Blood Pressure 101/64: What Does It Indicate?

A blood pressure of 101/64 indicates that your blood pressure is PERFECTLY NORMAL, and on par with the American Heart Association guidelines.

This article tells you:

• What does a 101/64 blood pressure mean?
• What should you do if you have 101/64 blood pressure?
• Some easy to do home remedies and supplementations.
• Frequently asked question that will answer many of your queries regarding your 101/64 blood pressure.

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What does a 101/64 blood pressure mean?

The blood pressure reading 101/64 indicates that the person in question has ideal blood pressure.

If a person has blood pressure within the range of [90/60] and [120/80], it will mean that the person has perfect blood pressure.

By extension, the blood pressure value of 101/64 means that the person is not at a prominent risk of any heart disease. His/her heart is functioning the way a healthy person’s heart should, and that is significantly good for that person.

Ideal blood pressure is the state in which the blood flowing through the blood vessels applies just the right amount of pressure over those and the heart walls. As an effect of this, the heart can pump blood to all the parts of the body rather effectively.

101/64 signifies that the lifestyle that you have adapted yourself to is well-supported by your body and health. Also, if you were to keep up with the same lifestyle, it would eliminate the possible risk of chronic heart disease from your life.

If you happen to have healthy blood pressure, then it will help improve your health in more ways than just one. Some of the benefits that are supported by your body for having an ideal blood pressure are as follows:

• An ideal blood pressure protects you from imminent risks of heart problems.
• It is an indication that you are not suffering from diabetes and that your endocrine glands are functioning perfectly.
• Ideal blood pressure helps you maintain the ideal body weight for you.
• Having an ideal blood pressure relatively decreases the possibility of heart and kidney failure.
• It will help in the regulation of minerals within your body.
• Ideal blood pressure decreases the possibility of stroke for you.

What should you do if you have 101/64 blood pressure?

Here is a set-by-step procedure to follow when you figure out you have a blood pressure of 101/64.

1. Your doctor has to diagnose

If your blood is 101/64 and you have checked the same in your home setup, it is highly recommended to get it checked at your doctor’s office.

A trained professional has to clinically assess your condition and confirm that your 101/64 is, in fact, clinically valid.

There are instances when your reading at home setup might give you a reading which is incorrectly reported. It could be because of an error in reading it, damage to your device, your physical or mental condition on that particular day, etc.

Therefore, a doctor has to assess it over the course of 7 – 30 days periodically before he/she can confirm the accurate stage of your blood pressure.

In some cases, a patient might report wrong blood pressure in a hospital setup, called white coat hypertension. Here the patient may show higher blood pressure than their actual because of the anxiety inside a hospital environment.

In contrast, some patients may have masked hypertension in which the person may show lower blood pressure at clinical setup, but at home, they may have higher blood pressure.

All these conditions are linked to physiology and psychology and, therefore, better to be validated by a doctor.

2. Keep it up!

The blood pressure readings of 101/64 are relatively good, even taking into consideration the entire range of the ideal blood pressure.

But just because it is good now does not mean that things won’t change over time. Considering that distinct possibility, you should stick to a lifestyle that will help keep you fit and support your health.

Following are some of the habits that you should adopt in your lifestyle to keep yourself healthy all the time:

• Try to maintain that it is in equilibrium with your age and lifestyle.
• Eat healthy meals and exercise regularly.
• Regulate the consumption of salts.
• Support the intake of natural supplements whenever you feel those to be necessary for your body.
• Take proper rest every day. Your rest and sleep should be priorities for you.
• Quit smoking and keep your alcohol consumption in a check.
• Do not subject yourself to excess stress and anxiety, or this might turn into an emotional burden for you.

3. Do you need any medicine to keep this up?

At this stage, you don’t need any medications and all thanks to those perfect numbers you have seen.

All you can do is indulge in a healthy amount of workouts and other physical activities with a good watch over general health.

Routine health checkups and periodic blood pressure measurements are critical at this stage, which is what most people miss doing firsthand.

Unlike people with hyper or hypotension, you don’t need to actively regulate your blood pressure; however, passive efforts to indirectly keep it under control shall be followed.

Water pills and diuretics are sometimes recommended by doctors after assessing the electrolyte concentration in your body. However, in most cases, you may also don’t want it.

If you are a little lazy to hit the gym for your cardio, then we have included some products in the dietary supplement class that you can consider. 

4. Diet check for 101/64 blood pressure

Your blood pressure and overall health are directly related to the type of food consumed daily.

Therefore, if you were to keep your dietary habits in a firm check and eat healthy meals, that would significantly contribute to your overall health. It will be good for your body as well as your mind

Following are some of the facts that you should take into account before planning your diet:

• Regulate the consumption of sodium salts: Sodium is an important nutrient for the human body. And the concentration of this salt has a direct impact on your blood pressure. By regulating its intake, you can maintain your blood pressure.
• Caffeine: Caffeine-related products contribute to increasing the blood pressure of a person. If the consumption of these products is not kept in check, it may lead to high blood pressure.
• Drink plenty of water: Keep yourself hydrated all the time. This will help maintain the level of fluids and salt in your body.
• Alcohol: High consumption of alcohol can lead to low blood pressure. Besides this, the consumption of alcohol in excess can not serve any good purpose as it dehydrates your body rather rapidly.
• Herbs and spices: Support the intake of herbs and spices that will help maintain your ideal blood pressure. Many natural herbs can serve that purpose.
• Supplements: Do not hesitate to opt for natural supplements if your body lacks nutrients or minerals of any kind. Besides, these are the first things that physiotherapists advise individuals who suffer from problems in blood pressure because of a lack of minerals.

5. Do I need more tests for my heart?

101/64 is a perfect value that one might want to see when their blood pressure is being checked. Still, does it mean you are perfectly fine? Should you conduct more studies to get a conclusive stat regarding your heart health?

Technically speaking, a perfect blood pressure reading isn’t the ultimate predictor of heart health. In fact, some people undergoing a heat attack may show no change in blood pressure or even exhibit hypotension.

However, blood pressure reading, in most cases, is a direct estimator of heart health. But the problem is that only a variation in reading would denote a cardiovascular problem.

 This is why the physician opts for having an ECG or echocardiography in order to seek better clarity on your cardio health.

The above is often read in reference to your blood test reports and other health assessment parameters to draw a conclusion.

6. Natural supplements for your rescue

Sometimes managing blood pressure is all about supplementing your body with the right diet. Food is undoubtedly the best primary source to supplement your body.

However, in the current scenarios, we all know how much adultered our foodstuff is, and most of us are pushed towards processed foods to feed ourselves in this fast-paced world.

All these food are high in sugar and sodium and doesn’t contain any vital nutrients that are important for a healthy heart.

This is where some of the nutraceutical-based blood pressure supplements come in handy. These products combine all critical nutrients your heart craves, thereby assisting the better function of your cardiovascular system.

Generally, these supplements are a concoction of herbs, plant-based products, dairy products, and some animal products. They are 100% organic and natural and don’t contain any harmful chemicals.

If you are hearing about these segments of products for the first time,  to start with, you may blindly go for Blood Pressure Support from Vita Balance Inc, Blood Pressure Optimizer from HFL, or Corsanum, marketed by PLT Group.

The only one thing to keep in mind is that choose the best blood pressure supplement, because when it comes to the heart, there is no taking of risk!

So having an 101/64 is the ideal blood pressure, and you can keep doing whatever you have been doing so far.

You may now know the thrust areas of health to focus on and some diet plans that you may want to befriend.

FAQ (Frequently Asked Questions)

1. What is the blood pressure, and what are the normal values?

Blood pressure is the pressure that is exerted by the blood flowing through arteries over those. Alongside that, this is the efficiency with which the blood is pumped by the heart to all the parts of the body through the circulatory system.

The normal values for blood pressure are between [90/60] and [120/80]. If a person has a blood pressure equivalent to this much, then it means that the blood will be flowing through the arteries relatively easily.

2. What is considered to be high blood pressure?

Blood pressure over the value of [130/80] is considered high blood pressure. This signifies that high pressure is being exerted by the blood flowing through the vessels over those.

And therefore, it is difficult for the human heart to be able to pump blood to all the parts of the body rather efficiently. This is a problem that can arise when the size of the vessels is contracted compared to the original size.

3. What is considered to be low blood pressure?

A blood pressure lesser than the value of [90/60] is termed low blood pressure. This type of value means that low pressure is put forward by the blood over the vessels that are carrying it. It can also be taken as a measure that, the blood is not able to reach all the parts of the body.

Or, the heart is not capable of circulating blood to all the parts of the body in an effective way. This problem in blood pressure is mainly the effect of dehydration and pregnancy.

4. What are hypertension and hypotension? Are they both the same as high and low blood pressure?

Hypertension is the condition that emerges when a person is having high blood pressure. Because of contraction in vessels, the blood can not flow through the vessels efficiently, and therefore, high pressure is exerted over the blood vessels, this particular condition is high blood pressure, also referred to as hypertension.

Hypotension is the condition that comes into effect when the blood pressure of a person is lower compared to the ideal value of blood pressure. This means that the heart is unable to pump blood through the blood vessels to all the body parts. This type of situation when observed is called low blood pressure, or hypotension.

5. What will happen to your general health when you have high blood pressure?

High blood pressure puts you at an imminent risk of arteries rupture because of the high pressure applied over those by the circulating blood. This can, in turn, affect the circulation of blood to all the parts of the body, and your heart itself. And, the latter part can lead you to some serious heart diseases. The high pressure applied over the heart walls can put you close to the risk of heart attack and heart failure.

6. What causes high blood pressure and low blood pressure?

The medical conditions of high blood pressure and low blood pressure are both effects of the lifestyle that we lead. This means that if we adapt to a lifestyle that is in line with our body and overall physical fitness, then we will have ideal blood pressure.

But, if our lifestyle is deviated from what we had started, some medical conditions can arise. High blood pressure and low blood pressure are some of those problems.

7. What are the risks of having high blood pressure?

The most serious risk that is faced by an individual that is suffering from high blood pressure is the risk of heart attack, heart failure, or some chronic disease related to the heart.

Moreover, there are also the additional risks of strokes, vision loss, diabetes, kidney failure, unresponsiveness to external stimuli, chronic chest pain, artery damage, and vascular dementia.

8. What can I do to lower my blood pressure?

To lower your blood pressure, the foremost step should be to limit the intake of sodium salts. Then, it will be good for you to opt for a healthy lifestyle; eat healthy meals and exercise daily. Try to maintain your weight to healthy proportions. Limit the intake of alcohol and caffeine-related beverages, and quit smoking.

Also, you need to have an adequate amount of rest every day and keep your stress and anxiety in proper check. If you continue to face high blood pressure problems even after making these changes in your lifestyle, it will be good for you to consult with a physiotherapist to discuss your blood pressure medications.

9. What are the risks of having low blood pressure?

The harmful effects that are associated with low blood pressure are not as prominent as what is associated with high blood pressure, but they can serve to be just as much harmful in the long run. Low blood pressure can lead to lightheadedness, dizziness, and confusion for a prolonged period.

This is a condition that can make you weak physically as well as mentally. Low blood pressure leads to a depletion in the effectiveness of motor senses, and the subject is likely to faint from time to time. This condition can also lead to blurred vision and can damage peripheral nerves over a long time.

10. What can I do to increase my blood pressure?

Increase the usage of table salts in your diet, and drink plenty of water. Limit your intake of alcohol as it is a dehydrating agent. Increase your diet by taking small meals multiple times with low carbs. Exercise daily and try to take up a lifestyle that will be good for your health and physical well-being.

Try to maintain a body weight that will be good as per your physical stature and age. Avoid changing positions abruptly, and wear compression stockings to improve blood flow in the legs. Also, consult a physiotherapist regarding your medications for low blood pressure.

11. Can smoking and alcohol affect my blood pressure?

Smoking and alcohol have an active impact on the blood pressure levels of an individual. These can lead to an effective change in the size of arteries that carry blood to all the parts of the body.

Heavy intake of alcohol can increase blood pressure in individuals to a significantly high level and this can even lead to long-term blood pressure issues in the individual. On the other hand, smoking is as bad as it can be. It leads to the contraction of blood vessels, which increases the pressure of blood over the heart walls. This puts you at risk of heart disease.

12. How to correctly check my blood pressure at home?

If you want to check your blood pressure at home, you can use portable blood pressure monitors to do so. These are highly adaptable and can help provide you with your blood pressure levels closest to accurate.

But if you are seeking precision in the readings, then it will be good if you were to follow certain measures. For once, avoid intake of caffeine and alcohol before taking the reading. And, have a proper rest of nearly 10 minutes before measuring your blood pressure.

13. Why is it important to visit a doctor to confirm high/low blood pressure?

It is important to visit a doctor regarding blood pressure for the sake of the precision of the outcome or the result of the readings. Moreover, in a proper medical facility and care of professionals, you will be able to get guidance about how to keep your blood pressure in check if it is not per your ideal blood pressure.

Also, you can get a consultation regarding the changes that you will need to make in your lifestyle to bring your blood pressure back in check.

14. Should you be worried about high blood pressure during pregnancy?

High blood pressure during the latter half of the pregnancy is not that rare of an occurrence. However, it is not something to make light of either. If not treated properly, or significant steps are not taken regarding it, this high blood pressure may pose danger to the health of the parent as well as the baby.

This type of high blood pressure or hypertension is called gestational hypertension, and it is not long-lasting. It goes away after the delivery of the baby.

15. What are some of the symptoms to watch out for in high blood pressure?

The symptoms of high blood pressure are not something that can be ignored readily. These symptoms include severe headache, anxiety attacks, shortness of breath, nosebleeds, blood spots in the eyes, intense fatigue, blurred or distorted vision, and vomiting or nausea. These symptoms are not something to be taken lightly.

High blood pressure is not an incurable problem, but measures are needed to be taken against it in the due time. So, don’t make light of the symptoms and consult a physiotherapist regarding these.

16. What foods should you eat to lower blood pressure?

To lower blood pressure eat a diet that is rich in minerals like calcium, magnesium and potassium.

Besides this, it is good to take short meals that are low in curbs. Instead of deep-fried products, it will be good if you were to incline towards a diet that is mainly consisting of vegetables like spinach, broccoli, and other leafy green vegetables.

Consume lots of low-fat poultry and dairy products. These will help enable a healthy diet for you and help you lean towards a healthy lifestyle.

17. What are the best herbs and spices for high blood pressure?

Many known herbs and spices are proven to have a significant effect on high blood pressure. Significantly, basil, parsley, Chinese cat’s claw, celery seeds, Brahmi, thyme, garlic, and ginger are the herbs that are most commonly made use of by people that are suffering from high blood pressure. Along with these, cardamom, cloves, ajwain, green oat, and flaxseeds are the spices that help manage high blood pressure.

References:

1. Borjesson M, Onerup A, Lundqvist S, Dahlof B. Physical activity and exercise lower blood pressure in individuals with hypertension: Narrative review of 27 RCTs. Br J Sports Med. 2016;50(6):356-361. doi:10.1136/BJSPORTS-2015-095786
2. High blood pressure (hypertension) – Diagnosis and treatment – Mayo Clinic. Accessed October 10, 2022. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/diagnosis-treatment/drc-20373417
3. Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory from the American Heart Association. Circulation. 2022;146(5):E18-E43. doi:10.1161/CIR.0000000000001078
4. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):E1082-E1143. doi:10.1161/CIR.0000000000000625
5. Brenner J, LeBlang S, Lizotte-Waniewski M, et al. Mindfulness with paced breathing reduces blood pressure. Med Hypotheses. 2020;142. doi:10.1016/J.MEHY.2020.109780
6. 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. Hypertension. 2018;71(6):E13-E115. doi:10.1161/HYP.0000000000000065
7. Chernova I, Krishnan N. Resistant Hypertension Updated Guidelines. Curr Cardiol Rep. 2019;21(10). doi:10.1007/S11886-019-1209-6
8. Agasthi P, Shipman J, Arsanjani R, et al. Renal Denervation for Resistant Hypertension in the contemporary era: A Systematic Review and Meta-analysis. Sci Rep. 2019;9(1). doi:10.1038/S41598-019-42695-9
9. Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3). doi:10.1542/PEDS.2017-1904
10. Muntner P, Shimbo D, Carey RM, et al. Measurement of blood pressure in humans: A scientific statement from the american heart association. Hypertension. 2019;73(5):E35-E66. doi:10.1161/HYP.000000000000008

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101/64 blood pressure – is it good or bad?

Home > Resources > Blood pressure lookup > 101/64

Maintaining a healthy blood pressure throughout your life is one of the most important things you can do for long-term health and longevity. Whether you’re looking up a blood pressure of 101/64 for yourself or a loved one or simply out of your own curiosity, you’re taking the right steps by being informed and empowering yourself or someone else to be their own best advocate.

According to the American Heart Association, a blood pressure reading of 101/64 would be considered
normal. Blood pressure is considered normal when the systolic reading (the top number) is between 90-119 and the diastolic reading (the bottom number) is less than 80.

Okay, now you know how to classify a blood pressure of 101/64, but now what do you do with that information? Read on to learn more or look up another blood pressure reading.

What is a good blood pressure reading?

According to the American Heart Association, a normal blood pressure reading is lower than 120/80. While there is no specific number for low blood pressure, most experts say blood pressure is too low when it causes symptoms or drops suddenly. In general, though, low blood pressure can be considered anything under 90/60.

More information about a blood pressure reading of 101/64

A blood pressure reading of 101/64 is pronounced “101 over 64.” You may also see it written colloquially as 101/64 bp.

In a blood pressure reading of 101/64, 101 is called the systolic number and 64 is called the diastolic number. Systolic refers to the part of the cardiac cycle in which the heart contracts and pumps blood from the chambers into the arteries, and diastolic refers to the part of the cardiac cycle in which the heart relaxes and allows the chambers to fill with blood. You may also hear the systolic and diastolic numbers referred to as the top number and the bottom number.

Systolic and diastolic readings are measured in mmHg, which is a unit of pressure equal to the pressure that can support a column of mercury 1 millimeter high. Hg is the chemical symbol for mercury. For a blood pressure reading of 101/64, you would pronounce it “101 over 64 millimeters of mercury.”

How do you measure blood pressure?

In a doctor’s office, blood pressure is traditionally taken manually by a doctor or nurse with a sphygmomanometer. A sphygmomanometer is a medical instrument with an inflatable cuff and pressure meter or dial. The sphygmomanometer is placed snugly around the upper arm and is inflated by hand, and the doctor or nurse listens to the brachial artery with a stethoscope as they gradually reduce the pressure of the cuff. When the whooshing sound of blood is first heard through the stethoscope, the doctor or nurse makes note of the reading on the pressure meter. This indicates the systolic blood pressure reading. When the sound disappears, the reading on the pressure meter indicates the diastolic pressure reading.

Blood pressure can also be taken at home using a number of a digital devices. They typically consist of an inflatable cuff and digital display and simply work by placing the cuff around the upper arm and pressing a button, after which the cuff inflatess, deflates, and displays a reading. The most popular blood pressure machines for home use are made by Omron, Beurer, and Paramed, amongst many others.

One thing to keep in mind is that blood pressure can vary by time of day and activity level, so if you’re taking it at home it’s important to check it around the same time each day and rest for a few minutes ahead of time to limit as many variables as possible. It can also be affected by eating.

Blood pressure tends to rise in the hours before waking and then drop in the afternoon and evening before dropping to its lowest point while sleeping, so one popular recommendation is to check it just after waking up and just before bed to identify trends in how it varies from morning until night. Because of this, you might find that if your blood pressure is 101/64 in the morning, it might be lower before bed, and vice versa. Of course, these are just general rules of thumb and may vary by the individual.

Relevant HSA expenses

If you have an HSA as part of your health insurance plan, you’ll be pleased to find that blood pressure monitors, blood pressure cuffs, and wrist blood pressure monitors are all eligible, including smart blood pressure monitors like the offerings from Qardio and Withings.

How the heck do you pronounce sphygmomanometer?

Sphygmomanometer is pronounced sfig-moh-muh-‘nah-mi-ter. Easy!

Explore blood pressure readings similar to 101/64

The following table shows related blood pressure readings because sometimes just one number can make all the difference.

Please note that if a field is blank, it’s not an accident—it simply means a record doesn’t exist for that particular blood pressure. This could be because going forward or backward would create a blood pressure reading that wouldn’t make sense, or because that blood pressure simply doesn’t exist in our records.

Sources

• Understanding blood pressure readings – American Heart Association
• High blood pressure – Mayo Clinic
• Get the most out of home blood pressure monitoring – Mayo Clinic
• Blood pressure – Wikipedia
• How to pronounce sphygmomanometer – Dictionary. com

Disclaimer

The information on this page is intended to be an educational reference and is not to be taken as medical advice. If you think you’re having a hypertensive or hypotensive emergency, or if you’re having any kind of medical emergency, please call 911 immediately.

Symptomatic episodes of hypotension in patients with arterial hypertension. Relationship with indicators of self-monitoring of blood pressure | Ermasova

Abstract

Purpose . To study the relationship between symptomatic episodes of hypotension (SEH) and parameters of self-monitoring of blood pressure (SBP) in patients with arterial hypertension (AH).

Material and methods . 77 patients from 40 to 76 years old with AH were examined. To identify SEG, a questionnaire developed by the authors was used. Patients carried out self-monitoring of blood pressure (BP) in the morning and evening, and also recorded SEG in the BP diary. The self-control period was 4 weeks. Patients without a history of myocardial infarction and/or stroke are conventionally named as having “uncomplicated” AH, and those with their presence are referred to as “complicated” AH.

Results. Among all the subjects, according to the SEG questionnaire, 48 (62.3%) were noted. With uncomplicated hypertension — 19 (51.4%), with complicated — 29 (72.5%) (p=0.05). BP during SEG was on average higher in patients with complicated AH 103/60 mm Hg, with uncomplicated AH — 95/60 mm Hg. (p=0.05). With a combination of uncomplicated hypertension and SEG, mean systolic BP (SBP) (125.9±10.5 vs 137.9±8.2 mm Hg), evening SBP (125.3±8.1 vs 133.3± 10.4 mm Hg), maximum SBP (149.8±11.8 vs 161.7±12.1 mm Hg) in the morning, and minimum SBP in the evening (101.8±10.8 vs. 113.7±9.7 mmHg) were lower than in patients without SEG (p<0.05).

In complicated hypertension, the reverse pattern was noted: patients with SEG had higher mean SBP (133. 49±12.4 vs 118.93±15.3 mm Hg), maximum SBP (162.8±11, 6 vs 141.7±12.0 mmHg) and diastolic BP (DBP) (91.5±5.6 vs 83.5±8.8 mmHg) in the morning (p<0.05 ), greater variability in morning (11.8±2.1 vs 8.2±2.7 mm Hg) and evening SBP (11.9±4.2 vs 8.6±3.2 mm Hg .) compared with patients without SEG (p<0.05). There were no significant differences in antihypertensive therapy.

Conclusion . More than half of patients with hypertension have SEG. During SEG, patients who had not suffered heart attacks or cerebral strokes had lower blood pressure levels than those with a history of cardiovascular events. Among patients with SEG without cardiovascular events, the values ​​of morning, evening, as well as the maximum values ​​of SBP in the morning are lower than in patients without SEG. In patients with complicated AH and SEG, the opposite trend was noted: higher SBP, DBP in the morning, morning and evening SBP variability, compared with those who did not experience SEG. These patterns cannot be explained by the antihypertensive drugs taken.

Unfavorable cardiovascular outcomes can be associated not only with high blood pressure (BP), but also with low ones [1][2], while episodes of lowering blood pressure, accompanied by a violation of well-being, deserve special attention. Obviously, symptomatic episodes of hypotension (SEH) are a manifestation of a significant violation of the blood flow of vital organs. The causes, pathogenesis and clinical significance of such episodes are not completely clear [3][4].

The moments of a significant decrease in blood pressure can probably be considered elements of blood pressure variability (VAP). Currently, the most studied transient hypotension, recorded using ambulatory blood pressure monitoring (ABPM), which can be considered as a manifestation of short-term VAP [5][6]. At the same time, it is known that the medium-term and long-term VAP has the greatest prognostic value [7]. These types of VAP can be studied on the basis of BP figures obtained as a result of self-monitoring of BP (SBP) by the patient. The value of information obtained using SCAD has been confirmed in prospective studies [8]. It is known that self-measurement data are more associated with the risk of cardiovascular outcomes than the results of clinical measurements of blood pressure and ABPM, but studies on this issue did not take into account SEG.

Purpose of : to study the relationship between SEG and
SCAD parameters in patients with arterial hypertension (AH) depending on the presence of target organ damage.

Material and methods

The study involved 77 patients with hypertension. All subjects signed an informed consent before entering the study. Their age ranged from 40 to 76 years.

The main exclusion criteria were: the presence of any form of atrial fibrillation, reduced ejection fraction (<40%), heart block 2 and 3 degrees, acute myocardial infarction (MI) and / or stroke, secondary hypertension, dementia, stroke corresponding to 4- 5 points on the modified Rankin scale, hemodynamically significant stenosis of the carotid and renal arteries, other serious diseases that can affect blood pressure. The study protocol was approved by the local ethics committee.

During interviews with patients, analysis of medical records collected demographic data, information about existing cardiovascular risk factors and cardiovascular diseases. The presence of a history of MI, ischemic stroke was taken into account. These conditions were analyzed as components of a combined cardiovascular event.

To identify patients suffering from EH, a questionnaire developed by the authors was used, which included questions about the presence of EH, their frequency, BP level and clinical manifestations. Currently, there are no clear criteria for arterial hypotension. And such a phenomenon as SEG, and their prognostic value have not been previously studied. In our work, SEG meant episodes of a fall in blood pressure at least 15% below the individual average values, recorded by the patient earlier during self-measurement at home and accompanied by a significant deterioration in well-being (dizziness, severe general weakness, headache, discomfort in the heart area). ), which occurred at least once every 3 months. and were not associated with any obvious causes (injury, dehydration, drug overdose, change in antihypertensive treatment, etc.). Taking into account the measurement of blood pressure while sitting and disturbances in well-being longer than a few minutes, which largely allowed us to exclude orthostatic hypotension. When describing the SEG, the question in the diary about the relationship of hypotension with food intake in more than 97% gave a negative answer.

Patients also performed self-monitoring of blood pressure, BPMS was carried out according to the guidelines for home self-monitoring of blood pressure of the European Society of Cardiology [9]. The duration of self-control was 4 weeks. Patients measured blood pressure and heart rate (HR) in the morning and evening, recorded the results in a patient diary developed by us. In addition to daily BP values, the diary made it possible to enter information about the SEG and their characteristics.

Antihypertensive therapy used by patients was recorded. The classes of drugs and doses were taken into account, which, in accordance with the guidelines, were subdivided as follows. “Initial” — recommended for starting therapy, “maximum” and “medium” [10].

Groups of patients with no history of myocardial infarction and/or strokes were identified, we conditionally named this part of the subjects – with “uncomplicated” AH, and with “complicated” AH, who had suffered MI or cerebral strokes.

Initially, 82 patients were selected for evaluation of SCAD parameters, but 77 patients were included in the analysis, since 5 patients provided diaries that were not suitable for analysis. Thus, the study included 37 patients with uncomplicated AH and 40 with complicated AH.

Excel programs (Microsoft Office 2003-2016 software package) and Statistica 10.0 software package (Statsoft Inc., USA) were used for material processing. Standard methods of descriptive statistics were used – calculation of means and standard deviations for quantitative variables with a normal distribution. For a preliminary assessment of the relationships, a correlation analysis was used with the calculation of the Gamma coefficient. Analysis of variance was used to compare the average values. Comparison of frequency indicators was carried out on the basis of the crosstabulation method and the criterion χ ² Pearson. Differences and relationships were considered statistically significant at p<0.05.

Results

The main characteristics of the groups of the examined are presented in Table 1. : * — significance of differences between groups of patients with complicated and uncomplicated hypertension, p< 0.05.
Abbreviations : AH — arterial hypertension, DM — diabetes mellitus, CHF — chronic heart failure.

In the “complicated” AH group, all patients had stage 3 disease and very high cardiovascular risk. In the group of “uncomplicated” AH, all subjects had some non-severe target organ damage, 58% of them also had associated clinical conditions (chronic heart failure of functional class I-II, diabetes mellitus), thus, the composition of patients with uncomplicated hypertension was as follows: 42% with stage 2 hypertension, 58% with stage 3, 64% of the subjects had a very high risk, 36% high risk. In general, the level of blood pressure in all study groups according to the SCAD data corresponded to the recommended values, only in patients in the group with uncomplicated hypertension without SEG did it slightly exceed the target level.

Groups of antihypertensive drugs were taken into account, the results are presented in Table 2.

Table 2

Groups of antihypertensive drugs taken in patients with complicated and uncomplicated hypertension
Note : * – statistically significant differences between groups with complicated and uncomplicated hypertension (p<0.05).
Abbreviations : AH = arterial hypertension, SEG = symptomatic episodes of hypotension.

Among all the subjects, according to the SEG questionnaire, 48 (62.3%) were noted. In the subgroup of uncomplicated AH, a smaller number of patients noted SEG — 19 (51.4%), with complicated — 29 (72.5%) (p<0.05).

When comparing BP diaries and patient responses in a separate special questionnaire, 72. 4% had information about the presence or absence of SEG episodes and their characteristics coincided. At the same time, 17.2% of the subjects during the survey answered that they did not notice SEG, however, when keeping a diary, they recorded episodes of poor health associated with a decrease in blood pressure. A small part of the subjects (10.3%), despite the fact that they noted the presence of SEG during the survey, did not record them in the BP measurement diary. In these two situations, patients were assigned to the SEG group.

When calculating the mean BP level during SEG episodes, it turned out that it was 95/60 mm Hg among patients without a history of vascular accidents, and 103/60 mm Hg among patients with complicated hypertension. (p=0.048).

A significant (p<0.05) relationship between the presence of SEG and some of the parameters of the CAD was found. The results of SBP are presented in Table 3.

Table 3

SBP indicators in patients with complicated and uncomplicated AH

Abbreviations : AH — arterial hypertension, DBP — diastolic blood pressure, SBP — systolic blood pressure, SEG — symptomatic episodes of hypotension, HR — heart rate.

In the group of patients with uncomplicated hypertension and SEG, it was noted that, on average, the values ​​of morning, evening, and also the maximum values ​​of systolic blood pressure (SBP) in the morning were lower than in patients without SEG. At the same time, the presence of SEG was also associated with lower minimum values ​​of SBP in the evening (p<0.05). Also, among patients with uncomplicated hypertension and SEG, the minimum values ​​of heart rate in the morning and evening were lower than in their absence (p<0.02).

Among subjects with complicated AH, the reverse pattern was noted: patients with SEG had higher mean SBP, maximum SBP and diastolic BP (DBP) in the morning (p<0.05). In addition, patients with SEG and complicated AH showed a higher variability in morning and evening SBP, compared with those who do not experience discomfort with a decrease in BP (p<0.05). In the group of patients with uncomplicated hypertension, no differences in VAP were found.

Groups of cardiovascular drugs taken were taken into account to explain the possible reasons for differences in heart rate and blood pressure levels. Of the significant differences in antihypertensive therapy, it was found that more patients in the group of complicated hypertension take beta-blockers. The frequency of use of initial, maximum and average doses of drugs was almost the same in groups with SEG and without them.

Discussion

The studied samples did not differ significantly in age and gender, which makes them fairly comparable. It is natural that among patients with a history of cardio- and cerebrovascular events, angina pectoris and signs of chronic heart failure were more common. Diabetes mellitus was also more common among them. The frequency of SEG cases among those examined was fundamentally consistent with that in larger samples [11]. The data obtained once again confirm that transient hypotension is a very common occurrence among patients with hypertension.

Our study confirmed that the method of identifying SEG using a questionnaire is as informative as a BP diary with direct recording of such episodes by the patient. Thus, among the majority of the examined, the questionnaire data coincided with the entries in the BP diary. The fact that some of the subjects answered negatively to the question about the presence of SEG, but subsequently, when keeping a diary, episodes of poor health were recorded with a decrease in blood pressure, indicates that the significance of such episodes is often underestimated both by the patient and, probably, by the doctor. A small part of the subjects, despite the fact that they noted the presence of SEG during the survey, did not record them in the BP measurement diary. However, most of them were characterized by rare SEGs, and, perhaps, they simply did not occur during the observation period.

When calculating the mean BP level during SEG episodes, it was lower among patients without a history of vascular accidents than among patients with complicated hypertension. Our previous studies have also demonstrated that patients with past cardiovascular events are characterized by higher BP values ​​during SEG [12]. 135/85 mm Hg. [10]. According to the results of our study, patients with uncomplicated AH, who noted SEG, achieved target BP levels against the background of ongoing antihypertensive therapy, in subjects without SEG, the average morning SBP was slightly higher than the above-mentioned norm. Excessive exposure to antihypertensive drugs could be one of the possible causes of EH in this category of patients. However, according to our data, there was no significant difference in antihypertensive therapy in the studied groups. Among patients with a history of cardio- and cerebrovascular events, a greater number took beta-blockers (mainly bisoprolol), but no significant differences were found between subjects with and without SEG. In previous studies on the identification of transient hypotension according to ABPM data, it was found that an increase in pulse wave velocity is a factor that contributes to the development of transient hypotension [13]. Since pulse wave velocity is an indicator of vascular stiffness, it can be assumed that these results do not contradict our observations.

Lower heart rate values ​​in patients with uncomplicated AH and SEG, in combination with the data obtained, may indicate an imbalance in the parts of the autonomic nervous system with a predominance of vagal influences as the most likely cause of SEG.

Among patients with complicated hypertension, SEG was observed in those who had higher mean and maximum SBP levels in the morning. In a study by Matsui Y, et al. [14] showed a significant relationship between the maximum levels of blood pressure in SCAD and damage to target organs. In addition, peak BP levels were strong and independent predictors of stroke [15]. Our observation confirms that the combination of high maximum SBP values ​​with episodes of falling blood pressure is associated with past heart attacks and strokes.

The presence of SEG in patients with complicated hypertension was also associated with higher variability in evening and morning SBP. As is known, an increase in VAP in this category of patients is due to structural changes in the vessels of the brain and heart. The relationship between VAP and markers of atherosclerosis has been previously established [16][17][18]. Thus, patients with complicated hypertension have more limited opportunities to maintain a constant blood flow in vital organs during fluctuations in blood pressure, incl. and when it decreases.

Thus, the results of our study suggest that EH in patients without a history of vascular accidents is associated mainly with dysregulation of vascular tone, imbalance of the autonomic nervous system. In turn, SEG in patients with stroke or MI is apparently largely a consequence of more severe damage to the cardiovascular system, stiffness of the vascular wall, and greater sensitivity of blood flow to BP fluctuations.

Conclusion

More than half of patients with hypertension report symptomatic episodes of hypotension, the presence of which was associated with SBP indicators, and the nature of the relationship depended on the presence of past cardiovascular events.

Patients without a history of heart attacks or cerebral strokes had lower blood pressure during SEG than subjects with a history of cardiovascular events at the same time.

Among SEG patients without a history of heart attacks or strokes, morning, evening, and peak morning SBP values ​​were lower than in patients without SEG on similar therapy.

In patients with complicated AH and SEG, the opposite trend was noted: higher SBP, DBP in the morning, morning and evening SBP variability, compared with those who did not experience SEG.

The above patterns cannot be adequately explained by the antihypertensive drugs taken and their doses.

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