if your pressure goes down on its own. Call 911. 

There are risk factors that can increase you chances of developing high blood pressure. Some factors you can control and others you can’t. 

Those that can be controlled include:

  • Smoking and exposure to secondhand smoke
  • Diabetes
  • Being obese or overweight
  • High cholesterol
  • Unhealthy diet (high in sodium, low in potassium, and drinking too much alcohol)
  • Physical inactivity

Factors that are difficult to control or cannot be modified include:

  • Family history of high blood pressure
  • Race/ethnicity
  • Increasing age
  • Gender (males)
  • Chronic kidney disease
  • Obstructive sleep apnea

Socioeconomic status and psychosocial stress are also risk factors for high blood pressure. These can affect access to basic living necessities, medication, healthcare providers, and the ability to adopt a healthy lifestyle changes.

Most the time, high blood pressure has not obvious symptoms. Because of this, many consider it a “silent killer.” The best way to protect yourself is to check you blood pressure and have heart-healthy lifestyle. If your blood pressure is extremely high, there may be some symptoms to look out for, including:

  • Severe headache
  • Fatigue or confusion
  • Vision problems
  • Chest pain
  • Difficulty breathing
  • Irregular heartbeat
  • Blood in your urine
  • Pounding in your chest, neck, or ears

If you are experiencing any of these symptoms, see a doctor immediately. You could be having a hypertensive crisis that could lead to a heart attack or stroke. 

High blood pressure is often the first sign of many health complications. If left unmanaged, high blood pressure can increase your risk of:

  • Stroke – high blood pressure can cause blood vessels in the brain to burst or clog more easily
  • Vision loss – high blood pressure can strain the vessels in the eyes
  • Heart failure – high blood pressure can cause the heart to enlarge and fail to supply blood to the body
  • Heart attack – high blood pressure damages arteries that can become blocked
  • Kidney disease/failure – high blood pressure can damage the arteries around the kidneys and interfere with their ability to effectively filter blood
  • Know your numbers. Get your blood pressure checked regularly.
  • Don’t smoke and avoid secondhand smoke.
  • Reach and maintain a healthy weight.
  • Eat a healthy diet that is low in saturated and trans fats and rich in fruits, vegetables, whole grains, and low-fat dairy products.
  • Aim to consume less than 1500 mg/day of sodium (salt). Even reducing your daily sodium intake by 1000 mg can help.
  • Eat foods rich in potassium. Aim for 3500-5000 mg of dietary potassium per day. 
  • Limit alcohol to no more than one drink per day if you’re a woman or two drinks a day if you’re a man. 
  • Be more physically active. Aim for at least 90 to 150 minutes of aerobic and/or dynamic resistance exercise per week, and/or three sessions of isometric resistance exercises per week.
  • Take medicine as prescribed by your doctor.
  • Know what your blood pressure should be and work to keep it at that level. 

Typically, more attention is given to the systolic blood pressure as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term buildup of plaque and an increased incidence of cardiac and vascular disease. 

However, either an elevated systolic or elevated diastolic blood pressure reading may be used to make a diagnosis of high blood pressure. According to recent studies, the risk of death form ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40-89.

How is blood pressure Checked?

A health professional will measure your blood pressure using a small gauge attached to an inflatable cuff. It is simple and painless. The person taking your blood pressure will wrap the cuff around your upper arm. Some cuffs may go around your wrist or forearm, but these are not as accurate. They will use a stethoscope to listen to the blood moving through your artery. 

The cuff will be inflated to a pressure higher than your systolic blood pressure, and it will tighten around your arm. When the doctor or nurse releases it, the cuff deflates. The first sound they hear will be the systolic pressure. The point where the noise goes away will mark the start of the diastolic blood pressure. Systolic and diastolic blood pressure is read as the systolic pressure over the diastolic pressure – for example: 120/80 or 120 “over” 80.

How ofter Should You go your blood pressure checked?
  • If your blood pressure is normal (less than 120/80), you typically get it checked once a year or more frequently if your doctor suggests it. 
  • If your blood pressure is elevated ( 120-129/ 80), your doctor will probably want to check your blood pressure every 3-6 months. 
  • If you are stage 1 hypertension (130-139/80-89), the doctor may suggest rechecking every 3-6 months.
  • Someone with stage 2 hypertension (140/90 or higher) will likely be prescribed medications and revisit the doctor in a month. 
Can I check my blood pressure at home?

Yes, keeping track of your blood pressure at home is important – especially if you have high blood pressure. This helps you and your doctor find out if your treatment is working. Ask your doctor to recommend an easy to use blood pressure monitor. Make sure the cuff fits properly. It is a good idea to bring the blood pressure monitor you use at home with you to the doctor’s office. You can compare readings to the numbers that doctor takes at the office visit. Avoid caffeine, cigarettes, and exercise for at least 30 minutes before the test.  

Sources: American Heart Association

Resources

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