Blood Pressure Readings

Blood Pressure Readings

Blood pressure reading consists of two numbers: the upper number or systolic pressure refers to arterial blood pressure during maximal heart muscle contraction to pump the oxygenated blood to nourish the body, and the lower number or diastolic pressure measures the arterial blood pressure during maximal heart relaxation. The blood pressure unit is mm. of mercury (mmHg). It can indicate if your heart is working too hard and help predict the risk of developing other severe diseases such as stroke or heart disease. Keeping your blood pressure in the normal range is crucial for a healthy life.

The blood pressure reading should derive from the average of multiple measurements instead of relying on a single blood pressure reading.

Blood Pressure

• Normal Blood pressure
  • The systolic pressure (upper number) is between 90-120 mmHg.  
  • The diastolic pressure (lower number) is between 60-80 mmHg.

It is essential to keep your blood pressure in the normal range, particularly for people with a history of hypertension. Maintaining a healthy weight and lifestyle can help prevent the development of hypertension.

• Mild Hypertension:
  • The systolic pressure is between 120-129 mm Hg, and
  • The diastolic pressure is around 80 mm Hg.

Medications are not needed yet. However, this is a warning sign that you need to change your lifestyle and start heart-healthy habits such as eating healthy and getting regular exercise.

• Stage 1 hypertension:
  • The systolic pressure is between 130-139 mm Hg, and
  • The diastolic pressure is between 80-89 mm Hg.

However, getting only one reading this high does not confirm that you have stage 1 hypertension. The number should be the average of your blood pressure measured and tracked over an interval. 

If you are at lower risk, change to a healthier lifestyle and have a follow-up appointment with your doctor within 3-6 months.

Your doctor will formulate an appropriate treatment plan if you are 65 or above. Treatment of high blood pressure may improve dementia and memory problems in older adults.

• Stage 2 hypertension is a more serious health problem:
  • The systolic blood pressure is 140 mm Hg or higher, and
  • The diastolic blood pressure is 90 mm Hg or higher

Doctors will prescribe one or more antihypertensive medications to manage your blood pressure. However, lifestyle modification is also necessary to control your blood pressure.

• Hypertensive crisis

A hypertensive crisis occurs when a blood pressure reading is over 180/120 mm Hg. It is possible that these high numbers are just temporary and may return to normal afterward. A nurse will repeat the blood pressure measurement after a few minutes to confirm the condition. A hypertensive crisis may indicate a serious underlying health condition that requires emergency medical treatment. 

You may experience headaches, chest pain, shortness of breath, changes in your vision, blood in urine, loss of facial muscle control, or paralysis.

Treatment

The doctors will include your blood pressure range, lifestyle, and risk factors in designing an appropriate treatment plan. 

• Mild Hypertension
  No need for drug treatment initially. The main goal is to change your daily activities to control hypertension.  The recommendations are:
  • Have a healthy diet
  • Exercise regularly
  • Lose weight if you are overweight or obese

• Stage 1 hypertension
  You will need to:
  • Eat less salt or sodium
  • Manage your stress
  • Take medications if your blood pressure is still high and doesn’t improve after one month of lifestyle change.

• Stage 2 hypertension
  Typically, you should modify your lifestyle and take one or more medications to lower your blood pressure, such as 
  • ACE inhibitors or ARB block a substance that narrows blood vessels. 
  • Alpha-blockers keep the arteries open and relaxed. 
  • Beta-blockers slow your heart rate.
  • Calcium channel blockers block calcium from entering the heart arteries so the blood vessels remain open.  
  • Diuretics decrease plasma volume in your veins and arteries.

• Hypertensive crisis
  Immediate treatment with oral or IV medications is necessary.
  
  

Prevention

It is crucial to control blood pressure as it helps prevent the risk of developing high blood pressure, other complications of hypertension, or heart disease. When you are over 50, systolic pressure typically increases, raising the risk of coronary heart disease and other health problems.

To lower the risk of developing hypertension, you can follow the preventive measures as follows:

• Keep your sodium or salt intake lower than 2,300 milligrams (mg) daily if you are healthy. Eat less than 1,500 mg per day if you have high blood pressure. Avoid processed foods high in sodium, and do not add extra salt or fish sauce to your foods.
• Exercise for 20-30 minutes every day.
• Maintain a healthy weight. Losing 2-5 kilograms of weight can improve your blood pressure. 
• Consume less caffeine as it can impact your blood pressure. 
• Manage your stress by doing yoga, meditation, or breathing exercise.  
• Quit smoking.
• Limit alcohol consumption. 

Hypotension

Low blood pressure occurs when your blood pressure ranges below 90/60 mm Hg. It means your heart and arteries are not supplying the body with adequate oxygenated blood. And you may experience dizziness. 

Possible causes of hypotension are:

• Malnutrition
• Pregnancy
• Dehydration
• Blood loss
• Heart conditions 
• Septicemia
• Anaphylaxis
• Endocrine disorders
• Medications

You should see your doctor for a proper diagnosis and treatment.

Article by
Dr Prapaporn Phimphilai

Internal Medicine
Doctor profile