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Blood pressure is a measurement of the force of blood against the arterial walls when the heart pumps. The pressure is measured in millimeters of mercury (mmHg) and is expressed as two numbers. For example, the optimal blood pressure for an adult is 120 over 80, or 120/80. The top number, called the systolic pressure, measures the highest pressure exerted when the heart contracts. The bottom number, called the diastolic pressure, shows the minimum pressure against the arteries when the heart rests between beats.
Blood pressure is measured with a cuff and stethoscope while the arm is in a resting position. The cuff is placed about one inch above the bend of the wrist, and is inflated until the mercury dial reaches 30 points higher than the person’s usual systolic pressure, or 210 if previous data is not available. A stethoscope is placed on an artery in the inside of the elbow, and the air is slowly allowed to escape from the cuff. The point at with the sound of the pulse is first heard is the systolic pressure number; the point at which the sound disappears is the diastolic number.
Several factors can affect blood pressure, so one high reading does not necessarily mean that a person has hypertension, or high blood pressure. Immediate stimuli such as fear, pain, anger, and some medications can temporarily raise a person’s blood pressure. If a high reading has occurred, and one of these factors is present, then the person needs to be monitored repeatedly over a period of time to determine if this is a persistent condition, or if the reading was simply based on circumstances.
Hypertension is a leading cause of strokes, cardiovascular disorders, kidney, urological and neurological conditions, and pre-eclampsia in pregnant women. A pressure reading of 120 over 80 or lower is considered healthy. If the systolic number ranges above 120 to 139 or the diastolic number ranges above 80 to 89, a person is considered to have pre-hypertension. Systolic readings from 140 to 159 or diastolic readings from 90 to 99 are classified as stage 1 hypertension. Systolic measurements of 160 or above or diastolic measurements of 100 or above indicate the severe condition of stage 2 hypertension.
If a person has been determined to have hypertension it is vital that the condition be addressed. Some lifestyle changes can be helpful, such as eating healthy, maintaining proper weight, exercising regularly, and limiting salt and alcohol consumption. In some cases, these efforts are not enough and medication is indicated. Even if a patient is on medication, changes to a healthy lifestyle will help control the condition and may reduce the amount of medication necessary to maintain a healthy blood pressure reading.
Sometimes patients have pressure readings that are lower than 90 over 60, which is what is considered the bottom of the normal range. This condition, called hypotension, may cause nothing more than a sense of dizziness when moving quickly from a sitting to a standing position. However, hypotension can be indicative of an underlying medical condition, such as heart failure, infection, severe diabetes, shock, gland disorders or dehydration. Alcohol, anti-anxiety and anti-depressant medications, diuretics, painkillers, and some other medications may also cause hypotension. A person’s blood pressure can change over time, so periodic monitoring should be a part of everyone’s preventative health care.
A. Blood pressure is important because the higher your blood pressure is, the higher your risk of health problems in the future.
If your blood pressure is high, it is putting extra strain on your arteries and on your heart. Over time, this strain can cause the arteries to become thicker and less flexible, or to become weaker.
If your arteries become thicker and less flexible, they will become more narrow, making them more likely to become clogged up. If an artery becomes completely clogged up (known as a clot), this can lead to a heart attack, a stroke, kidney disease or dementia.
More rarely, if an artery has become weakened, the extra strain may eventually lead to the artery bursting. This may also cause a heart attack or stroke.
The good news is that there are many ways in which you can lower your blood pressure and put less strain on your arteries and heart.
A. Whatever your blood pressure is at the moment, the message is the same:
the lower your blood pressure is, the lower your risk will be of having a heart attack or stroke in the future.
This means that all of us should be trying to lower our blood pressures, whether we have high blood pressure or not.
At the moment, optimal blood pressure is having a blood pressure of 120/80mmHg or less.
A. To have high blood pressure, your blood pressure must be consistently equal to or higher than 140/90mmHg over a number of weeks (if you have diabetes or kidney problems a lower level might be used).
It is worth knowing that you can have high blood pressure if just one of your numbers is consistently higher than it should be. In other words you may be told you have high blood pressure if your maximum or top number (systolic pressure) is consistently equal to or higher than 140 even if your minimum or lower number (diastolic pressure) never reaches 90 and vice versa.
High blood pressure is never diagnosed after just one reading. This is because there can be many reasons why you could have a one-off raised reading. For example, you might have a slightly raised blood pressure because you were feeling tense, had recently had some tea, coffee or cola, or you had been rushing around. Your doctor will usually be looking for a series of high readings, taken over a period of weeks, unless your blood pressure is particularly high to begin with in which case you will receive treatment immediately.
Many people ask if their age makes a difference in the levels used to diagnose high blood pressure. The answer is no: 140/90mmHg is the benchmark for everyone, regardless of whether they are 19 or 89 years old.
A. Low blood pressure is defined as having a blood pressure that is below 90/60mmHg.
Blood pressure can vary over a wide range. For instance, when the heart is pushing the blood round the body, your blood pressure can reach a top or maximum (systolic) level of anywhere between 90 to 240 mmHg and, when your heart is relaxing, your blood pressure can fall to a bottom or minimum (diastolic) level of between 40 to 160 mmHg.
About a hundred years ago it was first recognised that high blood pressure was a major cause of strokes and heart attacks. At this time, it was also thought that low blood pressure was a major cause of depression and tiredness. Many people were quite wrongly treated for low blood pressure in the UK in the early 1900s. However, there is no evidence that low blood pressure causes either of these symptoms.
It is only in a tiny minority of people with low blood pressure, ie, readings below 90/60 mmHg, where there is an underlying problem that is causing their blood pressure to be at this level and treatment may be needed. Most people with low blood pressure are going to live longer.
However, there are a few people with a blood pressure at these levels who require treatment. In nearly all of these cases, your blood pressure is much lower when you stand up, particularly if you stand up suddenly. This fall in blood pressure on standing is likely to cause symptoms of fainting and/or dizziness.
Normally, when you stand up blood tends to pool in the veins in your legs. This is stopped by nerves, which contract the veins in your legs ensuring that enough blood returns to your heart and that there is no reduction in the amount of blood that your heart pumps. This maintains the blood supply to your brain.
However, if there is pooling of blood in your veins, less blood returns to your heart and less is pumped out which means a reduction in the amount of blood going to your brain. This causes symptoms of dizziness and some people may faint. This is exactly what happens to guards on parade when they faint because they have been standing in one position for too long. You can mimic this effect when you squat down for a while, for instance when looking at books on a low shelf, and then stand up suddenly.
Therefore, if you have a low blood pressure and you also have symptoms of dizziness or faintness when standing up suddenly you should have your blood pressure checked by your doctor, both when you are lying down and when you then stand up. This drop in blood pressure when you stand up is called postural hypotension.
A. Your blood pressure is a measure of how hard your blood is pushing against the sides of your arteries. The higher the strain on your arteries (and your heart) the more likely it is that you will have health problems in the future. So the lower your blood pressure is, the better.
Blood pressure usually ranges between 90 to 250 for the top or maximum number (systolic) and 60 to 140 for the bottom or minimum number (diastolic).
Because the risk of heart attack and stroke goes up as a person's blood pressure rises, it is best to try to lower your blood pressure even if you don't have high blood pressure. For example someone with a blood pressure of 135/85 is twice as likely to have a heart attack or stroke in the future as someone with a blood pressure of 115/75. So, the lower you can get your blood pressure now, the better.
The readings below are a guide to blood pressure levels and any action you may need to take. These levels come from the British Hypertension Society Guidelines for Managing High Blood Pressure 2004.
Less than 120 over 80: Your blood pressure is normal and healthy. Follow a healthy lifestyle to keep it at this level.
Between 120 over 80 and 140 over 90: Your blood pressure is a little higher than it should be, and you should try to lower it. Make healthy changes to your lifestyle.
140 over 90 or higher (over a number of weeks): You have high blood pressure. Change your lifestyle - see your doctor or nurse and take any medicines they may give you.
A. Most people don't feel any different when they have high blood pressure. Although many people think that high blood pressure will give you headaches or dizziness, the truth is that very few people with high blood pressure ever experience these problems. The only way to know is to have your blood pressure checked regularly.
Your blood pressure numbers should be something you know in the same way that you know how much you weigh or how tall you are.
You can get your blood pressure measured at your GP surgery or, increasingly, at your local pharmacy or gym. Every adult should get their pressure checked at least every five years but more often than that is better. If you have had a high reading before, or have a blood pressure that is between 135/85 and 140/90 you should get yourself checked at least every year.
Knowing your blood pressure levels, or as the Blood Pressure Association says "Knowing your Numbers" is a key way to having long and healthy life.