Blood Pressure

Overview

What is blood pressure?

Your blood pressure is a measurement of the pressure/force inside your arteries with each heartbeat. Each time your heart beats, blood is pumped out of the heart into arteries that carry the blood throughout your body.

How is blood pressure measured?

A special cuff is used to measure your blood pressure. The cuff inflates and deflates, and during the process, your pressures are measured. Many times, a stethoscope is also used.

Blood pressure readings

Blood pressure is recorded as two measurements: systolic and diastolic blood pressure. Systolic blood pressure is the top/first number, and diastolic blood pressure is the bottom/second number. The numbers are expressed as millimeter of mercury (mmHg)

Systolic blood pressure
The pressure in the arteries when the heart is beating and the arteries are filled with blood

Diastolic blood pressure
The pressure in the arteries when the heart is resting between beats

What do the numbers mean?
Your blood pressure can be normal, elevated, or you may have Stage 1 or 2 hypertension (high blood pressure).
Normal blood pressure is <120/<80 mmHg
Elevated blood pressure is 120-129/<80 mmHg
Stage 1 hypertension is 130-139 (top number) OR 80-89 (bottom number)
Stage 2 hypertension is 140 or higher (top number) OR 90 or higher (bottom number)

Two or more readings are needed to determine if you have high blood pressure.

GET IMMEDIATE MEDICAL ATTENTION!
IF YOUR TOP NUMBER IS EVER 180 OR HIGHER AND/OR YOUR BOTTOM NUMBER IS EVER 110 OR HIGHER, GET EMERGENCY MEDICAL TREATMENT OR HAVE SOMEONE TAKE YOU TO THE HOSPITAL RIGHT AWAY!

Your blood pressure does not stay the same at all times. When you are exercising or excited, your blood pressure goes up. When you are resting, your blood pressure is lower. Your blood pressure can also change due to age, medications you take, and changes in position.

Tips for measuring your blood pressure

  • Sit for at least 5 minutes before your blood pressure is measured.
  • Do not smoke or drink caffeine 30 minutes before you measure your blood pressure.
  • If you are nervous when you go to the doctor, you could have a false high blood pressure reading. This is called “white coat syndrome.” If this happens, your doctor may ask you to: Use a blood pressure monitor to check your blood pressure throughout the day. You can bring a record of your readings to your appointments.

Some people are asked to wear a blood pressure monitor for 24 hours. The monitor is usually set to take blood pressure every 15 to 30 minutes as you go about your normal activities.

What are the symptoms of high blood pressure?

High blood pressure usually has no symptoms. It is often called the “silent killer” because it can damage your heart, kidneys and brain without you even knowing anything is wrong.

Who is at risk of getting high blood pressure?

Your risk of high blood pressure is higher if:

  • You have a family history of high blood pressure, cardiovascular disease or diabetes
  • You are African American
  • You are age 60 or older
  • You take oral contraceptives
  • You are overweight

Management and Treatment

What treatments are available for patients with high blood pressure?

High blood pressure is a major risk factor for cardiovascular disease. Without treatment, you can have a transient ischemic attack (TIA) or stroke, heart attack, enlarged heart, heart failure, peripheral vascular disease (such as poor circulation and pain in your legs), aneurysms, kidney disease, and broken blood vessels in your eyes. Treatment includes making changes recommended by your healthcare provider.

Diet and lifestyle changes:

  • Reach and stay at your ideal body weight
  • Get regular exercise
  • Eat a well-balanced, heart healthy diet that is low in salt, fat and cholesterol, and contains lots of fresh fruits and vegetables*
    • *Your diet is an important part of blood pressure control. The Dietary Approaches to Stop Hypertension (DASH) eating plan and limiting sodium (salt) help control blood pressure. Ask your doctor to refer you to a dietitian for a more personalized eating plan. More information is available from the National Heart, Lung and Blood Institute at www.nhlbi.nih.gov or the American Heart Association at www.americanheart.org*
  • Having no more than two alcoholic drinks per day (for most men) and no more than one drink per day for women and lighter-weight men. One drink is considered to be 12 ounces of beer or wine cooler, 5 ounces of wine or 1.5 ounces of 80-proof liquor
  • Control stress and anger
  • Avoid all tobacco and nicotine products
  • Other lifestyle changes, such as controlling lipid levels (LDL, cholesterol, triglycerides) and managing other health conditions, such as diabetes

Medications and follow-up care:

  • Take all medications as prescribed. Do not stop or start taking any medication without talking to your doctor. Blood pressure medication does not keep working after you stop taking it
  • Some over-the-counter medications, such as decongestants, can change the way your blood pressure medication works
  • Keep all follow-up appointments so your doctor can monitor your blood pressure, make any needed changes to your medications and help control your risk of cardiovascular disease

Your doctor may ask you to record your blood pressure at home. Follow your doctor’s instructions for recording your blood pressure.

Last reviewed by a Cleveland Clinic medical professional on 06/10/2019.

References

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Manage­ment of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. _J Am Coll Cardiol _2017;Nov 13

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