Q: What Advice Do You Give Patients Whose Blood Pressure Is In The 130/80 Range Who Previously Werent Diagnosed With High Blood Pressure And Now They Have It
A: This new classification is not saying that you or your doctor have been doing anything wrong with your blood pressure. We have always classified blood pressure above 120/80 as high. The goal of the new classification is to raise awareness about high blood pressure and improve treatment. By diagnosing high blood pressure earlier, we can help prevent more heart attacks and strokes. These new guidelines are not necessarily going to change whether you are prescribed medication for your high blood pressure or what medications youre on the levels. Were still prescribing the same medications you were on before. We are trying to help give everyone access to the treatments they need and more early aggressive treatment. Were just focusing a lot more on diet, weight loss and exercise.
Its really at 140/90 that were treating patients with medications. At 130/80, were looking at lifestyle changes. Its only people with a lot of risk factors that we will be aggressive with and try to get lower than 130/80.
Does High Blood Pressure Lead To Weight Gain
Some high blood pressure medications can, in fact, lead to weight gain. Common offenders include older beta-blockers such as propranolol and atenolol . There could be several reasons for this — including the fact that the medications can make patients feel tired and thus less likely to exercise.
- Minoxidil tablets — used only when other antihypertensive medications have failed — can also cause weight gain.
- Weight gain is also listed as a common side effect of doxazosin . Diuretics are more likely to cause weight loss.
Whats Considered High Blood Pressure In Adults
Healthy blood pressure in adults is a reading of 120/80 mm Hg or below. But, what does it mean if your blood pressure numbers are higher than this?
A blood pressure of 120 to 129 mm Hg systolic and under 80 mm Hg diastolic is considered elevated. Elevated blood pressure means you have a greater risk of developing high blood pressure later on.
Your doctor may suggest eating less salt, eating a heart healthy diet, or living a more active lifestyle.
If your blood pressure reading falls into any of the following ranges, its important to talk with your doctor about medication or other lifestyle changes that may help keep your hypertension under control.
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When To Call Your Doctor
The risks of both high and low blood pressure make monitoring your blood pressure at home essential to your overall health and well-being. Both Dr. Wong and Dr. Desai recommend calling your healthcare provider if your self-monitored blood pressure readings are greater than 180/120 mmHgeven if you have no other symptoms.
You should call 911 if these blood pressure readings are associated with symptoms of organ damage, such as headache, vision changes, weakness, numbness, chest pain or shortness of breath, says Dr. Wong.
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Normal Blood Pressure For Men
Men are recommended to have an average normal blood pressure of 120/80 however, as we have noted, there are varying factors to consider when determining what works for each person. What is normal for a man in his 30s is not deemed a normal reading for a man in his 60s.
The following are the average blood pressures and the corresponding lows and highs for men from ages 15 to 64 years.
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The Question Of Drug Dosages
In the 1960s we were still using medications that caused numerous side effectscentrally acting drugs, such as methyldopa and clonidine monoamine oxidase inhibitors vasodilators, such as hydralazine and potent sympathetic blockers. Dosages were higher than necessary. We had not realized that dose response curves for these agents were often not linearthat 300 mg/day of hydralazine was not always more effective than 150 mg or that 600 mg would not necessarily lower blood pressure more than 300 mg. Yet some investigators were using doses as high as 1 g or more a daypositive antinuclear antibodies tests were common and cases of lupus were reported at these higher dosages. Physicians in the United Kingdom were using propranolol in dosages up to 3 g a day. Small wonder that patients were fatigued or impotent and that many physicians were reluctant to use drugs to treat people with less severe disease and few or no symptoms. We have since learned that with many drugs, including the diuretics, ACE inhibitors, -blockers, etc, the percentage of responders does not always increase as dosage increases. Smaller doses often produce almost as great an effect as larger ones.
British Columbia Specific Information
High blood pressure, also called hypertension, can damage your blood vessels, heart and kidneys. This damage can cause a heart attack, stroke or other health problems. Your blood pressure reading is based on two measurements called systolic and diastolic. The systolic and diastolic are written as a ratio, for example . A reading of more than 140/90 mmHg taken at your healthcare providers office may indicate high blood pressure. This figure is different for people with diabetes whose blood pressure should be below 130/80 mmHg. People suffering from other illnesses will have different target normal values. For more information on hypertension, visit the Heart & Stroke Foundation and Hypertension Canada.
Healthy lifestyle choices can help lower your blood pressure and improve your health. For information on healthy eating for lowering your blood pressure, see:
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How Often Should You Get Your Blood Pressure Checked
If your blood pressure is higher than it should be, follow your doctors advice with regard to how often you should check your blood pressure at home. Also find out from your doctor what you should do if your blood pressure readings are higher than usual.
If you dont have high blood pressure, its still important to get it checked regularly, as blood pressure can change over time. Medical experts suggest the following timeline for low risk individuals:
- For people between 18 and 40. Get your blood pressure checked at least once every 2 years.
- For anyone over 40. Get your blood pressure checked at least once a year.
You may need to have your blood pressure checked more regularly if you:
- have a family history of hypertension
- have heart disease, diabetes, or kidney disease
- are overweight or have obesity
- have sleep apnea or insomnia
You dont necessarily have to get your blood pressure checked at your doctors office. Some health care clinics do free blood pressure screenings. You may also schedule an appointment at your local pharmacy.
Untreated and uncontrolled high blood pressure can damage your blood vessels and other organs, including your heart, kidneys, eyes, and brain.
Complications of hypertension can include:
Does Normal Blood Pressure Change With Age
Just as our blood pressure readings change according to our posture, sleep time, and stress levels throughout the day, our blood pressure changes as we age. Despite the fluctuating or changing measurements, we should maintain a normal range. As we age, we can expect changes in our cardiovascular health, including our blood pressure and cholesterol levels. There are several factors that reflect our blood pressure levels over the years, including normal blood pressure for seniors.
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What Questions Might I Be Asked In The Emergency Room
Your healthcare provider will interview you when you enter the emergency room. Do your best to prepare yourself to answer the following questions, and more, that your healthcare provider may ask.
- What medications are you on?
- Did you forget your blood pressure medication?
- What symptoms do you have?
- How long have you had these symptoms?
If youre unable to check your blood pressure, but think it might be high, dont hesitate to call 911 or go to the emergency room.
Last reviewed by a Cleveland Clinic medical professional on 01/14/2021.
The Ideal Blood Pressure Levels
Maximum blood pressure values of 120/80 when physically at rest are considered ideal for an adult. Blood pressure levels up to 139/89 are within the normal range that do not pose any health risk. Levels over 129/84, however, are already considered in the elevated-normal range.
Blood pressure readings over 159/99 are considered to be minor hypertension and require a medical attention to avoid harmful complications.
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Blood Pressure 100 Plus Your Age
Synopsis:Examines the past ideal blood pressure reading of 100 plus your age versus todays so called blood pressure targets. A former NASA astronaut and family doctor, says the 100+ age guideline for “normal” blood pressure was around for decades. The goal of maintaining a blood pressure at or near 140/80 is based on drug company hype, not science.
What Does High Blood Pressure Feel Like
High blood pressure often doesnt have any symptoms, so you usually dont feel it.
Hypertension is usually diagnosed by a health care professional during a routine checkup. The average person should get a blood pressure reading at least once a year. As a cardiologist, I think its important for everyone to know their numbers. That means knowing what your blood pressure is. And it also means knowing your blood sugar level, cholesterol and body mass index. When you know your numbers, you can work with your doctor to make a plan to reduce any risks.
Blood pressure is even more important to pay attention to, though, if you have a close relative with hypertension or other risk factors. And know that if your blood pressure is extremely high, you may have unusually severe headaches, chest pain, difficulty breathing or get easily worn out by workouts. If you have any of these symptoms, see your doctor right away.
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Q: What Prompted The Guideline Change
A: Hypertension is one of the biggest risk factors for heart disease and stroke. Lower blood pressure is associated with improved outcomes. What this group did was look at all the studies and determined the association of each level of blood pressure and your risk for heart disease and stroke. Redefining these, while it does classify more people with Stage 1 hypertension, its going to give them better access to treatments, therapies, knowledge and awareness of having high blood pressure so we can prevent heart disease and stroke.
What Do Blood Pressure Readings Mean
The American Heart Association defines normal blood pressure as less than 120/80. Elevated blood pressure ranges between 120/80 and 129/80, and high blood pressure is 130/80 and higher. In pregnancy, normal blood pressure should be below 120/80.
If your blood pressure reaches the high range, you should see your doctor about lifestyle changes, and possibly medication especially if you have other risk factors, such as diabetes or heart disease.
High blood pressure may indicate an emergency situation. If this high blood pressure is associated with chest pain, shortness of breath, headache, dizziness, or back or abdominal pain, seek medical care immediately. If you are experiencing no associated symptoms with a high blood pressure reading such as this, re-check it again within a few minutes and contact your doctor or go to an emergency room if it is still high.
If your blood pressure is lower than about 100/60 you may have low blood pressure, depending on the associated symptoms. If you are unsure, check with your doctor.
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Where Do We Go From Here
There are several newer antihypertensive agents, such as the angiotensin II receptor antagonists, that are now available. At present, however, we have no data that their use will decrease morbidity and mortality to either as great or a greater degree than older medications. The angiotensin II antagonists are highly effective when used with small doses of a diuretic, and the cough induced by ACE inhibitors in about 15% to 20% of cases is not a problem.
Renin inhibitors and vasopressor antagonists are also being studied, as are medications that either augment the effects or prevent the degradation of endothelium-relaxing factor .
Endopeptidase inhibitors that prevent the breakdown of atrial naturetic factor, which increases sodium excretion and lowers blood pressure, might also prove useful. Some investigators also believe that if insulin sensitivity can be increased, blood pressure might be better controlled.
Finally, several genes have been identified that may play a causative role in hypertension. Mutations of these genes have been identified in certain susceptible populations. The potential for gene therapy in hypertension is one that will be watched with interest.
Why Do I Need A Blood Pressure Chart
Older persons, those with a hereditary predisposition, heart problems, or systemic diseases are all especially prone to high blood pressure. A blood pressure chart helps a person to monitor their individual values, to identify abnormalities early on, and to treat unhealthy blood pressure values at an early stage.
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Does High Blood Pressure Have Any Symptoms
High blood pressure typically doesnt have any warning signs. Thats why its often called the silent killer. Because there may not be any symptoms, many people are unaware that they have high blood pressure.
However, early detection of hypertension is key as it can increase your risk for heart disease, stroke, kidney damage, and more.
If your blood pressure is dangerously high, you may have the following symptoms:
But, its important to know about your high blood pressure and the health risks it poses before it gets to this stage.
The only way to know for sure if you have hypertension is to get your blood pressure measured. You can then work with your doctor to find the treatment options that work best for keeping your blood pressure in a healthy range.
Q: What Can People Do Between Visits To The Doctor To Monitor Their Blood Pressure
A: We tell our patients to check their blood pressure at home before they take their medications. Write those numbers down and bring them to your visit. Bring your home blood pressure monitor to the clinic so we can look at those readings and correlate with office blood pressure measurements. We want to get better at tracking blood pressure so we know where each patient is at.
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Research Efforts Continued As Therapy Improved
In 1957, Dr. Page attempted to explain the mystery of hypertension as a mosaic . Many of the drugs that were and still are being used affect some of the factors noted in the mosaic theory of hypertension. For example, -blockers or angiotensin converting enzyme inhibitors block the effects of the sympathetic nervous system or the renin-angiotensin-aldosterone system. -Blockers reduce the contractile force and rate of the heartbeat diuretics increase excretion of sodium and water, etc. More recently, genes and gene mutations have been identified that someday may lead to the development of therapies that more specifically address the basic mechanisms that Dr. Page envisioned.
Blood Pressure: How High Is Too High And What Can You Do
Alan Segal, MD, is a nephrologist at The University of Vermont Medical Center where he is also Director of the Nephrology Fellowship Program. He is also an associate professor at the Larner College of Medicine at UVM.
High blood pressure, clinically known as hypertension, affects nearly 75 million adults in the United States and 1 billion people globally. Although one-third of adults in the United States are affected, only half of them have their blood pressure controlled.
That has significant costs, both in terms of health and economics. The estimated economic burden for hypertension in 2014 was nearly $75 billion worldwide. It is the single largest contributor to death and disability worldwide, in large part because it dramatically increases the risk of stroke, heart attack, heart failure, and chronic kidney disease. For example, starting at a blood pressure of 115/75, the risk of death doubles for every 20 mmHg increase in systolic pressure , and for every 10 mmHg increase in diastolic pressure .
Hypertension is the most common reason for office visits in adults and more prescriptions are written for blood pressure lowering drugs than for any other drug class.
Lets review the most frequently asked questions about hypertension and how to treat it.
What is blood pressure and what is hypertension?
According to the Joint National Committee :
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Heart Rate Vs Blood Pressure
Blood pressure measures the force that moves blood through your blood vessels while your heart rate is the number of times your heart beats per minute. They are both important health indicators, but they are measured independently and dont necessarily increase or decrease synchronously.
A temporary increase in heart rate, such as during exercise, is not considered problematic. In fact, your heart is expected to rise during a bout of activity and return to its resting rate afterward. And the more intense you work, the more you should expect your heart rate to rise during exercise. Your heart rate can safely double during activity so long as it returns to its resting rate relatively soon after you finish your workout.
Significant increases in blood pressure, on the other hand, are not normal and should be monitored and shared with your health care provider.