How To Read Blood Pressure Numbers
Now lets explore the measurement. Blood pressure is always shown as two numbers. Use 120 over 80, which is written as 120/80 mm Hg , as an example. The 120 is the top number and is known as systolic blood pressure. It represents the pressure in your arteries when your heart beats. The 80 is the bottom number and is known as diastolic blood pressure. This is the pressure measured between your heartbeats when your heart is relaxing.
While both numbers are important, the American Heart Association notes the top number usually gets more attention. Thats because it helps show your risk of having a stroke or heart attack, along with kidney disease, congestive heart failure, vision loss and memory loss.
A high systolic reading is considered a major heart disease risk factor for people older than 50. As we age, arteries can become stiff and develop plaque buildup. In other words, if your blood is essentially punching the walls inside your heart, over and over again, damage will eventually occur.
Heres how the American Heart Association categorizes blood pressure levels.
- Normal: systolic less than 120 and diastolic less than 80
- Prehypertension: systolic 120-139 or diastolic 80-89
- Stage 1 high blood pressure: systolic 140-159 or diastolic 90-99
- Stage 2 high blood pressure: systolic 160 or higher or diastolic 100 or higher
- Hypertensive crisis : systolic higher than 180 or diastolic higher than 110
Low blood pressure is typically not a problem unless you notice symptoms like:
How Can I Control My Blood Pressure
You can often lower your blood pressure by changing your day-to-day habits and by taking medication if needed. Treatment, especially if you have other medical conditions such as diabetes, requires ongoing evaluation and discussions with your doctor.
Lifestyle changes you can make to help prevent and lower high blood pressure:
In addition to recommending lifestyle changes, your doctor will likely prescribe medication to lower your blood pressure to a safe level. Isolated systolic hypertension, the most common form of high blood pressure in older adults, is treated in the same way as regular high blood pressure but may require more than one type of blood pressure medication. You may try several kinds or combinations of medications before finding a plan that works best for you. Medication can control your blood pressure, but it can’t cure it. If your doctor starts you on medication for high blood pressure, you may need to take it long-term.
When To Call Your Doctor
The risks of both high and low blood pressure make monitoring your blood pressure at home essential to your overall health and well-being. Both Dr. Wong and Dr. Desai recommend calling your healthcare provider if your self-monitored blood pressure readings are greater than 180/120 mmHgeven if you have no other symptoms.
You should call 911 if these blood pressure readings are associated with symptoms of organ damage, such as headache, vision changes, weakness, numbness, chest pain or shortness of breath, says Dr. Wong.
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How Is High Blood Pressure Treated
Treatment for hypertension depends on how high your blood pressure is, as well as your lifestyle and risk factors.
For elevated blood pressure, the goal is to keep your blood pressure from developing into clinical hypertension. No medications are necessary at this stage. Your doctor may recommend:
- losing weight if you have overweight or obesity
For stage 1 hypertension, your doctor may recommend lifestyle changes as mentioned above, as well as:
- reducing your sodium intake
- finding healthy ways to manage your stress
- medication, if your blood pressure doesnt improve after 1 month of lifestyle changes
For stage 2 hypertension, the typical treatment, in addition to a healthier lifestyle, is medication. Your doctor may prescribe one or more of the following medications to help lower your blood pressure:
- ACE inhibitors to block substances that tighten blood vessels
- alpha blockers to help relax the arteries
- beta-blockers to decrease your heart rate and block substances that tighten blood vessels
- calcium channel blockers to relax blood vessels and decrease the work of your heart
- diuretics to decrease the amount of fluid in your body, including your blood vessels
A hypertensive crisis requires immediate treatment. Medications may be given orally or intravenously .
The most for a hypertensive crisis include:
- vasodilators, such as hydralazine, nitroglycerin, and nitroprusside
- beta-blockers, such as labetalol and esmolol
High Systolic Blood Pressure Stage 1
A high systolic blood pressure stage 1 reading is when systolic blood pressure is between 130-139 mmHg, regardless of the diastolic number 3.
Doctors will recommend lifestyle changes and may consider prescribing medicine based on the risk of cardiovascular disease.
Systolic is just one of over ten topics in my article, What Is The Blood Pressure Chart? All Five BP Categories. Check it out and find out why the elevated pressure range is a major concern moving forward.
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The Blood Pressure Chart
Once you know your numbers, you can use the blood pressure chart to see what they mean and if your blood pressure is in the healthy range. The chart is suitable for adults of any age, as the cut-off point for diagnosing high blood pressure doesnt change with age.
How to use the blood pressure chart
Simply find your top number on the left side of the chart and your bottom number on the bottom. Where the two lines meet is your blood pressure.
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Diet For Lowering Blood Pressure
The most powerful lifestyle change to lower blood pressure is implementing a healthy diet. Making changes to your diet can lower your systolic blood pressure by up to 11 points.
The American Heart Association recommends the DASH diet to help lower blood pressure. The DASH diet is low in salt, added sugars, and red and processed meats.
Some additional diet guidance includes:
- Focus on eating colorful fruits and vegetables, since their high potassium content can help lower blood pressure.
- Choose whole grains whenever possible, and limit white flours such as those found in white bread and pasta.
- Avoid drinking sweetened drinks like juice and soda, and watch for salt in processed foods and canned items.
- Limit intake of saturated fat by choosing lean meats like skinless chicken and turkey.
- Choose low-fat or nonfat dairy items.
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Primary High Blood Pressure
While the specific cause of primary high blood pressure remains unknown, there is compelling evidence to suggest that a number of risk factors increase your chances of developing the condition.
These risk factors include:
- age – the risk of developing high blood pressure increases as you get older
- a family history of high blood pressure – the condition seems to run in families
- being of Afro-Caribbean or South Asian origin
- high amount of salt in your diet
- lack of exercise
- excessive alcohol consumption
A number of health conditions, such as diabetes and kidney disease, have also been linked to an increase risk of developing primary high blood pressure.
Symptoms Of Low Blood Pressure
Most doctors will only consider chronically low blood pressure as dangerous if it causes noticeable signs and symptoms, such as:
- Dizziness or lightheadedness
- Dehydration and unusual thirst
- Dehydration can sometimes cause blood pressure to drop. However, dehydration does not always cause low blood pressure. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can all lead to dehydration, a potentially serious condition in which your body loses more water than you take in. Even mild dehydration can cause weakness, dizziness and fatigue.
- Lack of concentration
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For High Blood Pressure
If you have high blood pressure, your doctor may watch it closely. This is because its a risk factor for heart disease.
Having elevated blood pressure puts you at risk for high blood pressure. If your blood pressure is elevated, your doctor may suggest lifestyle changes like eating a heart-healthy diet, cutting back on alcohol, and exercising regularly. These may help bring your blood pressure numbers down. You may not need prescription medications.
If you have stage 1 hypertension, your doctor may suggest lifestyle changes and medication. They may prescribe a drug like:
How Blood Pressure Is Controlled
When the heart contracts, the blood inside the left ventricle is forced out into the aorta and arteries. The blood then enters small vessels with muscular walls, called arterioles. The tone in the muscular walls of the arterioles determines how relaxed or constricted they are. If narrowed, they resist flow.Reduced flow of blood is detected in the brain, the kidneys and elsewhere. Nerve reflexes are stimulated and hormones are then produced. The heart is induced to beat more forcefully so that blood pressure is maintained at a higher level, to overcome the restricted flow through the arterioles. The achievement of good flow eases possible problems for function of the brain and kidneys.These adjustments occur normally. However, in some people the adjustments become fixed and high blood pressure persists. These people have developed hypertension.
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What Causes Low Blood Pressure
There are many possible reasons for low blood pressure, according to both Dr. Wong and Dr. Desai, including:
- Heart problems like heart failure or low heart rates
- Endocrine problems, such as parathyroid disease, adrenal insufficiency or hypoglycemia
- Side effects of medications for high blood pressure, prostatic hypertrophy, Parkinsons disease, depression and erectile dysfunction
- Massive weight loss
- Rapid heart rate
How Can I Tell If I Have High Blood Pressure
High blood pressure usually has no symptoms. In fact, many people have high blood pressure for years without knowing it. Thats why its called the silent killer. In 90-95 percent of cases, the cause of high blood pressure is unknown.
A single elevated blood pressure reading doesnt mean you have high blood pressure, but its a sign that further observation is required. The only way to find out if you have high blood pressure is to have your blood pressure checked.
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What Do The Readings Mean
As a general guide:
140/90mmHg or over you may have high blood pressureMost doctors use 140/90mmHg as the cut off for point for diagnosing . This is the point where your risk of serious health problems goes up. They might prescribe and advise you to make changes to your to bring your blood pressure down. 120/80mmHg up to 140/90mmHg pre-high blood pressureAlso called high-normal blood pressure. This is not high blood pressure, but it is a little higher than it should be and means you could go on to develop high blood pressure. See how you can make to lower it. 90/60mmHg up to 120/80mmHg ideal blood pressureAlso called normal blood pressure. Your blood pressure reading is healthy. At this level you have a much lower risk of heart disease and stroke. Following a will help you to keep it in the healthy range. 90/60mmHg or lower you may have low blood pressure usually isnt a problem, but it can sometimes make you feel faint or dizzy or could be a sign of another health problem.
The video below explains how your blood pressure numbers are linked to the risk of stroke and other disease.
Pearls And Other Issues
Isolated systolic hypertension is common in the elderly population. SBP has a better prediction for the risk of cardiovascular disease as compared to DBP. Hence, treatment of isolated systolic hypertension is beneficial to reduce all-cause mortality and cardiovascular risk, and stroke. The optimal SBP remained unclear, but an SBP goal of less than 140 mmHg and keeping DBP at 70 mmHg or higher are considered appropriate in most patient populations.
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Complications Of High Blood Pressure
Untreated or poorly managed high blood pressure can cause serious and even life threatening issues. It can damage your blood vessels as well as your organs. The longer your hypertension goes untreated, the more it can damage your body and affect your health.
Potential complications of high blood pressure include:
Diagnosing High Or Low Blood Pressure
Only one of your numbers needs to be higher than it should be to be diagnosed with high blood pressure, and only one needs to be lower than it should be to be diagnosed with low blood pressure.
So if your top number is over 140 or the bottom number is over 90, you may be diagnosed with , regardless of the other number. If your top number is under 90 or your bottom number is under 60, you may be diagnosed with . Use the to see where your numbers sit.
If your top number is consistently higher than 140mmHg, but the bottom number is healthy – this is known as Isolated Systolic Hypertension. If the bottom number is consistently higher than 90mmHg but the top number is healthy – this is known as Isolated Diastolic Hypertension.
Making sure your readings arent a one-off
A single high reading doesnt necessarily mean you have high blood pressure, as many things can affect your blood pressure throughout the day, such as the temperature, when you last ate, and if youre feeling stressed.
Your doctor or nurse will probably want to measure your blood pressure a number of times over a few weeks to make sure the reading wasnt just a one off and that your blood pressure stays high over time.
Read about how , getting a , the you might have if you have a high blood pressure reading, and .
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How Is Blood Pressure Measured
Blood pressure is defined as the amount of pressure that is exerted on the artery walls as blood moves through them. It is measured in millimetres of mercury, or mmHg.
A more detailed explanation is provided below.
Two measurements are used to measure blood pressure:
- Systolic pressure – the measure of blood pressure exerted when your heart beats and forces blood around your body.
- Diastolic pressure – the measure of blood pressure when your heart is resting in between beats.
Both the systolic and diastolic pressures are measured in millimetres of mercury .
The figures are usually represented with the systolic pressure first, followed by the diastolic pressure. Therefore, if your GP says that your blood pressure is ‘120 over 80’, or 120/80mmHg, they mean that you have a systolic pressure of 120mmHg and a diastolic pressure of 80mmHg.
Causes Of High Blood Pressure
Although the exact cause is unknown, certain conditions, traits or habits may raise your risk for the condition. These are known as risk factors and include:
Non-modifiable risk factors: These factors are irreversible and cannot be changed. The more of these risk factors you have, the greater your chance of developing HBP.
- Starting at age 18, ask your doctor for a blood pressure reading at least every two years. If you’re age 40 or older, or you’re 18 to 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year.
- Family history/Genetics
- African Americans and non-white Hispanic Americans are at higher risk for developing high blood pressure than any other group in the U.S.
Modifiable risk factors: These factors can be modified, treated or controlled through medications or lifestyle changes.
- Excessive alcohol consumption over many years.
- Little to no physical activity
- Excessive amounts of salt in diet that excess the recommended amounts of 1,500 to 2,300 mg of sodium per day.
- Long history of smoking and/or drug abuse
- Extreme emotional stress
Other conditions that contribute to developing high blood pressure
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How Is It Treated
If your systolic blood pressure is too high, your doctor may prescribe medicine to help bring it down. Drugs used to control blood pressure include:
- Diuretics to help your kidneys flush water and sodium from your body
- Beta-blockers to make your heart beat slower and less forcefully
- Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers , or calcium channel blockers to relax your blood vessels
- Renin inhibitors to keep your kidneys from making a chemical that can lead to higher blood pressure
Your doctor also may recommend you do a few other things:
- If you smoke, stop. There are lots of good reasons for this, but nicotine in cigarette smoke can raise your blood pressure.
- Lower the amount of salt in your diet.
- Cut back on alcohol if you drink.
- Get to or stay at a healthy weight.
Isolated Systolic Hypertension In The Elderly
Systolic blood pressure rises steadily with age. This is due to the increasing stiffness of large arteries, long-term plaque buildup and an increased incidence of cardiovascular disease.
According to a recent study, persons who reached age 65, if they lived another 20 years, had a 90% lifetime risk of developing isolated systolic hypertension or high blood pressure 5.
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Risks Of High Blood Pressure
If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes.
Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening health conditions, such as:
- have a relative with high blood pressure
- are of black African or black Caribbean descent
- live in a deprived area
Making healthy lifestyle changes can sometimes help reduce your chances of getting high blood pressure and help lower your blood pressure if it’s already high.