Under Pressure: How To Use The New Blood Pressure Guidelines
In November 2017, the American Heart Association and the American College of Cardiology released new guidelines for blood pressure, lowering the range of whats considered a high blood pressure reading. The end result: 46 percent of Americans now are considered to have high blood pressure, up from 32 percent under the old guidelines.
It may seem scary to think about 30 million more people having high blood pressure, or hypertension, essentially overnight. But the new guidelines are a step in the right direction. They recognize our growing understanding of high blood pressure and why we shouldnt manage it through medical treatments alone. Patients and their doctors have to have strong communication and good partnerships in order to understand and treat this dangerous condition.
We measure blood pressure in millimeters of mercury, or mmHg. Youve probably heard blood pressure given as one number over another number, such as 120 over 80. The first number is systolic pressure, and the second number is diastolic pressure.
The new blood pressure scale is as follows:
- Normal blood pressure: less than 120 mmHg systolic less than 80 mmHg diastolic
- Elevated blood pressure: 120 to 129 mmHg systolic less than 80 mmHg diastolic
- Stage 1 high blood pressure: 130 to 139 mmHg systolic 80 to 89 mmHg diastolic
- Stage 2 high blood pressure: 140 or above mmHg systolic 90 or above mmHg diastolic
What Can I Do To Prevent Or Manage High Blood Pressure
Many people with high blood pressure can lower their blood pressure into a healthy range or keep their numbers in a healthy range by making lifestyle changes. Talk with your health care team about
- Getting at least 150 minutes of physical activity each week
- Managing stress
In addition to making positive lifestyle changes, some people with high blood pressure need to take medicine to manage their blood pressure. Learn more about medicines for high blood pressure.
Talk with your health care team right away if you think you have high blood pressure or if youve been told you have high blood pressure but do not have it under control.
What Are The Symptoms Of High Blood Pressure
The only way you can know for sure if you have high blood pressure is by having a nurse or doctor measure it. Monitoring your blood pressure at home also helps keep your blood pressure in check. Most often, high blood pressure is silent, meaning it has no other signs to warn you, according to the CDC.
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Average Blood Pressure By Age
As you get older, your blood vessels tend to become stiffer and plaque can build up in them, which can raise your blood pressure. If your blood pressure becomes too high, you’re at a greater risk for heart disease, strokes, and more.
In 2015, the average blood pressure worldwide was 127/79 mm Hg in men, and 122/77 mm Hg in women, according to a study analysis published in Lancet.
When researchers for the National Center for Health Statistics looked at average blood pressure in U.S. adults between 2001 and 2008, the average reading was 122/71 mm Hg. The breakout was 124/72 mm Hg for men, and 121/70 mm Hg in women. It rose by age and was significantly higher in Black people.
The researchers found the following breakdown by age, sex, and race or ethnicity:
|Blood Pressure by Age|
As the population ages and life expectancy increases, high blood pressure is becoming more common.
What Affects A Blood Pressure Reading
Many things can affect a blood pressure reading, including:
- Nervousness about having your blood pressure taken. This is called white coat syndrome. As many as 1 in 3 people who have a high blood pressure reading at the doctors office may have normal blood pressure readings outside of it.1
- What you ate, drank, or did before your reading. If you smoked, drank alcohol or caffeine, or exercised within 30 minutes of having your blood pressure measured, your reading might be higher.2
- How you are sitting. Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.2
Its important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke.
A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. A reading that says your blood pressure is higher than it actually is may lead to treatment you dont need.
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What Is The Correct Way To Measure Blood Pressure
Learn the correct way to have your blood pressure taken, whether youre getting it checked at the doctors office or checking it yourself at home. Use this checklist:
- Dont eat or drink anything 30 minutes before you take your blood pressure.
- Empty your bladder before your reading.
- Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
- Put both feet flat on the ground and keep your legs uncrossed.
- Rest your arm with the cuff on a table at chest height.
- Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
- Do not talk while your blood pressure is being measured.
If you are keeping track of your blood pressure at home, use these additional tips.
What Is A Healthy Blood Pressure
When the heart is squeezing blood into the arteries, the pressure is high. When the heart is relaxed, the pressure is lower.
Your blood pressure is a measurement taken of the highest reading and the lowest reading . It is given as 2 figures highest over lowest or systolic over diastolic. Blood pressure is measured in mmHg, which refers to millimetres of mercury.
Your blood pressure varies from day to day, even moment to moment. Most doctors would say that a healthy blood pressure is higher than 90/60 mmHg but lower than about 140/90.
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Get Regular Blood Pressure Checks
If your blood pressure is in the healthy range and you have no other risk factors for cardiovascular disease, and no personal or family history of high blood pressure, it is still important to have a check at least every two years. Your doctor can also check your blood pressure during routine visits.
If your blood pressure is highnormal , or if you have other risk factors for cardiovascular disease, such as a personal or family history of high blood pressure, stroke or heart attack, it is best to have it checked more frequently such as every 6 to 12 months or as directed by your doctor. Ask your doctor for advice.
What Does A Blood Pressure Reading Look Like
When you have your , you will be given two numbers, a top number and a bottom number.
- Systolic blood pressure. This is the first, or top, number. This is the highest level your blood pressure reaches when your heart beats, forcing blood around your body.
- Diastolic blood pressure. The second number, or bottom number, is the lowest level your blood pressure reaches as your heart relaxes between beats.
Blood pressure is measured in millimetres of mercury . If the first number is 120 and the second number is 80, this would be written as 120/80mmHg, and youd call it 120 over 80.
This video explains more about systolic and diastolic blood pressure.
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What If Lifestyle Changes Dont Help Lower My Blood Pressure
If diet, exercise and other lifestyle changes dont work to lower your blood pressure, your healthcare provider will prescribe medications to help lower your blood pressure. Your provider will take into account other conditions you may have, such as heart or kidney disease and other drugs youre taking when prescribing medications to treat your high blood pressure. Be sure to follow your providers dosing directions exactly.
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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Blood Pressure Monitor Vs Blood Pressure Cuff
Blood pressure monitor and blood pressure cuff are two phrases often used to describe the same blood pressure measurement tool. The blood pressure cuff is the element that wraps around either the upper arm, wrist or finger to measure blood pressure. The blood pressure monitor is the element in charge of inflating and deflating the cuff, as well as providing your blood pressure reading on an easy-to-read display.
Most experts recommend using a blood pressure monitor with an upper arm blood pressure cuff for at-home readings because they tend to be more accurate than wrist cuffs and finger cuffs.
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Symptoms Of Abnormal Blood Pressure
You can even have hypertension for years without any symptoms. High BP can damage organs and arteries. This is why hypertension is called the silent killer.
Symptoms may appear, but only after BP has reached a crisis stage. At this stage, you may experience severe chest pain, severe headaches with blurred vision, nausea and vomiting, shortness of breath, and/or seizures. Often, high BP is identified during a routine physical exam.
Hypotension can cause symptoms, including:
- Diminished concentration
Medications For High Blood Pressure
There is a large variety of medicines available to lower and manage high blood pressure. Your doctor may call them antihypertensives, .
These medications do not cure high blood pressure, but they do help manage it. Once you start to take medicines to manage your blood pressure, you may need to take them for the rest of your life. However, the dose of these medicines may change over time.
If you need to take medication, your doctor will advise you on the correct type and dose. Two or more different medications are often needed to manage blood pressure.
Make sure you take your medicines regularly. Some things that may help you remember to take them include:
- Building them into your daily routine by taking them at the same time each day.
- Keeping them somewhere that will remind you such as next to your alarm, or with your coffee or tea.
- Using a weekly pill box.
- Asking a family member or friend to remind you.
- Always carrying a list of your medicines and their doses with you.
- Entering a daily alarm in your mobile phone or download an app to remind you.
Take any blood pressure medicine exactly as prescribed. Dont stop or change your medicine, unless your doctor advises you to.
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How To Treat Low Blood Pressure
Low blood pressure can be prevented or treated using the following methods:
- Consume lots of fluids
- Stay hydrated, especially during hot weather or during viral flu
- Drink more nonalcoholic drinks
- Exercise regularly to encourage blood flow
- Avoid sitting or standing quickly
- While rising, take care to sit upright for a few seconds and then get off the bed
- Stay away from heavy lifting
- Avoid standing still for a prolonged time
- Avoid straining while passing stools
- Avoid prolonged exposure to hot water such as sauna, hot water springs, and spas
- Compression stocking covering the thigh and calf restricts the blood flow to the lower part of the body
- Try eating smaller, more frequent meals to avoid post-meal dizziness
- Any consumption of over-the-counter medications should be reported to the physician.
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
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Multiple Readings Should Be Taken
One blood pressure reading is not enough to get an accurate measurement. While the specifics of how many readings are necessary can change based on many factors, the essential need for multiple measurements does not.
To ensure an accurate reading, your doctor should be checking your blood pressure over time, and watching the how the values change between office visits. More than this, though, he should actually be taking your blood pressure more than once during each office visit.
Because things like temperature and stress can change blood pressure, more than one reading in a single office visit allows the ability to correct for these variations. For example, your blood pressure is often higher at the beginning of an office visit than at the end. Taking a reading at both the beginning and the end gives a more accurate average reading.
Your doctor should be checking your blood pressure:
- In both arms, not just one
- At both the beginning and the end of your appointment
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What Is Diastolic Blood Pressure
The second number in a blood pressure measurement is your diastolic blood pressure, which indicates the pressure in your arteries between heartbeats.
A normal diastolic blood pressure usually comes in at around 80 or less, while a reading between 80 and 89 is considered normal, but higher than ideal. Repeated blood pressure readings of 90 or higher are where cause for concern may start, as they can be indicative of high blood pressure.
Normal And Abnormal Blood Pressure Levels For Men Over 50
If you are over 50, the recommendation of how far you should keep your blood pressure off is usually closely dependent on certain health conditions that you have.
According to an article published on the official site of the Department of Health and Human Services, the level of blood pressure that is higher than 140/90 mm Hg in men over 50 can be categorized into hypertension.
So, make sure to control the systolic and diastolic numbers lower than 140 /90! However, your doctor may ask you to keep your blood pressure much lower than 140 /90 if you have certain health problem. For more advice, talk with your doctor!
Update: New guidelines from most Health Organizations announced that 130/80 mm HG is now categorized into hypertension for all adults younger than age 65 . This suggests, there would be more men over 50 categorized as having hypertension.
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