How Blood Pressure Is Measured
It is best to measure blood pressure when you are relaxed and sitting. Blood pressure is usually measured by wrapping an inflatable pressure cuff around your upper arm.
Blood pressure is recorded as two numbers, such as 120/80. The larger number indicates the pressure in the arteries as the heart pumps out blood during each beat. This is called the systolic blood pressure.
The lower number indicates the pressure as the heart relaxes before the next beat. This is called the diastolic blood pressure. Both are measured in units called millimetres of mercury .
Facts About High Blood Pressure
There’s a good reason why every doctor’s appointment starts with a blood pressure check. While one in three American adults has high blood pressure, about 20% of people are unaware that they have it because it is largely symptomless.
In fact, most people find out they have high blood pressure during a routine office visit.
Blood pressure is the force of blood pushing against the walls of arteries as the heart pumps blood. High blood pressure, also referred to as hypertension, is when that force is too high and begins harming the body. If left untreated, it willl eventually cause damage to the heart and blood vessels.
Your blood pressure is measured in two numbers: The top systolic blood pressure measures the force pushing against artery walls when the heart is contracting. The bottom diastolic blood pressure measures pressure in the arteries when the heart is resting between beats.
Normal blood pressure levels are 120 mmHg/80 mmHg or lower. At risk levels are 120-139 mmHg/80-89 mmHg. Readings of 140 mmHg/90 mmHg or higher are defined as high blood pressure.
Here are six other things you should know about high blood pressure.
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- Acupressure is a well known ancient healing practice that has its roots in Traditional Chinese Medicine . This practice promotes relaxation of muscle tension, improved blood circulation, and resolution of symptoms such as pain and discomfort.
- In acupressure, skilled therapists use their thumbs, fingers, elbows, feet, or special devices to apply pressure on specific body points known as acupressure points. By stimulating these points that lie along channels of energy flowing through your body, it is possible to improve the symptoms of various health conditions.
- To manage high blood pressure, the acupressure points focus on stimulating the function of your heart and kidneys, as they play a major role in blood circulation.
- Acupressure may help in enhancing the functioning of your blood vessels, improving circulation, and regulating your heart rate. It thus may help bring down your blood pressure and lower the risk of any related complications such as heart diseases.
- The acupressure points that are used to manage hypertension include Liver 3 , Large Intestine 4 , Gall Bladder 20 , Pericardium 6 , and Governing Vessel 20 .
- Avoid heavy meals an hour before or after performing acupressure, take adequate rest after each session, avoid smoking and alcohol consumption on the days of therapy, and do not discontinue any medications prescribed by your doctor while undergoing acupressure sessions.
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Is White Coat Hypertension A Concern
You might be thinking, So what if my blood pressure is a little high for a few minutes while Im at the doctors office? Its fine the rest of the time so it cant be that big of a deal
While White Coat Hypertension is largely nothing to worry about, it can be an early-indicator of potential future problems. In other words, if a doctors office visit can stress you out to the point of physical symptoms, its not a far leap to assume that you experience those same symptoms with other day-to-day stressors like work or family .
How To Use A Blood Pressure Monitor At Home
There are a variety of home blood pressure monitors available, including wrist and upper arm devices. Some blood pressure monitors let you share your results with a doctor from any location. When to take your blood pressure:
- Measure your blood pressure at least twice a day
- Take the first measurement in the morning
- Dont take it right after you wake up
- Measure your blood pressure before eating or taking medication
- Take the second reading in the evening
- Take two or three readings each time you measure to make sure the results are accurate
- Remember, your blood pressure can fluctuate during the day for a number of reasons.
Did you know you can with your physician easily through OMRONs VitalSight?
How to get the best reading when using a blood pressure monitor:
- Avoid food and caffeine for 30 minutes before measuring
- A full bladder can affect your numbers
- Sit quietly for a few minutes before your reading
- Keep your legs and ankles uncrossed
- Keep your back supported
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Causes And Risk Factors
You may be at an increased risk for high blood pressure if you smoke, areoverweight, eat a diet thats low on produce and fiber and/or high in fatand salt, drink alcohol to excess, live with chronic stress or dont getmuch physical activity. Some causes of hypertension cannot becontrolledincluding your genes and your race . Aging also plays a role. Even if you do not have hypertensionby age 55 to 65, your lifetime risk for developing it is a whopping 90percent.
But doctors no longer consider hypertension inevitable or untreatable withage, saysSamuel Durso, M.D., director of the Division of Geriatric Medicine and Gerontology at JohnsHopkins.
In one Johns Hopkins study of 975 older women and men with hypertension,healthy lifestyle steps helped 40 percent stop taking blood pressuremedications. Other research has shown that lifestyle changes can lower therisk for hypertension in African-Americans and others at an increasedgenetic risk.
Blood Pressure Is Linked To Other Medical Issues
High blood pressure can be the first indication of a serious underlying condition. When a patient comes in with high blood pressure, doctors will check their urine and kidney function do an electrocardiogram to check the size of the heart and look for lung changes.
Stress on the blood vessels makes people with hypertension more prone to heart disease, peripheral vascular disease, heart attack, stroke, kidney disease and aneurysms. Correspondingly, chronic conditions such as diabetes, kidney disease, sleep apnea and high cholesterol increase the risk for developing high blood pressure.
In some women, pregnancy can contribute to high blood pressure, leading to preeclampsia. Postpartum blood pressure typically goes back to normal levels within six weeks. However, some women who have high blood pressure during more than one pregnancy may be more likely to develop high blood pressure and other cardiovascular diseases as they age.
Some of these medical issues can also cause spikes in high blood pressure .
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If Your Blood Pressure Is Normal At Home
For many years, doctors shrugged off the in-office spike in blood pressure to nerves. But, recent research suggests that white coat hypertension may be a sign that youre at a higher risk for developing sustained high blood pressureand may be at increased risk for cardiovascular events like heart attack and stroke. Those with white coat hypertension have a three-to-fourfold increased risk of developing hypertension within 10 years compared to normotensive patients.
In fact,a 2019 meta-analysis of 27 studies in the Annals of Internal Medicine found that people who had untreated white coat hypertension were at increased risk for developing heart disease. People with untreated white coat hypertension were also twice as likely to die from heart disease when compared to normotensive peoplethat is, people who have normal blood pressure.
In other words, white coat hypertension is not innocent. It can predict long-term health, according to a 2017 study in the Journal of Hypertension. Maintaining close follow-up with a physician can help you stay in optimal health.
Your healthcare provider may not recommend treatment with medication yet,
but still want to monitor you, though, because of the increased risk of developing sustained hypertension in the future.
Study Limitations And Continued Research
The authors noted several limitations in their study. Firstly, the research only included white participants, so it is unclear how much of the data applies to other groups. Additionally, more men participated in the study than women, so results may not be equally applicable for other genders.
Prof. Cheung also offered the following words of caution:
There were findings that were difficult to explain. For example, the pulse rate increased by an average of only one beat per minute on standing in the hyperreactive group. One would expect a higher pulse rate if there is increased epinephrine output.
Also, he continued, people with an exaggerated blood pressure response to standing were surprisingly less likely to be treated with antihypertensive drugs. It seems that further study is required before incorporating the lyingstanding systolic blood pressure as a cardiovascular risk factor.
Dr. Palatini explained to MNT:
Measuring on standing after the patient has been lying on the bed is a very simple and costless maneuver that every doctor should do in office. If the patient has a systolic increase greater than 67 mm Hg, this patient is at high risk of cardiovascular events.
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Measuring Ambulatory Blood Pressure
High blood pressure can also be diagnosed through a special device called an ambulatory blood pressure monitor. A doctor, nurse or pharmacist will get you to wear the device for a full day. The device measures blood pressure every 20 to 30 minutes and gives the doctor an average of your blood pressures during the day and while you are sleeping. These devices are not available everywhere and can be uncomfortable to wear.
Variations In Blood Pressure
Your blood pressure changes to meet your bodys needs. If a reading is high, your doctor may measure your blood pressure again on several separate occasions to confirm the level.
Your doctor may also recommend that you measure your blood pressure at home or have a 24-hour recording with a monitoring device.
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Good Sleep Can Prevent And Manage High Blood Pressure
Most people experience a dip in blood pressure during the deepest stage of sleep , which is the body’s normal and healthy reaction to sleep. Not having that nighttime dip is a risk factor for heart disease and may increase daytime blood pressure.
Typically people spend 90 minutes to two hours in slow wave sleep per night. A recent study published in Hypertension found that men who got less slow wave sleep each night were a higher risk for hypertension than men who got more deep sleep.
While sleep disorders, like sleep apnea, and age can both affect the amount of deep sleep you get, there are steps you can take to ensure a good night’s sleep. Getting seven to eight hours of sleep a night, maintaining a consistent sleep schedule and being more active during the day can help improve the quality of your sleep.
Excessive Salt Raises Blood Pressure
Too much sodium can cause water retention that puts increased pressure on your heart and blood vessels. People with high blood pressure and those at a high risk for developing hypertension, including adults over 50 and black men and women, should have no more than 1,500 milligrams of sodium daily of salt.
Even people with normal levels should eat salt in moderation. Stick to no more than 2,300 mg of sodium , per day.
Most dietary sodium comes from processed foods. Rules of thumb are to choose foods with 5% or less of the daily value of sodium per serving and opt for fresh poultry, fish and lean meats, rather than canned, smoked or processed. Similarly, fresh or frozen vegetables are better than canned.
A study published in the New England Journal of Medicine found that if people cut just 1/2 teaspoon of salt per day, it could help lower the number of new cases of heart disease per year by up to 120,000.
Further, potassium found in foods like sweet potatoes, spinach, bananas, oranges, low-fat milk and halibut can counterbalance the pressure-increasing effects of sodium by helping to rid the body of excess sodium.
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Medications Used To Treat High Blood Pressure
These high blood pressure medications flush extra water and sodium from your body. Diuretics may cause these side effects:
- Extra urination. Extra water out means more time in the bathroom. Take these medications earlier in the day and when you’re not far away from a bathroom.
- Erection problems in some men
- Weakness, leg cramps, or fatigue. Diuretics may decrease the body’s levels of the mineral potassium, which can lead to these side effects. Certain potassium-sparing diuretics do not have this effect, however.
- Intense and sudden foot pain, which is a symptom of gout this is rare.
Beta-blockers make your heart beat less forcefully and more slowly. These medications may cause side effects such as:
- Insomnia and sleep problems
Angiotensin Converting Enzyme Inhibitors
These high blood pressure medications block formation of a hormone that causes blood vessels to narrow, so vessels relax. ACE inhibitors may cause these side effects:
- A dry, hacking cough that doesn’t go away. If you have this side effect, the doctor may prescribe another type of medication.
- Skin rash and a loss of taste are two other possible side effects of ACE inhibitors.
Angiotensin II Receptor Blockers
These high blood pressure medications shield blood vessels from a hormone that causes blood vessels to narrow. This allows blood vessels to stay open. One of the more common side effects of ARBs is dizziness.
Calcium Channel Blockers
Alpha-2 Receptor Agonist
Measuring Your Blood Pressure
Your GP, nurse, or other professional measuring your blood pressure, will ask you to sit comfortably and rest one arm on the table. They will then place a fabric cuff around your upper arm wear a T-shirt or loose clothes so that you can roll up your sleeves easily.
The inflatable cuff is attached to a small machine via a plastic tube. Your GP will inflate the cuff using a small hand-held pump, and as the cuff deflates the machine will read your blood pressure and display the numbers on a screen. This only takes a minute or two.
Sometimes your doctor might use a hand-held gauge, which looks a lot like a clock face, and a stethoscope to measure your blood pressure, rather than a machine. This is called an aneroid sphygmomanometer a sphygmomanometer is a device used to measure your blood pressure. Your GP might check your pulse before measuring your blood pressure, because an irregular pulse can mean the automatic monitors dont give an accurate reading. In which case, they will use a stethoscope instead.
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What Is White Coat Syndrome
White coat syndrome is when your blood pressure is raised due to the stress of being in clinic, so your reading is higher than it would be if you measured it at home. Its also known as the white coat effect and is fairly common. The term white coat refers to the white coats traditionally worn by doctors.
Most people are more tense than usual in medical settings and might not even realise it. So your blood pressure can be raised even if you dont feel stressed.
On average, the top number tends to be about 10mmHg higher in a clinic than at home. The bottom numbers tends to be about 5mmHg. Some peoples blood pressure will be affected more than others, and if you feel very worried or stressed it could be raised by as much as 30mmHg.
Getting an accurate reading
When you have your blood pressure checked in clinic, arrive a few minutes early if you can and take a few minutes to sit quietly and relax first.
Health professionals are aware of white coat syndrome, so if you have a high reading in clinic, they might want you to measure your blood pressure yourself away from the clinic. You can do this using a , or with , where you wear a small monitor attached to a belt for a day as you go about your usual routine. These can give a better idea of what your blood pressure is really like as youll be in familiar surroundings, away from the stress of the clinic.
If High Blood Pressure Drug Side Effects Bother You
Partner with your doctor. Ask if there are any steps you can take to lessen medication side effects. For example, to lessen the effects of low blood pressure, it may help to avoid standing for a long time in the sun. In some cases, side effects such as fatigue or diarrhea may subside with time. In other cases, your doctor may change the dosage or prescribe another high blood pressure medication. A combination of medications sometimes works better than one medication alone by not only improving high blood pressure control but also by reducing side effects.
Also, when you first start a new high blood pressure medicine, be aware of rare allergic reactions. Call 911 right away if you develop hives, wheezing, vomiting, light-headedness, or swelling in your throat or face.
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What Does High Blood Pressure Feel Like
High blood pressure often doesn’t have any symptoms, so you usually don’t feel it. Thats why its important to stay up to date on your preventive care screenings can help identify potential problems like elevated blood pressure when its easiest to treat.
If your blood pressure reaches extremely high levels, you may get a headache, shortness of breath or a nosebleed. However, these symptoms may not be specific to your blood pressure. Critically high blood pressure can be caused by conditions that can have similar symptoms, like strokes, heart attacks, heart failure, kidney failure or certain drug interactions.