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 .
What Causes High Blood Pressure In The First Place
If you have HBP, youre hardly alone. According to the Centers for Disease Control and Prevention , nearly half of all adults in the U.S. have hypertension or take a medication to manage it. Only one-quarter of them have it under control.
Your doctor most likely wont be able to pinpoint the reason why you have HBP. Thats because as many as 95% of HBP cases have no known cause. If you fall into this vast category, you have whats known as primary hypertension. Among the much, much smaller number of people who do have a known cause, their HBP is known as secondary high blood pressure because its caused by an underlying, or already present, health condition.
These underlying secondary causes include:
Signs And Symptoms Of Hypertension In The Elderly
There is a big problem we need to mention here. And it involves high blood pressure in the elderly, usually showing no symptoms. As much as one-third of people who have high blood pressure dont know that they have it. Often, the only way to diagnose it is by taking proper blood pressure measurements.
Fortunately, as you know, this is very simple, and it is one of the first things your doctor does when performing a physical exam. Therefore, if you regularly visit your doctors office, high blood pressure wont be left undiagnosed. Its recommended for people over the age of 21 to keep track of their blood pressure, and even more so for seniors.
When it comes to high blood pressure in the elderly, symptoms start to appear only at dangerously high levels. The symptoms of extreme hypertension can include:
- Intense headache
- Pulsating in the chest, neck, or ears
- Blood in the urine
If you have any of these symptoms, you must see a doctor immediately. You could be having a hypertensive crisis that requires urgent treatment because it can lead to a heart attack or stroke.
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What Is Normal Blood Pressure
A blood pressure reading is written like this: 120/80. It’s read as “120 over 80.” The top number is called the systolic, and bottom number is called the diastolic. The ranges are:
- Normal: Less than 120 over 80
- Elevated: 120-129/less than 80
- Stage 1 high blood pressure: 130-139/80-89
- Stage 2 high blood pressure: 140 and above/90 and above
- Hypertension crisis: higher than 180/higher than 120 — See a doctor right away
If your blood pressure is above the normal range, talk to your doctor about how to lower it.
When To See A Doctor
If a person who monitors their blood pressure at home does not see lower readings despite implementing lifestyle changes, they should get in touch with a doctor to determine the underlying cause of their high blood pressure.
A person should seek immediate medical attention if they get two readings of 180/120 mm Hg or higher within a 5-minute period, especially if they are experiencing a headache or nosebleed.
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How To Measure Blood Pressure
If you want to know how to control high blood pressure in old age, or in fact, any age, the first step is measuring it. There are a few ways to measure blood pressure, the simplest being with an electronic sensor that goes around your wrist. You can use it yourself, and its relatively accurate but not the most sensitive device out there.
What is the normal pulse rate for an elderly person? Regular heart rate varies from person to person, but a normal range for adults is 60 to 100 beats per minute. Additionally, low pulse rate and high blood pressure in the elderly are possible, especially if ones hypertension is chronic. Namely, a low pulse rate may indicate a problem with the hearts electrical conduction pathway.
There are special devices called ambulatory blood pressure monitors that record your blood pressure for the entire day and give the most accurate readings, but theyre more expensive, and they arent the standard practice yet. And, of course, theres the good old blood pressure cuff and stethoscope.
Even more important than the device you use is the way you take the measurements. First of all, they have to be performed multiple times before making a definitive diagnosis. Second, the person has to be adequately prepared. What does that mean? For the most accurate readings of high blood pressure in elderly people, the patients should:
Surprising Causes Of High Blood Pressure
Quick – what causes high blood pressure? The first culprits that pop into your mind are likely to be: eating too much salt, being stressed out all the time, and alcohol abuse. And you would be right. But there are also less obvious causes of high blood pressure, a condition that affects about one in three, or 78 million, adults in the U.S.
The best data demonstrates that hypertension is almost unavoidable as we age, says Clyde Yancy, MD, chief of cardiology and associate director of the Bluhm Cardiovascular Institute in Chicago, Illinois. Once we reach age 55, we have a 90 percent chance of becoming hypertensive.”
Yet that inevitability doesnt mean we cant do something about it. Step one is to modify your lifestyle: lose weight, exercise, and eat a wholesome diet, explains Dr. Yancy. Another thing you can do: Get to know these less well-known blood pressure factors:
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Youre Not Factoring In Electronic Units Correctly
Electronic blood pressure units also called Non Invasive Blood Pressure machines, sense air pressure changes in the cuff caused by blood flowing through the BP cuff extremity. Sensors estimate the Mean Arterial Pressure and the patients pulse rate. Software in the machine uses these two values to calculate the systolic and diastolic BP.
To assure accuracy from electronic units, it is important to verify the displayed pulse with an actual patient pulse. Differences of more than 10 percent will seriously alter the units calculations and produce incorrect systolic and diastolic values on the display screen.
Given that MAP is the only pressure actually measured by an NIBP, and since MAP varies little throughout the body, it makes sense to use this number for treatment decisions.
A normal adult MAP ranges from 70 to 105 mmHg. As the organ most sensitive to pressure, the kidneys typically require an MAP above 60 to stay alive, and sustain irreversible damage beyond 20 minutes below that in most adults. Because individual requirements vary, most clinicians consider a MAP of 70 as a reasonable lower limit for their adult patients.
Finally, and especially in the critical care transport environment, providers will encounter patients with significant variations between NIBP and arterial line measured blood pressure values.
What Causes Systolic Hypertension
Several psychological and physical factors can impact systolic blood pressure in an individual. However, it is important to keep in mind that blood pressure is not a static measurement, as the values for both systolic and diastolic ranges change constantly throughout the day. This is because your circulatory system is a dynamic structure that has to adjust to various stressors. As a result, your doctor will never make a diagnosis of hypertension from a single visit, but rather take blood pressure readings across multiple visits before making a definite diagnosis.
Every organ in the body contributes to your blood pressure, with the kidneys, heart, and brain playing the biggest roles in systolic blood pressure values. Heart health can directly create a significant impact on systolic blood pressure, as the force its creates may have to pump harder if you suffer from medical conditions. Having kidney failure will also lead to increases in blood pressure due to the ineffective removal of excess fluid, creating an increased burden on the heart.
Factors affecting our mental state, such as being frightened or anxious, can also affect systolic blood pressure. This is an autonomic response by the body to help deal with immediate stressors. These situations typically result in increased heart rate and blood pressure, as your body is preparing to go into action.
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High Blood Pressure During Pregnancy
Women with hypertension can deliver healthy babies despite having the condition. But it can be dangerous to both mother and baby if its not monitored closely and managed during the pregnancy.
Women with high blood pressure are more likely to develop complications. For example, pregnant women with hypertension may experience decreased kidney function. Babies born to mothers with hypertension may have a low birth weight or be born prematurely.
Some women may develop hypertension during their pregnancies. Several types of high blood pressure problems can develop. The condition often reverses itself once the baby is born. Developing hypertension during pregnancy may increase your risk for developing hypertension later in life.
What Are The Symptoms Of High Blood Pressure
Most people who have high blood pressure do not have symptoms. This is why its sometimes called the silent killer. It is very important to have your blood pressure checked regularly.
Some people experience headaches, nosebleeds, or shortness of breath with high blood pressure. However, those symptoms can mimic many other things . Usually, these symptoms occur once blood pressure has reached a dangerously high level over a period of time.
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What Is High Blood Pressure
High blood pressure, also called hypertension, is blood pressure that is higher than normal. Your blood pressure changes throughout the day based on your activities. Having blood pressure measures consistently above normal may result in a diagnosis of high blood pressure .
Your health care team can diagnose high blood pressure and make treatment decisions by reviewing your systolic and diastolic blood pressure levels and comparing them to levels found in certain guidelines.
The guidelines used to diagnose high blood pressure may differ from health care professional to health care professional:
- Some health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 140/90 mm Hg or higher.2 This limit is based on a guideline released in 2003, as seen in the table below.
- Other health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 130/80 mm Hg or higher.1 This limit is based on a guideline released in 2017, as seen in the table below.
|systolic: 130 mm Hg or higherdiastolic: 80 mm Hg or higher|
If you are diagnosed with high blood pressure, talk with your health care team about your blood pressure levels and how these levels affect your treatment plan.
Complications Of Hypertension In The Elderly
Untreated high blood pressure in older people causes some potentially life-threatening complications. While most of these problems wont present themselves until old age, there arent complications of hypertension only in elderly people. In fact, more and more young people have hypertension, so diagnosing and treating it on time is crucial for preventing the following problems:
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Home Blood Pressure Monitoring
Some people buy their own blood pressure monitor to use at home. This means you can measure your blood pressure on an ongoing basis.
The blood pressure readings you do at home are as good as those done by your doctor.
If you decide to buy one, it’s important to get the correct cuff size. If the cuff is too big or too small, it can give an inaccurate reading.
If you take your own blood pressure and get an unusually high reading, take it a second time after at least five minutes. If it’s still high and you’re worried, contact your nurse or GP.
You Rarely Go Outside
Binging a new show on Netflix for days on end while quarantining inside your home should protect you from COVID-19, but it could increase your blood pressure or worsen existing hypertension, suggests a study in the Journal of American Heart Association. And why is this? It’s the lack of sunlight that’s boosting your blood pressure.
In the observational study, researchers analyzed 46 million blood pressure readings from 342,000 patients in 2,200 dialysis clinics and found that exposure to UV sunlight was associated with lower systolic blood pressure. For decades, scientists have known of seasonal variation in blood pressure, but had linked it to factors such as air temperature and vitamin D, which is produced when sunlight hits the skin. This new study found that temperature played a role, but “half the seasonal variation in blood pressure is independent of temperature. It’s due to the UV alone,” said lead author Dr. Richard Weller of the University of Edinburgh in Scotland.
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Can You Help Control Your Blood Pressure
Yes, you can help. There are three things you can do: have a more active lifestyle, make healthy food choices, and, if needed, take your medicine every day as it is prescribed. With prehypertension, some people can bring blood pressure down to normal through weight loss, exercise and other changes for a healthy lifestyle. Medications are used to control high blood pressure. Medicines may be recommended for some people with prehypertension who also have other diseases, such as diabetes mellitus, chronic kidney disease and coronary artery disease.
If you have slightly high blood pressure, your doctor may suggest these steps:
- lose weight if you are overweight,
- get regular physical activity,
- cut down on alcohol, and
- change your food choices to those with less salt and fat
A special eating plan called DASH can help you lower your blood pressure. DASH stands for Dietary Approaches to Stop Hypertension. The DASH eating plan emphasizes fruits, vegetables, fatfree or lowfat milk and milk products, wholegrain products, fish, poultry, beans, seeds, and nuts. The DASH eating plan also contains less salt/sodium, sweets, added sugars, sugar containing beverages, fats, and red meats than the typical American diet.
COVID-19 patients can become kidney patients.
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Dangers Of Low Blood Pressure
Low blood pressure may not be discussed as often as high blood pressure, but it should be addressed, as prolonged low blood pressure can negatively affect your organs.
A certain amount of blood pressure is needed to maintain blood flow to the organs, says Dr. Wong. The blood supplies oxygen and nutrients to these organs. If the blood pressure is too low, an adequate blood supply cannot get to these organs.
If left untreated, low blood pressure can increase your risk of fainting, heart attack and organ damage, adds Dr. Desai.
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Why You Should Take Your Own Blood Pressure At Home Or On The Go
Because of regular fluctuations in blood pressure, white-coat syndrome, and masked hypertension, doctors may recommend self-monitoring for people with HBP. There are many benefits to taking your own BP:
- Knowing your actual, average blood pressure outside of regular fluctuations
- Gaining more control over your blood pressure
- Tracking your progress
- Saving time and possibly money from frequent doctor visits and complications
What Are The Risk Factors For Hypertension
While the exact causes of HBP remain a mystery in most cases, risk factors are much easier to identify. Fortunately, most of them are within your power to controlwhich means your hearts destiny may lie largely in your own hands. They include:
If youre overweight or obese, your body requires your heart to pump more blood to supply it with oxygen and other essential nutrients. This extra work adds to the pressure on the walls of your blood vessels.
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Family History And Genetics
High blood pressure often runs in families. Much of the understanding of the body systems involved in high blood pressure has come from genetic studies. Many different genes are linked to a small increase in the risk of developing high blood pressure. Research suggests that certain DNA changes as an unborn baby grows in the womb may also lead to high blood pressure later in life.
Some people have a high sensitivity to salt in their diet. This can also run in families.
Improving Health With Current Research
Learn about the following ways in which we continue to translate current research and science into improved health for people who have high blood pressure. Research on this topic is part of our broader commitment to advancing scientific discovery in heart and vascular disease and health disparities and inequities research.
Learn about some of the pioneering research contributions we have made over the years that have improved clinical care.
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What Are The Medications For Hypertension
If you are in stage 2, or in stage 1 with an elevated risk of heart disease, youll need to make the above lifestyle modifications and probably get started on at least one blood pressure-lowering medication.
If your blood pressure is very high, you will need whats called combination therapy, or medications from two different classes of drugs. Your doctor has many options to choose from. The choice will depend on the severity of your HBP as well as underlying health conditions you may have, like diabetes and heart disease. In all likelihood, your doctor will try you on more than one medication or dosage before determining what works best for you.
Short for angiotensin-converting enzyme inhibitors, this class of drug prevents your body from producing the blood vessel-narrowing and blood pressure-boosting hormone angiotensin II. These meds are often prescribed to people with diabetes because it also has kidney benefits.
Angiotensin II Receptor Blockers
ARBs for short, they also prevent angiotensin II from narrowing your blood vessels, easing the strain on your heart.
These drugs slow your heart rate so that it does not have to work as hard. This lowers your blood pressure.
Calcium Channel Blockers
These help your blood vessels to relax, allowing blood to flow more easily. They also lower BP by slowing your heart rate, give your heart a chance to rest.