What is blood pressure?
When your heart beats, it pumps blood around your body to give it the energy and oxygen it needs. As the blood moves, it pushes against the sides of the blood vessels. The strength of this pushing is your blood pressure. If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and this may lead to heart attacks and strokes. The first (or top) number is your systolic blood pressure. It is the highest level your blood pressure reaches when your heart beats. The second (or bottom) number is your diastolic blood pressure. It is the lowest level your blood pressure reaches as your heart relaxes between beats.
Why Monitor Your Blood Pressure?
- 1 in 3 Americans have elevated blood pressure and don’t know they have it.
- Untreated hypertension can lead to heart damage, heart attack, congestive heart failure, aortic dissection, chronic kidney disease, atherosclerosis (fatty buildups in the arteries that cause them to harden), stroke and eye damage that impairs vision.
- Treatment of high blood pressure substantially decreases the incidence of cardiovascular events.
- Blood pressures can be artificially elevated in the office visit due to stress, caffeine intake, smoking, pain or anxiety. It may reflect a temporary reading that wouldn’t warrant treatment. Home blood pressures can give a more accurate representation.
How To Measure Blood Pressure at Home
- Don’t smoke, drink caffeinated beverages, or exercise for 30 minutes before you measure.
- Measure at the same time each day.
- Place the cuff around a bare arm.
- Rest for five minutes before measuring your blood pressure.
- Sit with your back supported, your feet flat on the floor, and your arm supported (with the upper arm at heart level) while you measure your blood pressure.
- Don’t talk while you are measuring.
- Record both the top number (systolic pressure) and the bottom number (diastolic pressure), along with the date and the time taken.
- Take readings for several days in a row and at different times of the day.
Current Thinking About Goal Blood Pressure
In December 2013, a panel of experts on hypertension (the Joint National Committee known as JNC 8) published updated recommendations for blood pressure goals in the Journal of the American Medical Association. These recommendations allowed for higher blood pressure numbers. However, a more recent study in late 2015, The Systolic Blood Pressure Intervention Trial, or SPRINT, included more than 9,300 people with high blood pressure who were age 50 and older and had at least one other risk factor for heart disease and stroke. Lowering the systolic blood pressure to 120 reduced the risk of having or dying from a heart attack, stroke or heart failure by a quarter. When investigators looked only at deaths caused by heart disease and stroke, the nation’s No. 1 and No. 5 killers, the risk of dying fell by 43 percent in the more aggressively treated group. The risk of dying from any cause fell by 27 percent.
- Age 60+: The blood pressure goal is 150/90 if you are healthy and have no other cardiovascular risk factors.
- Under age 60: The goal is 140/90 if you are healthy and have no other cardiovascular risk factors.
- If you have other risk factors (i.e. smoker, diabetes, family history of cardiovascular disease) then a discussion of treatment with your provider is warranted for a blood pressure above 120/80.
- Above 180/110: Seek medical attention the same day.
What Can You Do to Improve Blood Pressures?
First choice therapies for elevated blood pressure are lifestyle changes:
- Eat healthy foods. Try the Dietary Approaches to Stop Hypertension (DASH) plan.
- Be physically active. Aim for 30 minutes of aerobic activity daily.
- Maintain a healthy weight. If you’re overweight, losing even 10 pounds can lower blood pressure.
- Reduce sodium intake. 2.3 grams per day, about a teaspoon of table salt.
- Limit alcohol intake. Two drinks per day for men and one drink for women. One drink equals 12 ounces of beer, five ounces of wine, or 1.5 ounces of 80-proof liquor.
- Stop smoking. It reduces the risk of having a heart attack or stroke.
Approx. Systolic BP Reduction
|Reduce Weight||5-20 / 10kg|
|Adopt DASH Eating Plan||8-14|
|Lower Sodium Intake||2-8|
|Moderation of Alcohol Consumption||2-4|
Lifestyle interventions can control blood pressure if the elevation is mild to moderate or can reduce medications if your blood pressure is higher. Your provider should discuss these interventions with you before starting medication.
DISCLAIMER: The contents and opinions expressed by Everett Clinic teammates and providers on “A Healthier You” blog and those providing comments are theirs alone and are not a substitute for medical advice. Consult your own provider for personal health recommendations.
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