Blood Pressure 101: What You Need to Know
Blood pressure measures the force blood exerts on the walls of your blood vessels as it travels through your body. If you have high blood pressure, your heart needs to pump extra hard. Over time, this puts you at risk for heart disease and stroke. High blood pressure is also linked to kidney disease, aneurysms, eye damage, sexual dysfunction, and other conditions. Because high blood pressure does not cause symptoms, it is known as a “silent killer,” second only to smoking, as a cause of preventable heart disease and stroke deaths.
High blood pressure is the most common risk factor for stroke and heart disease. In addition, more than 50% of hypertensive patients have additional cardiovascular risk factors:
- Diabetes – 15%–20%
- Elevated LDL– cholesterol and triglycerides – 30%
- Excess weight/obesity – 40%
- Too much uric acid in the blood (Hyperuricemia) – 25%
- Metabolic syndrome – 40%)
- Unhealthy lifestyle choices such as smoking, high alcohol consumption, lack of exercise – 28-30%
Blood Pressure Guidelines
Blood pressure is measured with two numbers. The first number, systolic pressure, is the maximum pressure your heart exerts when it beats. The second number is diastolic pressure, which measures the maximum pressure in your arteries between heartbeats. The guidelines are as follows:
- Normal is 120/80 or less
- Elevated blood pressure is 120 to 129 over 80 or less
- Stage 1 hypertension is 130 to 139 over 80 to 89
- Stage 2 hypertension is 140 and higher/90 and higher
Hypertension is not a normal part of aging. If your blood pressure is above the normal range, talk to your doctor. The first step in treating high blood pressure is making healthy lifestyle changes. This includes weight loss if you are overweight or obese; a heart-healthy diet with sodium restriction and potassium supplementation; and increased physical activity. Alcohol should be limited to no more than two drinks per day for men and no more than one per day for women.
Depending on your numbers, you may need medication, or you may be able to manage your blood pressure with diet and lifestyle changes.
How to Dependably Monitor Your Own Blood Pressure
It’s important to monitor your blood pressure at home. Blood pressure fluctuates, and levels should be based on an average of two to three readings on different occasions. Combining regular home readings with readings at a healthcare provider’s office can help identify the following:
- White coat hypertension, in which the blood pressure is elevated in a medical setting but not in everyday life. People with white coat hypertension feel stressed during a doctor visit, which temporarily raises their blood pressure. They do not have as elevated a heart disease risk as those with sustained high blood pressure.
- Masked hypertension, in which blood pressure is normal at the doctor’s office but elevated at home. People with masked hypertension may have stressors at home or at work that they don’t experience in the doctor’s office. Their heart disease risk may be like those with sustained high blood pressure.
Blood Pressure Monitoring Tips
- Successful home monitoring starts with the right device.
- Upper arm cuff devices are typically best, and the cuff size does matter: "universal" cuffs will work for most people, but seek an alternative if you have a very slender or large arm.
- Select a monitor that the American Medical Association recognizes as validated for clinical accuracy (you can find a list here).
- Don’t smoke, drink caffeinated beverages, or exercise in the 30 minutes before taking your blood pressure.
- Empty your bladder and relax quietly for at least five minutes before you take your blood pressure.
- Sit with your back straight and supported on a hard-backed chair as opposed to a sofa or soft armchair. Keep your feet flat on the floor and don’t cross your legs. Place your bare arm on a table next to you with your upper arm at heart level–don’t take measurements over clothing. Place the bottom of the cuff directly above the bend in your elbow. Check your monitor’s instructions for an illustration or have your healthcare provider show you how.