What do the numbers mean?
Everyone would like to have healthy blood pressure. But what exactly does that mean?
When your doctor takes your blood pressure, it’s expressed as a measurement with two numbers, with one number on top (systolic) and one on the bottom (diastolic), like a fraction. For example, 120/80 mm Hg.
The top number refers to the amount of pressure in your arteries during the contraction of your heart muscle. This is called systolic pressure.
The bottom number refers to your blood pressure when your heart muscle is between beats. This is called diastolic pressure.
Both numbers are important in determining the state of your heart health.
Numbers greater than the ideal range indicate that your heart is working too hard to pump blood to the rest of your body.
What’s a normal reading?
For a normal reading, your blood pressure needs to show a top number (systolic pressure) that’s between 90 and less than 120 and a bottom number (diastolic pressure) that’s between 60 and less than 80. The American Heart Association (AHA) considers blood pressure to be within the normal range when both your systolic and diastolic numbers are in these ranges.
Blood pressure readings are expressed in millimeters of mercury. This unit is abbreviated as mm Hg. A normal reading would be any blood pressure below 120/80 mm Hg and above 90/60 mm Hg in an adult.
If you’re in the normal range, no medical intervention is needed. However, you should maintain a healthy lifestyle and healthy weight to help prevent hypertension from developing. Regular exercise and healthy eating can also help. You may need to be even more mindful of your lifestyle if hypertension runs in your family.
Elevated blood pressure
Numbers higher than 120/80 mm Hg are a red flag that you need to take on heart-healthy habits.
When your systolic pressure is between 120 and 129 mm Hg and your diastolic pressure is less than 80 mm Hg, it means you have elevated blood pressure.
Although these numbers aren’t technically considered high blood pressure, you’ve moved out of the normal range. Elevated blood pressure has a good chance of turning into actual high blood pressure, which puts you at an increased risk of heart disease and stroke.
No medications are necessary for elevated blood pressure. But this is when you should adopt healthier lifestyle choices. A balanced diet and regular exercise can help lower your blood pressure to a healthy range and help prevent elevated blood pressure from developing into full-fledged hypertension.
Hypertension: Stage 1
You’ll generally be diagnosed with high blood pressure if your systolic blood pressure reaches between 130 and 139 mm Hg, or if your diastolic blood pressure reaches between 80 and 89 mm Hg. This is considered stage 1 hypertension.
However, the AHA notes that if you get only one reading this high, you may not truly have high blood pressure. What determines the diagnosis of hypertension at any stage is the average of your numbers over a period of time.
Your doctor can help you measure and track your blood pressure to confirm whether it’s too high. You may need to start taking medications if your blood pressure doesn’t improve after one month of following a healthy lifestyle, especially if you’re already at high risk for heart disease. If you’re at lower risk, your doctor may want to follow up in three to six months after you’ve adopted more healthy habits.
If you’re 65 years or older and otherwise healthy, your doctor will likely recommend treatment and lifestyle changes once your systolic blood pressure is greater than 130 mm Hg. The treatment for adults 65 and older who have significant health problems should be made on a case-by-case basis.
Treating high blood pressure in older adults appears to decrease memory problems and dementia.
Hypertension: Stage 2
Stage 2 high blood pressure indicates an even more serious condition. If your blood pressure reading shows a top number of 140 or more, or a bottom number of 90 or more, it’s considered stage 2 hypertension.
At this stage, your doctor will recommend one or more medications for keeping your blood pressure under control. But you shouldn’t rely solely on medications to treat hypertension. Lifestyle habits are just as important in stage 2 as they are in the other stages.
Some medications that can complement a healthy lifestyle include:
- ACE inhibitors to block substances that tighten blood vessels
- alpha-blockers used for relaxing arteries
- beta-blockers to decrease heart rate and block substances that tighten blood vessels
- calcium channel blockers to relax blood vessels and decrease the work of the heart
- diuretics to decrease the amount of fluid in your body, including your blood vessels
A blood pressure reading above 180/120 mm Hg indicates a serious health problem. The AHA refers to these high measurements as a “hypertensive crisis.” Blood pressure in this range requires urgent treatment even if there are no accompanying symptoms.
You should seek emergency treatment if you have blood pressure in this range, which may accompany symptoms such as:
- chest pain
- shortness of breath
- visual changes
- symptoms of stroke, such as paralysis or a loss of muscle control in the face or an extremity
- blood in your urine
However, sometimes a high reading can occur temporarily and then your numbers will return to normal. If your blood pressure measures at this level, your doctor will likely take a second reading after a few minutes have passed. A second high reading indicates that you’ll need treatment either as soon as possible or immediately depending on whether or not you have any of the symptoms described above.
Even if you have healthy numbers, you should take preventive measures to keep your blood pressure in the normal range. This can help you lower your risk of developing hypertension, heart disease, and stroke.
As you age, prevention becomes even more important. Systolic pressure tends to creep up once you’re older than 50, and it’s far more importantTrusted Source in predicting the risk of coronary heart disease and other conditions. Certain health conditions, such as diabetes and kidney disease, may also play a role. Talk to your doctor about how you can manage your overall health to help prevent the onset of hypertension.
The following preventive measures can help lower or stave off high blood pressure:
Reducing sodium intake
Reduce your sodium intake. Some people are sensitive to the effects of sodium. These individuals shouldn’t consume more than 2,300 mg per day. Adults who already have hypertension may need to limit their sodium intake to 1,500 mg per day.
It’s best to start by not adding salt to your foods, which would increase your overall sodium intake. Limit processed foods as well. Many of these foods are low in nutritional value while also high in fat and sodium.
Reducing caffeine intake
Reduce your caffeine intake. Talk to your doctor to see if caffeine sensitivity plays a role in your blood pressure readings.
Exercise more often. Consistency is key in maintaining a healthy blood pressure reading. It’s better to exercise 30 minutes every day rather than a few hours only on the weekends. Try this gentle yoga routine to lower your blood pressure.
Maintaining a healthy weight
If you’re already at a healthy weight, maintain it. Or lose weight if necessary. If overweight, losing even 5 to 10 pounds can make an impact on your blood pressure readings.
Manage your stress levels. Moderate exercise, yoga, or even 10-minute meditation sessions can help.
Reducing alcohol intake and quitting smoking
Reduce your alcohol intake. Depending on your situation, you may need to stop drinking altogether. It’s also important to quit or refrain from smoking. Smoking is incredibly harmful to your heart health.
Blood pressure that’s too low
Low blood pressure is known as hypotension. In adults, a blood pressure reading of 90/60 mm Hg or below is often considered hypotension. This can be dangerous because blood pressure that is too low doesn’t supply your body and heart with enough oxygenated blood.
Some potential causes of hypotension can include:
- heart problems
- blood loss
- severe infection (septicemia)
- endocrine problems
- certain medications
Hypotension is usually accompanied by lightheadedness or dizziness. Talk to your doctor to find out the cause of your low blood pressure and what you can do to raise it.
Keeping your blood pressure in the normal range is crucial in preventing complications, such as heart disease and stroke. A combination of healthy lifestyle habits and medications can help lower your blood pressure. If you’re overweight, weight loss is also important in keeping your numbers down.
Remember that a single blood pressure reading doesn’t necessarily classify your health. An average of blood pressure readings taken over time is the most accurate. That’s why it’s often ideal to have your blood pressure taken by a healthcare professional at least once a year. You may require more frequent checks if your readings are high.
Alcohol: Does it affect blood pressure?
Does drinking alcohol affect your blood pressure?
Answer From Francisco Lopez-Jimenez, M.D.
Drinking too much alcohol can raise blood pressure to unhealthy levels. Having more than three drinks in one sitting temporarily raises your blood pressure, but repeated binge drinking can lead to long-term increases.
To understand how much alcohol is too much and how cutting back can lower your blood pressure, it may be helpful to know the definitions of excessive drinking.
- Binge drinking is defined as four or more drinks within two hours for women and five or more drinks within two hours for men.
- Moderate drinking is up to one drink a day for women, two for men.
- Heavy drinking is more than three drinks a day for women, four for men.
Heavy drinkers who cut back to moderate drinking can lower their top number in a blood pressure reading (systolic pressure) by about 5.5 millimeters of mercury (mm Hg) and their bottom number (diastolic pressure) by about 4 mm Hg.
If you have high blood pressure, avoid alcohol or drink alcohol only in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
A drink is 12 ounces (355 milliliters) of beer, 5 ounces (148 milliliters) of wine or 1.5 ounces (44 milliliters) of 80-proof distilled spirits.
Keep in mind that alcohol contains calories and may contribute to unwanted weight gain — a risk factor for high blood pressure Also, alcohol can interact with certain blood pressure medications, affecting the level of the medication in your body or increasing side effects.sources
Exercise: A drug-free approach to lowering high blood pressure
Your risk of high blood pressure (hypertension) increases with age, but getting some exercise can make a big difference. And if your blood pressure is already high, exercise can help you control it. Don’t think you’ve got to run a marathon or join a gym. Instead, start slow and work more physical activity into your daily routine.
How exercise can lower your blood pressure
How are high blood pressure and exercise connected? Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. If your heart can work less to pump, the force on your arteries decreases, lowering your blood pressure.
Becoming more active can lower your systolic blood pressure — the top number in a blood pressure reading — by an average of 4 to 9 millimeters of mercury (mm Hg). That’s as good as some blood pressure medications. For some people, getting some exercise is enough to reduce the need for blood pressure medication.
If your blood pressure is at a desirable level — less than 120/80 mm Hg — exercise can help prevent it from rising as you age. Regular exercise also helps you maintain a healthy weight — another important way to control blood pressure.
But to keep your blood pressure low, you need to keep exercising on a regular basis. It takes about one to three months for regular exercise to have an impact on your blood pressure. The benefits last only as long as you continue to exercise.
How much exercise do you need?
Aerobic activity can be an effective way to control high blood pressure. But flexibility and strengthening exercises such as lifting weights are also important parts of an overall fitness plan. You don’t need to spend hours in the gym every day to benefit from aerobic activity. Simply adding moderate physical activities to your daily routine will help.
Any physical activity that increases your heart and breathing rates is considered aerobic activity, including:
- Household chores, such as mowing the lawn, raking leaves, gardening or scrubbing the floor
- Active sports, such as basketball or tennis
- Climbing stairs
The Department of Health and Human Services recommends getting at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous activity. Aim for at least 30 minutes of aerobic activity most days of the week.
If you can’t set aside that much time at once, remember that shorter bursts of activity count, too. You can break up your workout into three 10-minute sessions of aerobic exercise and get the same benefit as one 30-minute session.
Also, if you sit for several hours a day, try to reduce the amount of time you spend sitting. Research has found that too much sedentary time can contribute to many health conditions. Aim for five to 10 minutes of low-intensity physical activity — such as getting up to get a drink of water or going on a short walk — each hour. Consider setting a reminder in your email calendar or on your smartphone.
Weight training and high blood pressure
Weight training can cause a temporary increase in blood pressure during exercise. This increase can be dramatic, depending on how much weight you lift.
But weightlifting can also have long-term benefits to blood pressure that outweigh the risk of a temporary spike for most people. And it can improve other aspects of cardiovascular health that can help to reduce overall cardiovascular risk. The Department of Health and Human Services recommends incorporating strength training exercises of all the major muscle groups into a fitness routine at least two times a week.
If you have high blood pressure and you’d like to include weight training in your fitness program, remember:
- Learn and use proper form. Using proper form and technique when weight training reduces the risk of injury.
- Don’t hold your breath. Holding your breath during exertion can cause dangerous spikes in blood pressure. Instead, breathe easily and continuously during each exercise.
- Lift lighter weights more times. Heavier weights require more strain, which can cause a greater increase in blood pressure. You can challenge your muscles with lighter weights by increasing the number of repetitions you do.
- Listen to your body. Stop your activity right away if you become severely out of breath or dizzy, or if you experience chest pain or pressure.
If you have high blood pressure, get your doctor’s OK before adding weight training exercises to your fitness routine.
When you need your doctor’s OK
Sometimes it’s best to check with your doctor before you jump into an exercise program, especially if:
- You’re a man older than age 45 or a woman older than age 55.
- You smoke or quit smoking in the past six months.
- You’re overweight or obese.
- You have a chronic health condition, such as diabetes, cardiovascular disease or lung disease.
- You have high cholesterol or high blood pressure.
- You’ve had a heart attack.
- You have a family history of heart-related problems before age 55 in men and age 65 in women.
- You feel pain or discomfort in your chest, jaw, neck or arms during activity.
- You become dizzy with exertion.
- You’re unsure if you’re in good health or you haven’t been exercising regularly.
If you take any medication regularly, ask your doctor if exercising will make it work differently or change its side effects — or if your medication will affect the way your body reacts to exercise.
Keep it safe
To reduce the risk of injury while exercising, start slowly. Remember to warm up before you exercise and cool down afterward. Build up the intensity of your workouts gradually.
Stop exercising and seek immediate medical care if you experience any warning signs during exercise, including:
- Chest, neck, jaw or arm pain or tightness
- Dizziness or faintness
- Severe shortness of breath
- An irregular heartbeat
Monitor your progress
The only way to detect high blood pressure is to keep track of your blood pressure readings. Have your blood pressure checked at each doctor’s visit, or use a home blood pressure monitor.
If you already have high blood pressure, home monitoring can let you know if your fitness routine is helping to lower your blood pressure, and may make it so you don’t need to visit your doctor to have your blood pressure checked as often. Home blood pressure monitoring isn’t a substitute for visits to your doctor, and home blood pressure monitors may have some limitations.
If you decide to monitor your blood pressure at home, you’ll get the most accurate readings if you check your blood pressure before you exercise.
How to check your blood pressure manually
To manually take your blood pressure, you’ll need a blood pressure cuff with a squeezable balloon and an aneroid monitor, also known as a sphygmomanometer, and a stethoscope. An aneroid monitor is a number dial. If possible, enlist the help of a friend or family member, because it can be difficult to use this method on your own.
Here are the steps to taking your blood pressure at home:
- Before taking your blood pressure, make sure you’re relaxed. Position your arm straight, palm facing up on a level surface, such as a table. You’ll place the cuff on your bicep and squeeze the balloon to inflate the cuff. Using the numbers on the aneroid monitor, inflate the cuff about 20-30 mm Hg over your normal blood pressure. If you don’t know your normal blood pressure, ask your doctor how much you should inflate the cuff.
- Once the cuff is inflated, place the stethoscope with the flat side down on the inside of your elbow crease, toward the inner part of your arm where the major artery of your arm is located. Be sure to test the stethoscope before using it to make sure you can hear properly. You can do that by tapping on the stethoscope. It’s also helpful to have a high-quality stethoscope and to ensure that the ears of the stethoscope are pointed in toward your eardrums.
- Slowly deflate the balloon as you listen through the stethoscope to hear the first “whoosh” of the blood flowing, and remember that number. This is your systolic blood pressure. You’ll hear the blood pulsing, so keep listening and allow the balloon to slowly deflate until that rhythm stops. When the rhythm stops, record that measurement. This is your diastolic blood pressure. You’ll record your blood pressure as the systolic over the diastolic, such as 115/75.
Apps to track blood pressure
Although there are apps that promise to check your blood pressure without using equipment, this isn’t an accurate or reliable method.
However, there are apps available that can help you track your blood pressure results. This can be helpful in identifying patterns in your blood pressure. Your doctor may use this information to determine if you require blood pressure medications.
Some examples of free blood pressure-monitoring apps include:
- Blood Pressure Monitor – Family Litefor iPhone. You can enter your blood pressure, weight, and height, as well as track the medications you take.
- Blood Pressure for Android. This app tracks your blood pressure and features several statistical and graphical analysis tools.
- Blood Pressure Companion for iPhone. This app allows you to track your blood pressure as well as view graphs and trends on your blood pressure readings across several days or weeks.
These apps can help you quickly and easily track your blood pressure readings. Measuring your blood pressure regularly on the same arm can help you most accurately track your blood pressure readings.sources
High blood pressure dangers: Hypertension’s effects on your body
High blood pressure is a risk factor for more than heart disease. Discover what complications high blood pressure can cause.
High blood pressure (hypertension) can quietly damage your body for years before symptoms develop. Uncontrolled high blood pressure can lead to disability, a poor quality of life, or even a fatal heart attack or stroke.
Treatment and lifestyle changes can help control your high blood pressure to reduce your risk of life-threatening complications.
Here’s a look at the complications uncontrolled high blood pressure can cause.
Damage to your arteries
Healthy arteries are flexible, strong and elastic. Their inner lining is smooth so that blood flows freely, supplying vital organs and tissues with nutrients and oxygen.
Hypertension gradually increases the pressure of blood flowing through your arteries. As a result, you might have:
- Damaged and narrowed arteries. High blood pressure can damage the cells of your arteries’ inner lining. When fats from your diet enter your bloodstream, they can collect in the damaged arteries. Eventually, your artery walls become less elastic, limiting blood flow throughout your body.
- Aneurysm. Over time, the constant pressure of blood moving through a weakened artery can cause a section of its wall to enlarge and form a bulge (aneurysm). An aneurysm can potentially rupture and cause life-threatening internal bleeding. Aneurysms can form in any artery, but they’re most common in your body’s largest artery (aorta).
Damage to your heart
High blood pressure can cause many problems for your heart, including:
- Coronary artery disease. Arteries narrowed and damaged by high blood pressure have trouble supplying blood to your heart. When blood can’t flow freely to your heart, you can have chest pain (angina), irregular heart rhythms (arrhythmias) or a heart attack.
- Enlarged left heart. High blood pressure forces your heart to work harder to pump blood to the rest of your body. This causes part of your heart (left ventricle) to thicken. A thickened left ventricle increases your risk of heart attack, heart failure and sudden cardiac death.
- Heart failure. Over time, the strain on your heart caused by high blood pressure can cause the heart muscle to weaken and work less efficiently. Eventually, your overwhelmed heart begins to fail. Damage from heart attacks adds to this problem.
Damage to your brain
Your brain depends on a nourishing blood supply to work properly. But high blood pressure can cause several problems, including:
- Transient ischemic attack (TIA). Sometimes called a ministroke, a TIA is a brief, temporary disruption of blood supply to your brain. Hardened arteries or blood clots caused by high blood pressure can cause TIA. TIA is often a warning that you’re at risk of a full-blown stroke.
- Stroke. A stroke occurs when part of your brain is deprived of oxygen and nutrients, causing brain cells to die. Blood vessels damaged by high blood pressure can narrow, rupture or leak. High blood pressure can also cause blood clots to form in the arteries leading to your brain, blocking blood flow and potentially causing a stroke.
- Dementia. Narrowed or blocked arteries can limit blood flow to the brain, leading to a certain type of dementia (vascular dementia). A stroke that interrupts blood flow to the brain can also cause vascular dementia.
- Mild cognitive impairment. This condition is a transition stage between the changes in understanding and memory that generally come with aging and the more-serious problems caused by dementia. Studies suggest that high blood pressure can lead to mild cognitive impairment.
Damage to your kidneys
Kidneys filter excess fluid and waste from your blood — a process that requires healthy blood vessels. High blood pressure can damage the blood vessels in and leading to your kidneys. Having diabetes in addition to high blood pressure can worsen the damage.
Kidney problems caused by high blood pressure include:
- Kidney scarring (glomerulosclerosis). This type of kidney damage occurs when tiny blood vessels within the kidney become scarred and unable to effectively filter fluid and waste from your blood. Glomerulosclerosis can lead to kidney failure.
- Kidney failure. High blood pressure is one of the most common causes of kidney failure. Damaged blood vessels prevent kidneys from effectively filtering waste from your blood, allowing dangerous levels of fluid and waste to accumulate. You might ultimately require dialysis or kidney transplantation.
Damage to your eyes
High blood pressure can damage the tiny, delicate blood vessels that supply blood to your eyes, causing:
- Damage to your retina (retinopathy). Damage to the light-sensitive tissue at the back of your eye (retina) can lead to bleeding in the eye, blurred vision and complete loss of vision. You’re at an even greater risk if you have diabetes in addition to high blood pressure.
- Fluid buildup under the retina (choroidopathy). Choroidopathy can result in distorted vision or sometimes scarring that impairs vision.
- Nerve damage (optic neuropathy). Blocked blood flow can damage the optic nerve, leading to bleeding within your eye or vision loss.
The inability to have and maintain an erection (erectile dysfunction) becomes increasingly common in men as they reach age 50. But men with high blood pressure are even more likely to experience erectile dysfunction. That’s because limited blood flow caused by high blood pressure can block blood from flowing to your penis.
Women can also experience sexual dysfunction as a result of high blood pressure. Reduced blood flow to the vagina can lead to a decrease in sexual desire or arousal, vaginal dryness, or difficulty achieving orgasm.
High blood pressure emergencies
High blood pressure is usually a chronic condition that gradually causes damage over the years. But sometimes blood pressure rises so quickly and severely that it becomes a medical emergency requiring immediate treatment, often with hospitalization.
In these situations, high blood pressure can cause:
- Memory loss, personality changes, trouble concentrating, irritability or progressive loss of consciousness
- Severe damage to your body’s main artery (aortic dissection)
- Chest pain
- Heart attack
- Sudden impaired pumping of the heart, leading to fluid backup in the lungs resulting in shortness of breath (pulmonary edema)
- Sudden loss of kidney function
- Complications in pregnancy (preeclampsia or eclampsia)