Blood pressure: Can it be too low?

New findings focus on diastolic blood pressure—the second number in your blood pressure reading.

Image: mangostock/Thinkstock

Of the two numbers that make up your blood pressure reading, the first one (systolic blood pressure) typically gets more attention. That’s because as people age, their arteries lose their elasticity, and the inner walls are more likely to accumulate cholesterol-laden plaque. These factors tend to raise systolic blood pressure, a measure of the pressure inside the arteries when the heart contracts to pump blood throughout the body.

Current guidelines suggest that most people should aim for a systolic blood pressure reading of 140 millimeters of mercury (mm Hg) or lower. But last year, a widely publicized clinical trial suggested that a target of 120 mm Hg could further reduce the dangers associated with high blood pressure (namely, heart attack, stroke, heart failure, and death).

Yet reaching that lower target required an average of three blood pressure medications, which resulted in more side effects. Now, two recent observational studies highlight some concerns about blood pressure that’s too low, particularly with regard to diastolic blood pressure. Diastolic blood pressure (the second number in a reading) represents the pressure between beats when the heart relaxes.

Low diastolic pressure: No symptoms

“When your systolic blood pressure gets too low, it can manifest as lightheadedness, fainting, and weakness. But low diastolic pressure by itself doesn’t have any symptoms,” says Dr. Paul Conlin, professor of medicine at Harvard Medical School and chief of medicine at the VA Boston Healthcare System.

One of the new studies, which analyzed the medical records of more than 11,000 adults over a period of three decades, found that people who had low diastolic blood pressure (60 to 69 mm Hg) were twice as likely to have subtle evidence of heart damage compared with people whose diastolic blood pressure was 80 to 89 mm Hg. Low diastolic values were also linked to a higher risk of heart disease and death from any cause. The findings appeared in the Aug. 30, 2016, Journal of the American College of Cardiology.

Another study, published in The Lancet, involved more than 22,000 people with heart disease, whom researchers grouped according to their blood pressure readings. People with well-controlled blood pressure values (120 to 129 mm Hg systolic and 80 to 89 mm Hg diastolic) were considered the reference group.

Not surprisingly, people with high systolic blood pressure (140/80 or higher) were more likely to experience heart attacks or strokes, be hospitalized with heart failure, or to die compared with people in the reference group. But the same was true for heart attacks, heart failure, and death in people with low blood pressure (less than 120 mm Hg systolic and less than 70 mm Hg diastolic).

The J curve

These results lend further support to the “J curve” phenomenon for blood pressure, where the bottom of the J represents the ideal range for blood pressure. Higher values raise cardiovascular risk, but lower values also seem to raise your risk (see graph).

The findings about low diastolic blood pressure are intriguing, and they make sense intuitively, Dr. Conlin says. Diastolic pressure is measured during the point in the heart cycle where blood flows into the coronary arteries that feed the heart. If those arteries are clogged with fatty deposits (as in a person with heart disease), blood pressure beyond the narrowed areas will drop as blood flows through that narrow channel. As a result, part of the heart muscle may not get enough blood. Starved for oxygen and nutrients, the heart may become weak and prone to damage.

Because of this potential concern, people with heart disease may want to check that their diastolic blood pressure values don’t fall too far below 70 mm Hg, which can happen when you try to reach a low systolic number, says Dr. Conlin. “For a systolic blood pressure goal, I tend to be comfortable with a value of around 130,” he says. Going lower than that can be a double-edged sword in terms of side effects and other adverse events.

But he encourages discussion about such decisions with his patients. Everyone is unique, not only with regard to medical history, but also in willingness to take additional medication and accept certain risks. So talk to your doctor about what blood pressure goal makes sense for you, he advises.

Share this page:

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Understanding Blood Pressure [Ultimate BP by Age Chart]

We all know that understanding blood pressure & maintaining healthy readings are important for our overall health and longevity. After all, it’s one of the most talked about indicators of health, particularly when it comes to your heart.

But what exactly is blood pressure? Do you know what your blood pressure numbers mean? Compare your measurements to the charts below and read about understanding blood pressure readings.

Nov. 2017 American Heart Association New Blood Pressure Chart Guidelines and Updates:

The American Heart Association recently released a new set of stricter guidelines. Changing the numbers means that more Americans will now meet the guidelines for high blood pressure, also known as hypertension. Here are some of the changes:

• Greater Emphasis on Measurements
• The AHA is putting more pressure on Americans to stay on top of their readings. They recommend that routine measurements are taken on a regular basis at home, and not just at the doctor’s office..

• Guidelines Remove “Prehypertension”
• By eliminating the Prehypertension category, more Americans now fall into the range of high blood pressure. The goal behind these changes is to initiate prevention, evaluation, and treatment of higher numbers far sooner than in the past.

• New “Elevated” Blood Pressure
• Measurements ranging from 120-129 mm Hg (systolic) and less than 80 mm Hg (diastolic)

• Hypertension Stage 1
• Previously defined as greater than 140 to 153 mm Hg (systolic) over 90 to 96 mm Hg (diastolic)
• New definition = 130 to 139 mm Hg (systolic) over 80 to 89 mm Hg (diastolic)

• Hypertension Stage 2

• Previously defined as greater than 160 mm Hg (systolic) over 100 mm Hg (diastolic)
• New definition = 140/90 mm Hg or greater

General Blood Pressure Ranges

The chart below provides a general overview of blood pressure ranges updated to match the new American Heart Association guidelines. Take your blood pressure and identify your systolic & diastolic readings to compare ranges on the chart, OR enter your results in the blood pressure calculator to learn more about causes, symptoms, and treatment for your blood pressure readings

Keep in mind that it is possible for your readings to be affected by other factors like age, medication, & sometimes even gender. Check out the chart below for a breakdown of blood pressure ranges by age.

Remember, your blood pressure is recorded as two numbers – systolic and diastolic – diagnosing high or low blood pressure only requires one of these numbers to be outside of the healthy range.

Blood Pressure Chart by Category:

The categories above are based off the official American Heart Association blood pressure guidelines, which were recently updated in November of 2017 ( Chart Reference)

*For proper blood pressure diagnosis, talk to your primary care physician or cardiologist

Looking to track your blood pressure? Understand your readings and learn ways you can improve your blood pressure with our FREE PDF.

Blood Pressure Calculator: Understanding your Blood Pressure Numbers

Please remember that for an official blood pressure diagnosis and treatment regimen, you must consult your primary physician or medical care professional  who will do a thorough assessment to determine the proper diagnosis.

Enter both Systolic & Diastolic readings (in mm Hg) below. Results will display the corresponding blood pressure category & information regarding the causes, symptoms, and treatment options for your range of blood pressure.

Normal Blood Pressure Chart by Age

How Age Affects Blood Pressure

For infants, toddlers, and pre-adolescent aged children, doctors follow separate guidelines and standards to define high blood pressure. Average readings tend to be lower at a younger age and increase as you grow older . During late adolescence (around 17-19 yrs old) doctors typically begin to follow the standard adult guidelines for high blood pressure.

As you age, your risk of developing high blood pressure increases.

Click Here for Pediatric Blood Pressure Chart by Age Reference

Charted Blood Pressure Ranges

The following table provides a rough guide to understanding blood pressure as you age. Start by taking your blood pressure to find your systolic (top number) & diastolic (bottom number) pressure. Then, locate your age range in the right-hand column to see where your readings fall.

S = Systolic Pressure
D = Diastolic Pressure

Blood pressure charts aren’t commonly broken down by age, however, pediatric charts are often separated into ranges for infants, toddlers, and pre-adolescents. Pediatric standards for high and low blood pressure differ from those used for adults. Sometimes gender can influence readings, but measurements are still compared on the same scale. ( Chart reference)

Click here to download your FREE + PRINTABLE Blood Pressure PDF & make understanding your readings easy. 

Locate your readings on the chart above & Click below to learn more about your blood pressure:

*Remember to always consult with your doctor for an accurate diagnosis and treatment plan when it comes to your blood pressure readings.

What Affects Blood Pressure?

Personal characteristics which play a role in blood pressure readings are:

• Gender and Blood Pressure

According to the National Institute on Aging, males are more likely to have high blood pressure before age 55,  while normal blood pressure for women tends to rise after menopause. Women are less likely than men to experience complications associated with high blood pressure.

However, regardless of differences in the prevalence and complications of high blood pressure between the sexes, treatment and diagnosis are the same for both men and women.

• Normal Blood Pressure By Age

As you age, your body goes through many changes that can put you at risk for other conditions. If you’re over 50, having a higher than usual systolic pressure might increase your risk of developing heart disease. Systolic blood pressure tends to increase steadily over time due to stiff arteries, a build-up of plaque, and a higher rate of cardiac and vascular disease. This means older adults need to be even more vigilant about monitoring their blood pressure and practicing heart-healthy self-care.

• Height and Blood Pressure

Height isn’t a risk factor but taller people tend to have higher blood pressure because this offsets gravity and other factors to ensure the brain – the highest organ – gets enough blood flow and oxygen. However, the effect of height is minor, so it’s not taken into account in blood pressure range guidelines.

Traits can be passed from one generation to the next. This is known as heredity. There is a genetic role in high blood pressure, heart disease, and other heart conditions. However, researchers believe that it may be partly due to sharing common environments and other behaviors that can increase your risk.

• Normal Blood Pressure and Heart Rate

While a rising heart rate will increase blood flow through the body, it does not necessarily correspond with an increase in the pressure of that blood flow. This is because blood vessels can increase in size (dilate) to facilitate larger quantities of blood. Even if your heart rate were to double, your normal blood pressure & high pulse may only slightly increase blood pressure.

Understanding Blood Pressure Measurements

Understanding blood pressure numbers is a crucial part of overall well-being. When your heart beats, it moves blood through your body to deliver oxygen and other nutrients. The blood pushes on the walls of the blood vessels as it travels through the body. The force of the blood pressing against the vessel walls is known as blood pressure.

Your blood pressure readings consist of two numbers:

Systolic Blood Pressure

Your systolic blood pressure measures the pressure on the walls of the vessel as your heart is contracting or beating. It is recorded as the top number in your blood pressure reading.

Diastolic Pressure

Your diastolic blood pressure is the pressure in the vessels while the heart is relaxed, in between heartbeats. It is recorded as the bottom number in your blood pressure reading.

Your blood pressure is reported by placing the systolic number over the diastolic number. For example, your blood pressure might be reported as 120/80. To be diagnosed with high blood pressure, only one of these numbers must be outside of the normal range. But, remember that one high reading doesn’t mean there’s a problem. High blood pressure is a condition that can only be diagnosed by your doctor.

Normal Blood Pressure

Normal blood pressure can range from 110 to 134 (systolic) over 75 to 87 (diastolic), depending on your age.

Recent updates by the American Heart Association now recognizes normal blood pressure as readings of 90/60 mm Hg or less

If your blood pressure reading is defined as ‘normal,’ that means you’re within the healthy range – which is great news for your arteries, heart, brain, and kidneys!

How to Maintain Normal Blood Pressure Level

Here are some tips to help keep your blood pressure readings within the normal and healthy range:

A diet rich in fresh fruits and vegetables, whole grains, nuts, seeds, and lean protein sources like fish and beans goes a long way toward maintaining normal blood pressure and heart health.

Be sure to avoid processed foods, trans fats, and red meat, and cut down on your intake of sugar and saturated fat.

Season your food with herbs and spices instead of salt – which is known to raise blood pressure. The American Heart Association recommends an ideal limit of no more than 1,500 mg of sodium a day (a little over half a teaspoon of salt). Bear in mind that over 75% of our sodium intake comes from the salt already added to processed foods and restaurant meals, and not from the salt shaker.

A high salt intake throws off the balance of sodium and potassium in the body, increasing fluid retention, and putting excess strain on the kidneys and the blood vessels that serve them. Potassium-rich foods such as potatoes, bananas, avocados, sweet potatos, and dark leafy greens will help lessen the effects of sodium.

• Exercise Regularly or Stay Active

Make sure to engage in regular activities to keep blood pressure within the normal range. Exercise causes the body to release nitric acid, which helps blood vessels to dilate, reducing blood pressure.

Regular activity also helps with weight loss, stress reduction, and overall heart health.

Resistances bands are simple way to add routine exercise into your daily life & maintain normal readings or lower high blood pressure. ( Find the Best Resistance Band Sets Here)

• Maintain a Healthy Weight

Staying within a healthy weight range for your height is important to keep blood pressure under control. Excess pounds are a risk factor for heart disease and type 2 diabetes, two conditions associated with high blood pressure.

Control stress levels. Stress causes an increase in blood pressure, so staying cool and calm can help you maintain your healthy blood pressure readings. Relaxation techniques like deep breathing, meditation, and yoga are proven stress-busters.

Too much alcohol increases blood pressure and contributes to weight gain. According to the, Mayo Clinic, women of any age and men over 65 should enjoy no more than one drink a day, and men under 65 should have no more than two drinks daily.

Smoking increases blood pressure and heart rate and raises the risk of heart attack or stroke. Nicotine also leads to narrowing and hardening of the arteries, which can increase your blood pressure readings.

Elevated Blood Pressure (previously labeled Prehypertension)

Recently added by the AHA, Elevated blood pressure is the new “Prehypertension” (so to say)

This range of blood pressure was previously defined as slightly elevated blood pressure that may lead to hypertension if left untreated. Measurements ranged from 130 to 146 (systolic) over 85 to 91 (diastolic), depending on age. New standards now classify Elevated Blood Pressure as:

• Measurements ranging from 120-129 mm Hg (systolic) and less than 80 mm Hg (diastolic)

Causes of elevated blood pressure are the same as the causes of hypertension, and the treatment options are similar.

At this stage, there may be no noticeable hypertension symptoms , but damage to the body may still be occurring, and your risk of heart attack and stroke is increased.

Click below to learn more about what causes elevated blood pressure, the symptoms & the best treatment methods

Stage 1 Hypertension

Readings in this category range from 130 to 139 mm Hg (systolic) over 80 to 89 mm Hg (diastolic), depending on age.

Recent updates by the American Heart Association now recognizes stage 1 hypertension as readings of 130/80 mm Hg or higher.

Stage 1 hypertension, which can be caused by everything from poor diet to stress, is considered to be mild to moderate high blood pressure.

Many people with stage 1 hypertension don’t experience any noticeable symptoms . However, your doctor may decide that you need treatment, even without symptoms. It’s vital that you follow up with your primary care doctor for any blood pressure concerns.

If not addressed, stage 1 hypertension will increase your risk of heart attack, stroke, and other serious health issues. It may also progress to stage 2 hypertension – a more severe type of high blood pressure.

Click below to learn more about what causes stage 1 hypertension, the symptoms & the best treatment methods

Stage 2 Hypertension

Blood pressure readings higher than 1 40/90 mm Hgindicate stage 2 hypertension, which is considered severe high blood pressure.  This is a serious condition and requires immediate treatment – which includes eliminating the root causes of the condition.

Recent updates by the American Heart Association now recognizes stage 1 hypertension as readings of 140 /9 0 mm Hg or higher

Stage 2 hypertension is severe high blood pressure. 

At this stage, you may be noticing some symptoms of hypertension and your risk of heart attack, stroke, and other serious health issues greatly increase.

Click below to learn more about what causes stage 2 hypertension, the symptoms & the best treatment methods

Hypertensive Crisis:

The term Hypertensive Crisis encompasses both Hypertensive Urgency and Hypertensive Emergency. These conditions are caused by untreated hypertension and require immediate attention.

If your blood pressure reading is 180/120 or higher, wait about five minutes and retake your blood pressure. If you have two readings that are this high, but you aren’t having any other concerning symptoms such as chest pain, back pain, shortness of breath, change in vision, numbness/weakness, or difficulty speaking – you are experiencing hypertensive urgency.

Contact your physician immediately to discuss next steps. This type of blood pressure problem can usually be handled by adjusting your medications, but it is crucial that you speak to your doctor.

If your blood pressure reading is 180/120 or higher and you’re experiencing symptoms such as shortness of breath, back pain, chest pain, numbness/weakness, change in vision, or difficulty speaking – you’re having a hypertensive emergency and need to seek emergency medical attention. Do not wait to see if your blood pressure improves. Call 911 or head to the nearest emergency room. To treat this serious condition, doctors may give you blood pressure medications intravenously (IV),  or other treatments aimed to decrease your risk of long-term effects.

If left untreated, you might begin to experience signs of organ damage that include:

• Body weakness or numbness
• Trouble breathing
• Chest pain
• Back pain
• Slurred speech
• Headache
• Seizure
• Changes in vision

Treatment for a Hypertensive Crisis

If you are experiencing a Hypertensive Crisis, never wait for your blood pressure to come back down before seeking medical attention. Treatment options include blood pressure medication administered through IVs and specific therapy treatment for possible organ damage.

Causes of High Blood Pressure

For many people, no one specific factor leads to the development of high blood pressure. It tends to develop gradually over time as a result of age and the build-up of fatty deposits in the arteries.

However, some lifestyle factors can speed up the onset of high blood pressure. A few of these factors include a high-sodium diet, too much alcohol, inactivity, and stress.

Health conditions like thyroid disease, kidney disease, and sleep apnea might increase your risk of high blood pressure. Taking medications such as prescription drugs, decongestants, and pain relievers may also be contributing factors.

Hypertension Symptoms and Risks

Risks associated with high blood pressure can become life-threatening if not adequately monitored or addressed ( Image reference).

Most people with high blood pressure, particularly prehypertension and stage 1 hypertension, don’t experience any symptoms.

Even at stage 2, hypertension may not cause any noticeable effects. Those who do experience symptoms may notice:

• Headaches
• Nosebleeds
• Shortness of breath

However, even in the absence of symptoms, the elevated blood pressure is still damaging your blood vessels and heart and increasing the risk of heart attack, heart disease, stroke, and more.

For these reasons, regular check-ups along with at-home blood pressure monitoring are necessary to stop progression or reverse some of the damage done.

Treatments for High Blood Pressure

Whether you have prehypertension, or full-blown hypertension at any stage, the treatments options are the same. However, those with more severe high blood pressure may need to be more aggressive in their approach than those with blood pressure readings which are close to normal. Common treatment regimen include…

At Home Monitoring

A small, portable, at-home blood pressure monitor cuff is a convenient way to stay on top of your readings throughout the day ( Image Reference).

If you have any of the health conditions associated with high blood pressure, including sleep apnea, kidney problems, or thyroid disease, it’s esstenial to follow the treatment plan you were prescribed. Invest in an at-home blood pressure monitor to help track your readings. Careful monitoring can:

• Identify abnormal measurements
• Recognize lifestyle habits that increase your blood pressure
• Monitor in-between routine doctor visits
• Keep track of blood pressure while on medication

Healthy Diet

A healthy, balanced, diet helps to keep high blood pressure at bay ( Image Reference).

What you put in your body can have a profound impact on your health. Choose to fill your plate with fresh fruits and vegetables, whole grains, nuts, seeds and lean protein sources like fish and beans. Make sure to incorporate drinks that lower blood pressure and avoid diuretics.

For lower blood pressure and all-around better health, avoid processed foods, trans fats, and red meat, and cut down on your intake of sugar and saturated fat.

Ditch the Salt

Too much dietary salt disturbs the delicate balance of sodium and potassium in the body. This increases fluid retention and puts excess strain on the kidneys and the blood vessels around the kidneys.

The American Heart Association recommends people consume no more than 1,500 mg of sodium a day – which is a little over half a teaspoon of salt. It’s not just the salt in the salt shaker you should be concerned with – research shows that over 75% of our sodium intake comes from the salt already added to processed foods and restaurant meals.

Potassium-rich foods such as potatoes, bananas, avocados, sweet potatos, and dark leafy greens will help lessen the effects of sodium.

Stay Active

Make sure to engage in regular activities to bring your blood pressure back into the normal range.

Exercise causes the body to release nitric acid, which helps blood vessels to dilate, reducing blood pressure. Regular activity also helps with weight loss, stress reduction, and heart health.

Walking, cycling, swimming, water aerobics, golf (without a cart), and yoga are all fantastic exercises for adults of all ages.

Don’t forget that other everyday activities which involve movement – known as incidental physical activities – can contribute to improved fitness levels, at least according to some research. This includes things like moderate intensity gardening, vacuuming, washing the car, or walking around the supermarket.

Maintain a Healthy Weight

Carrying excess weight can be dangerous to your heart health, as it requires your arteries to work harder. Set goals and track progress with a simple at home scale ( See Product on Amazon).

If you are overweight, If you’re overweight, talk to your doctor about a weight loss regimen. Losing as little as 5 pounds can make a difference!

Being overweight or obese is also a risk factor for heart disease and type 2 diabetes, two conditions associated with high blood pressure.

Stop Stressing

Stress and anxiety may be contributing to your elevated blood pressure results. Practice relaxation techniques like deep breathing, meditation, and yoga on a regular basis to lower your blood pressure, and even bring it back within the normal range.

Enjoy Alcohol in Moderation (or Not at All!)

While we’ve all heard the health benefits of a glass of red wine now and then, too much alcohol increases blood pressure, contributes to weight gain, and can cause you to make poor food choices.

For better health, women of any age and men over 65 should enjoy no more than one drink a day, and men under 65 should have no more than two.

Quit Smoking

There are no health benefits to smoking! Nicotine not only increases blood pressure and heart rate, but it also raises the risk of heart attack or stroke, and leads to narrowing and hardening of the arteries.

Discuss Medication with a Doctor

When dealing with high blood pressure readings, it’s necessary to consult with your doctor to find proper ways to manage and prevent hypertension.

Depending on your age, lifestyle, and blood pressure readings, your doctor may recommend medication as part of a treatment program for hypertension.

It’s not clear if medication is beneficial for adults who have prehypertension alone. However, if you have another medical condition along with prehypertension, such as diabetes or kidney disease, your doctor might decide it’s best to start treatment as early as possible.

Those with stage 1 and stage 2 hypertension may be prescribed one or more of the following drugs:

• ACE inhibitors
• Aldosterone antagonists
• Alpha blockers
• Alpha-beta blockers
• Angiotensin II receptor blockers (ARBs)
• Beta-blockers
• Renin inhibitors
• Thiazide diuretics
• Vasodilators

Hypotension (Low Blood Pressure)

While all the focus seems to be on high blood pressure, low blood pressure (hypotension) is also a potentially dangerous condition. In severe cases, it can cause shock – a life-threatening condition that occurs when the body isn’t receiving adequate blood flow.

A reading of less than 90 (systolic) or 60 (diastolic) can indicate low blood pressure, although this may vary from person to person. As a result, you may not experience any symptoms of hypotension even if your blood pressure readings indicate you have it. In cases like this, a doctor may or may not recommend interventions.

Causes of Hypotension

There are several possible causes of low blood pressure, and you must find the root cause raise your readings back to a normal range.

Possible causes include:

• Anaphylaxis – a severe allergic reaction
• Blood loss
• Dehydration
• Heart problems such as low heart rate, heart attack, or heart failure
• Low blood sugar or diabetes
• Medications such as diuretics, alpha blockers, beta blockers, some antidepressants, erectile dysfunction treatments, and drugs for Parkinson’s disease
• Nutrient deficiencies, particularly a lack of Vitamin B12 and folate
• Pregnancy
• Septicemia – a severe infection in the bloodstream
• Thyroid conditions

Low blood pressure can also be encountered when moving quickly to a standing position after sitting or lying down. Hypotension after meals (postprandial hypotension) is common in older adults.

Symptoms and Risks of Hypotension

If you have low blood pressure, you may experience:

• Blurred vision
• Dizziness
• Extreme tiredness
• Fainting
• Inability to concentrate
• Lightheadedness
• Nausea

Severe cases of hypotension can result in shock – a life-threatening condition which requires emergency medical intervention. Shock is characterized by:

• A weak and rapid pulse
• Cold and clammy skin
• Confusion, especially in older adults
• Quick and shallow breathing

Treatments for Hypotension

If your hypotension is just slightly below the healthy range and doesn’t cause you any symptoms, it’s unlikely you need treatment.

Those who do experience symptoms may wish to:

Increase Fluid Intake

Water is a staple in any healthy diet, but maintaining hydration and avoiding diuretics can help to increase low blood pressure ( Image Reference).

Drinking more water will help to raise blood volume and prevent dehydration. Steer clear of coffee, tea, and alcohol – which are diuretics – and can increase your risk of becoming dehydrated.

Eat a Balanced Diet with Regular Meals

A diet rich in fresh fruits and vegetables, whole grains, nuts, seeds and lean protein sources like fish and beans is important for blood pressure and heart health. Avoid processed foods, trans fats, and red meat, and cut down on your intake of sugar and saturated fat.

As blood pressure tends to drop after eating, several smaller, low-carb meals spaced throughout the day may help ease symptoms. It can also be helpful to reduce your intake of high-carbohydrate foods like potatoes, white pasta, and white bread.

Add More Salt

People with low blood pressure may actually benefit from a little extra dietary sodium, which can help to raise blood pressure.

However, it’s important to discuss this with your doctor first, because too much salt can cause heart failure, especially in older adults or those with underlying health conditions.

Invest in Compression Stockings

These stockings – which are often used to treat varicose veins – help those with hypotension by preventing blood from pooling in the legs.

Discuss Medication with a Doctor

Some medications are available to help those with hypotension – a doctor will be able to advise you of your options.

Slowly Change Body Positions

Hypotension which causes symptoms from quickly changing body positions can be remedied by slowing down and noticing how you move.

Be sure to move from a sitting position to a standing one gently. Before getting out of bed in the morning, practice some deep breathing exercises, and slowly move from a horizontal position to a sitting one, before gently standing upright.

If you notice symptoms while standing by crossing your legs and squeezing your thighs.

Good Practices for Taking Your Blood Pressure

While monitoring your blood pressure at home is a great way to keep your health on track, it’s cruical that you use the device properly. For accurate readings, follow these good practice guidelines:

Next time you have a doctor’s appointment, bring along your home monitor and have your doctor compare readings between your device and theirs. You should re-test for accuracy in this manner if you drop or damage the device.

To confirm that you are using your device properly, ask your doctor to watch you take a reading. For the greatest accuracy, take two or three readings each time, leaving two minutes between results.

When taking your blood pressure, it’s imperative that the cuff is put on correctly before starting the measurment. Be sure to refer to your device’s manual for specifications and instructions on proper placement. Also, ensure that the cuff is appropriately sized for your arm. Universal cuff sizes work for most, but custom small or large cuffs are available.

You should measure your blood pressure in the morning, but not immediately after waking. Make sure to take a reading before you exercise, eat, or take medications.

In the evening, take a second reading, ensuring it’s not within 30 minutes of eating, smoking, or consuming caffeine or alcohol.

Use the same arm each time you take your blood pressure. Prop up the arm, at heart level, on a steady surface, using a cushion if necessary. You should place the cuff against your bare skin rather than your clothing.

1. Be sure to sit in a comfortable and upright position throughout the measurement
2. Do not cross your legs
3. Avoid talking until results are displayed

Stress can cause your blood pressure to shoot up, which can leave you feeling even more stressed! Stay Zen-like before taking your daily readings for a more accurate result.

If your device doesn’t automatically log your results, write them down on a dedicated notepad. It’s normal for there to be some variation in readings. For example, your blood pressure numbers are often higher in the morning or when taken at the doctor’s office.

However, if you have concerns about any of your blood pressure readings, contact your doctor.

Understanding Blood Pressure Infographic – Know Your Numbers

Having blood pressure outside the normal range puts your health in jeopardy. If it’s too high, you’re at risk of serious medical conditions, including heart attacks and stroke. Blood pressure that’s too low can be life-threatening in severe cases.

Regardless, ALWAYS discuss readings and health conditions with your physician to ensure accurate results and the safest actions for your health.

Keep in mind that you can have high blood pressure and not even know it. This silent condition might be doing untold harm to your body. Knowing your numbers is the only way to find out for sure if your blood pressure readings fall within the optimal range, and making smart lifestyle choices is the only way to keep them there!

Stay consistent with your health. Use the infographic below as a reminder and helpful guide to understanding your blood pressure readings. View below or click image for free PDF 🙂

Sources:

https://www. health.harvard.edu/blog/new-high-blood-pressure-guidelines-2017111712756

New blood pressure guidelines put half of U.S. adults in unhealthy range

Chart Reference

Low Blood Pressure (Hypotension) | Symptoms & Treatment

Some people may naturally have low blood pressure all the time with no symptoms. Their low readings are normal for them. But for others, their blood pressure may drop for a variety of reasons ranging from a medical condition to dehydration.

Low blood pressure is only a problem if a person develops symptoms, which can include dizziness, fainting or shock. In severe cases, it can be life-threatening. But low blood pressure without these serious symptoms is usually not unhealthy.

Low blood pressure that reduces the blood supply to your body’s organs can cause stroke, kidney failure or heart attack.

Understanding how to treat and prevent low blood pressure is important for your cardiovascular health.

Understanding Blood Pressure

Blood pressure is the force of blood pressing against arteries as the heart pumps it through the body. The pressure is highest when your heart beats, pumping the blood. It’s lowest between beats, when the heart rests.

Blood pressure is measured by comparing these two numbers, placing one over the other. The high measurement is called the systolic pressure, and it is placed on the top of the reading. The lower pressure is called the diastolic pressure, and it’s written as the bottom number.

EXPAND

Ideally, your blood pressure should be 120 over 80 — written as 120/80 — or lower. Low blood pressure is anything lower than 90/60.

What Causes Low Blood Pressure?

Causes of low blood pressure are wide-ranging and can include changes in your body’s functions, environmental causes, and trauma or a serious medical condition.

Causes of low blood pressure include:

• Anaphylactic shock
• Endocrine conditions such as Addison’s disease, hypothyroidism, parathyroid disease, low blood sugar and diabetes
• Heart conditions such as heart attack, heart failure, low heart rate and heart valve issues
• Long-term bed rest
• Medications
• Nutritional deficiencies such as low folic acid or vitamin B12 levels, which can lead to anemia
• Pregnancy, especially in the first 24 weeks
• Septic shock
• Sudden loss of blood volume such as from an accident, dehydration or internal bleeding

Source: American Heart Association

Age, medications and medical conditions are all risk factors for low blood pressure.

People with Parkinson’s disease, diabetes and certain heart conditions are at greater risk. Those 65 and older are more likely to experience a sudden blood pressure drop when standing or right after eating.

Medications that Can Cause Low Blood Pressure

Several medicines may cause low blood pressure, including some medications used to control high blood pressure.

Working with your doctor or other health care provider to change your medication or adjust your dosage can help control low blood pressure. You should never modify a dose or stop taking a medication without first consulting your health care provider.

Alpha and beta blockers, diuretics, erectile dysfunction drugs, Parkinson’s disease drugs and some types of antidepressants can cause low blood pressure.

Medications that can cause low blood pressure include:

• Benicar (olmesartan medoxomil) — a prescription blood pressure medication
• Cialis (tadalafil) — an erectile dysfunction drug; risk is especially high when taken with nitroglycerin heart medication
• Cymbalta (duloxetine) — a serotonin and norepinephrine inhibitor (SNRI) antidepressant
• Hydrochlorothiazide — a widely used generic diuretic
• Inderal, Innopran XL and other versions of propranolol — beta blockers
• Lasix (furosemide) — a diuretic
• Levodopa — a generic name for Parkinson’s disease drugs
• Minipress (prazosin) and other alpha blockers
• Mirapex (pramipexole) — a Parkinson’s disease drug
• Tenormin (atenolol) — an alpha blocker
• Tricyclic antidepressants — includes Silenor (doxepin) and Trofranil (imipramine)
• Valsartan and other blood pressure drugs in the sartan family
• Viagra (sildenafil) — an erectile dysfunction drug; risk is especially high when taken with nitroglycerin heart medication

Side Effect Information

Valsartan side effects range from headaches to low blood pressure. Learn more about the common and serious side effects assciated with this blood pressure medication.

View Side Effects

Symptoms

In most cases, you shouldn’t worry about a low blood pressure reading unless you have symptoms of a serious or underlying problem.

Common symptoms of low blood pressure include:

• Blurred vision
• Dehydration
• Depression
• Fainting
• Fatigue
• Lack of concentration
• Lightheadedness or dizziness
• Nausea

Severe or extreme low blood pressure can be life-threatening. This can happen if your body goes into shock from blood loss, an anaphylactic reaction or septic shock from a serious infection.

Serious symptoms of low blood pressure include:

• Rapid but weak pulse
• Rapid shallow breathing
• Pale, cold, clammy skin
• Confusion (especially in older people)

What to Do if You Experience a Sudden Drop in Blood Pressure

A single low blood pressure reading is no cause to be concerned unless you experience other symptoms.

A sudden drop in blood pressure — as little as a drop from 120 to 100 in your systolic (top) number — can be dangerous if it triggers dizziness and fainting. Such symptoms can be a sign of an underlying problem that may need medical attention.

You should keep a record of your activities and when symptoms happen to discuss them with your doctor. If you experience any low blood pressure symptoms related to shock, you should seek immediate medical attention.

Types of Low Blood Pressure

There are three major types of low blood pressure: orthostatic hypotension, postprandial hypotension and neurally mediated hypotension. Each is triggered by something different such as a change in body position, a meal or an abnormal reflex.

Orthostatic Hypotension

Orthostatic hypertension is low blood pressure caused by a change in your body’s position that most often happens when you stand up after lying down. It lasts only a few seconds or minutes.

Orthostatic low blood pressure is caused by gravity as your blood pools in your legs. Your heart would normally compensate, pumping more blood to your brain. But with this type of low blood pressure, that mechanism fails, your brain gets less oxygen from the bloodstream and you may feel lightheaded or dizzy. In some cases, you may faint.

It most often affects older people, people with high blood pressure and those with Parkinson’s disease. But you may also experience it if you are pregnant, dehydrated, overheated, or have heart problems, diabetes or certain nerve disorders.

Postprandial Hypotension

Postprandial hypotension is a sudden drop in blood pressure after eating.

Usually after a meal, your heart rate ramps up to send blood flowing to your digestive system. But with this type of low blood pressure, the mechanism fails causing dizziness and fainting. It can also cause people to fall and possibly injure themselves.

Eating small meals that are low in carbohydrates can sometimes reduce symptoms.

Neurally Mediated Hypotension

Neurally mediated hypotension happens when there is an abnormal reflex between a person’s otherwise normally functioning heart and brain, according to Johns Hopkins Hospital. It’s sometimes called the fainting reflex.

People with this type of low blood pressure may feel lightheaded or dizzy or may faint. Other symptoms may include chronic fatigue, muscle aches, headaches and confusion.

Symptoms may happen after being in warm surroundings such as a hot shower or bath or hot summer weather. Other triggers include standing quietly for a long period of time, such as a service member at attention. It can happen after exercise, after eating or following emotionally stressful situations.

With this type of low blood pressure, gravity allows blood to pool in the legs. The heart needs to beat faster to supply the brain with enough blood, but a malfunction causes the brain to tell the heart to beat less, decreasing the blood supply to the brain.

Treatments

Low blood pressure seldom requires treatment, unless it’s the result of sudden trauma, infection, anaphylactic shock or other serious underlying cause.

If it’s caused by medications, your doctor may prescribe a different medication or simply alter your dosage.

Ways to correct low blood pressure:

• Wear compression stockings to prevent the pooling of blood in the legs
• Drink fluids to prevent or relieve dehydration, a major cause of common low blood pressure
• Eat more salt to raise blood pressure

Your doctor may prescribe Orvaten (midodrine) to raise your blood pressure if you are diagnosed with chronic orthostatic hypotension. For milder forms, a doctor may prescribe fludrocortisone to boost your blood volume. There are several other drugs that may be available depending on your particular type and severity of low blood pressure.

Top Blood Pressure Number Is Key in Seniors

Aug. 31, 2004 — People aged 60 and older commonly face a unique blood pressure problem. And new research shows that this is something that shouldn’t be ignored.

Blood pressure is noted by two numbers. The upper number, systolic blood pressure, measures the pressure in the arteries when the heart pumps blood throughout the body; the lower number, diastolic blood pressure, is the pressure in the arteries when the heart is relaxing (in between beats).

When systolic blood pressure rises above 160 in people aged 60 and older, it’s time to consider treatment — even if the lower number is normal, less than 90. New research on systolic high blood pressure, which is much more common as we age, is published in The Journal of the American Medical Association.

Sarwat Chaudhry, MD, of the West Haven Veterans Affairs Medical Center in West Haven, Conn., and colleagues conducted the research. Chaudhry’s team reviewed more than 1,000 related studies done between 1996 and 2004, focusing on 36 articles in particular.

Continued

Chaudhry and colleagues found “strong evidence” to support treating systolic high blood pressure in people aged 60 and older. Doing so can decrease the likelihood of developing heart disease or having a stroke.

Systolic blood pressure is considered high when it’s 140 or above. When the lower blood pressure number is less than 90, treatment is generally considered only when systolic blood pressure tops 160. Among older patients, the evidence isn’t yet clear that the pros outweigh the cons of treating it in the 140-160 range.

High systolic blood pressure in people 60 and over is a much more important heart disease risk factor than high diastolic blood pressure, write the researchers.

More Studies Needed

More studies are needed to sort that out — and the sooner, the better. America’s population is aging and high systolic blood pressure is becoming all too common, say the researchers.

“Given the scope of the problem and the growing size of the elderly population, there remains an acute need for more study,” they write.

Even the most elderly patients — those older than 85 — might benefit from treatment, write the researchers. But again, experts can’t be sure, since too few of the “oldest old” have been studied so far.

Continued

Likewise, it’s not yet known how much lifestyle changes such as shaping up, limiting salt and alcohol intake, and getting enough potassium can help older people with high systolic blood pressure. You guessed it — not enough research there, either.

The two options for treating systolic high blood pressure that had the strongest support in the studies reviewed by Chaudhry’s team are thiazide diuretics, commonly known as water pills, and blood pressure medications called long-acting calcium-channel blockers. Doctors have several options to choose from.

Doctors and patients should work together to judge the risks and benefits of systolic high blood pressure treatments, say the researchers. Meanwhile, advanced age doesn’t appear to be a reason to automatically avoid treatment.

My Blood Pressure is 103/63

Blood pressure 103/63 – what does it mean?

Your blood pressure reading of 103/63 indicates Hypotension. This means your blood pressure is lower than the usual with values at a systolic (upper) value under 105 mmHg and a diastolic (lower) value of under 60 mmHg.

However, in most cases this is no reason to be concerned. If your blood pressure is only slightly under said values and there are no health impairments a hypotense blood pressure might be alright.

By the way: Your diastolic value of 63 mmHg is better than your systolic value and would classify as Ideal. But if you are getting two different types of classification for your blood pressure it is correct to choose the one that is considered worse.

What you should know about a blood pressure of 103/63

Low blood pressure rarely causes any severe symptoms, but some patients experience debilitating side effects. The recommended blood pressure reading for healthy adults is 90 (systolic) over 60 mm Hg (diastolic). Your blood pressure of 103/63 is below the recommended range and considered low blood pressure. Fainting episodes and dizzy spells are two common symptoms associated with dangerously low blood pressure or BP. This condition is known as hypotension and can have life-threatening consequences if left unchecked. Several health-related conditions and life events can cause BP levels to drop. In some cases, an underlying medical condition, surgical disorders, or dehydration might be responsible.

Symptoms:

• Fatigue
• Poor concentration
• Nausea
• Dizziness
• Blurred vision
• Fainting

If a patient experiences extreme hypotension, it can trigger symptoms such as palpitations, confusion, pale skin, and breathing difficulty. It is wise to seek medical attention if this happens because it can result in shock.

How to raise blood pressure quickly?

1. Increase aggregate sodium intake. Table salt has a balanced amount of sodium content, which can help boost BP levels instantaneously. However, patients should consult their physician before adding more salt to the diet. High salt consumption can sometimes be dangerous and life-threatening.
2. Eat wholesome, well-balanced meals to maintain a healthy diet. Sometimes low BP is triggered by poor eating habits and nutrient deficiencies. A lack of iron, folic acid, and vitamin B- 12 is a leading cause of anemia. If the body is not making an adequate volume of blood, it could lower pressure levels.
3. Drink more water. Mild dehydration can lower blood pressure activity, which causes hypotension in extreme cases. Sometimes, sickness involving frequent vomiting, diarrhea, excess sweating, and fever may result in dehydration. In such circumstances, an adequate intake of water to rehydrate the body is necessary. For long-term benefits, those affected must maintain a healthy water drinking habit to stabilize low BP levels.

What are some healthy lifestyle changes to improve low blood pressure long-term?

Controlling low blood pressure naturally can sometimes be challenging, but equally doable with the right self-intervention measures. Numerous studies say regular exercise can have positive effects on cardiovascular health, which in turn can balance low blood pressure. However, individuals should avoid exercising in extreme heat and outdoors, especially during the summer months. Researchers also advise against prolonged rest and spending long hours in the steam room, sauna, or hot tub. Also, compression socks can improve blood flow throughout the body and boost blood pressure levels.

Low blood pressure during pregnancy: Causes and remedies

Low blood pressure during pregnancy is a normal occurrence. Fluctuating hormones and changes in circulation can often lower the blood pressure, especially in the first and second trimester of pregnancy.

Low blood pressure (hypotension) during pregnancy does not usually cause significant health issues, and most women can treat it at home.

However, very low blood pressure can be a cause for concern, and some women experience bothersome symptoms. In this article, we look at the causes, treatments, and when to see a doctor.

Share on PinterestRegular health checks with a doctor are recommended during every stage of pregnancy.

Pregnancy causes many changes as a woman’s body adapts to the effort it takes to create a baby. This is why it is so important for pregnant women to have regular check-ups with their doctor during all stages of pregnancy.

During these check-ups, doctors will likely ask the woman questions about her lifestyle. The doctor will also check the woman’s blood pressure during each visit.

Blood pressure changes slightly depending on a woman’s energy levels, nervousness, lifestyle, and stress levels. Blood pressure can also get higher or lower depending on the time of day.

A woman’s blood pressure may be lower in the first 24 weeks of pregnancy. This is probably caused by the circulatory system, as blood vessels expand to let blood flow to the uterus.

Other temporary causes also exist, such as standing up too quickly or lying in a hot bath for too long.

While this is common, some other factors can contribute to the issue and cause the blood pressure to drop even lower than usual. For pregnant women, this may include:

It is also possible for some medications to lower blood pressure, so it is vital that pregnant women let their doctor know which medicines they are taking.

Extremely low blood pressure may also be a sign of a complication in early pregnancy, such as ectopic pregnancy, where a fertilized egg implants itself somewhere other than the uterus.

During pregnancy, blood pressure is a sign of the health of both mother and baby. Doctors will use the numbers to help diagnose any underlying issues or possible complications.

According to the American Heart Association, normal blood pressure is less than 120 over 80—120 millimeters of mercury (mmHg) is the systolic reading (during contraction of the heart) and is always the top number on the device.

The 80 mmHg is the diastolic reading (when the heart is at rest between beats) and is the lower number on the device. Anything lower than this is considered a low reading but may be normal for many people.

A doctor will usually diagnose low blood pressure when the reading is around 90 mmHg over 60 mmHg.

During the first 12 weeks of pregnancy, a woman might notice a drop in her blood pressure. This low blood pressure will often remain at a low level throughout the first and second trimester and will rise again during the third trimester.

Doctors will continue monitoring blood pressure in the days that follow the birth to look out for any post-pregnancy complications.

Share on PinterestLightheadedness, dizziness, and nausea are symptoms of low blood pressure.

While low blood pressure is usually nothing to be concerned about, the symptoms may be troubling or reduce the quality of life for some women, especially if they have not experienced them before.

Symptoms of low blood pressure include:

• dizziness or confusion
• nausea
• lightheadedness that may result in fainting, especially after standing up quickly
• general fatigue that may get worse throughout the day
• not being able to catch the breath or taking shallow, rapid breaths
• thirst, even after drinking
• cold, pale, or clammy skin
• vision problems, such as blurred vision or double vision
• depression

Any woman who experiences troublesome symptoms such as these should report them to a healthcare professional. They may do some tests to make sure that low blood pressure is the cause and not another underlying condition.

One of the primary risks for women who have low blood pressure is falling caused by fainting. Some women with low blood pressure who stand up too quickly after sitting or lying down may faint.

Frequent fainting spells may be dangerous, especially when pregnant. A woman may injure herself if she falls and loss of blood circulation may cause internal issues.

Severe low blood pressure may result in shock or organ damage. It may keep blood from reaching the baby, which poses risks to the baby’s health.

According to one study, there is a small amount of research that shows continuous low blood pressure during pregnancy has a negative effect on the outcome of the pregnancy, including stillbirth.

However, there are many other possible reasons for these negative impacts on the baby’s health, and low blood pressure alone does not usually have serious complications.

There is usually no medical treatment for low blood pressure during pregnancy, but a woman may try several home remedies to alleviate symptoms. The blood pressure will often return to normal around the third trimester of pregnancy.

However, some women who experience episodes of unusually low blood pressure may require medication. Any underlying conditions that may be causing the drop in blood pressure, such as anemia or a hormonal imbalance, will need to be treated first.

If a doctor suspects that a particular drug is causing low blood pressure, they may offer an alternative medication.

Instead of medical treatment, many women rely on home remedies to help them cope with low blood pressure.

Rest

Share on PinterestResting often during pregnancy is recommended, especially with low blood pressure.

When dealing with low blood pressure during pregnancy, it is important to remember to take things slowly.

Taking time to wake up slowly in the morning instead of jumping out of bed, and getting up from the chair or sofa slowly during the day can help prevent dizziness or fainting.

If a woman does feel faint, she should sit or lie down gently to avoid falling and take steady breaths. Lying on the left side may also help increase blood flow to the heart, which may help stabilize the body.

It is also essential for pregnant women to rest often, especially when they have low blood pressure. Getting off the feet and resting periodically throughout the day can give the body time to recover and reduce fatigue.

Wearing loose-fitting, non-restrictive clothing may help avoid dizziness and fatigue as well. Some women might find that wearing compression stockings or snug knee-high socks can help improve circulation.

Liquids

It is crucial to drink plenty of liquids and to treat any morning sickness or vomiting that is occurring.

If low blood pressure is causing nausea, warm herbal tea may help settle the stomach. Staying hydrated with water can also help.

Diet

Doctors may also recommend eating many small meals throughout the day rather than a few large meals. Eating a varied and nutrient-rich diet is especially important during pregnancy and may help reduce symptoms where possible.

A doctor may also recommend that a woman increase her daily salt intake if she is experiencing low blood pressure during pregnancy. Too much salt can have a negative impact, however, so it is essential to speak with a healthcare professional before adding extra salt to the diet.

When to see a doctor

A doctor will usually monitor a woman’s blood pressure during regular pregnancy check-ups and offer advice or treatment options if it is too low or high. High blood pressure is a more common problem in pregnancy.

Low blood pressure is normal during pregnancy, but it is important to know when to see a doctor or midwife. Anyone who is having frequent dizziness or fainting spells should seek medical care as soon as possible.

If any woman experiences fainting or dizziness along with a severe headache, vision changes, or shortness of breath, she should seek emergency care. Chest pains and feelings of numbness or weakness one side of the body also require emergency care.

A woman may also want to discuss low blood pressure with a doctor if it persists into the third trimester, or if it continues for an extended period.

If a woman has a history of low blood pressure, she should mention this to the health professional during the initial pregnancy check-ups to ensure the blood pressure does not go too low.

Working with a doctor or midwife to treat the symptoms of low blood pressure during pregnancy can help keep both mother and baby happy and healthy.

Blood Pressure Changes – Managing Side Effects

Blood Pressure Changes Include:

High blood pressure
(hypertension), and managing low
blood pressure (hypotension)

Common Examinations for Blood Pressure Changes:

• Blood pressure monitoring – Your healthcare provider may take your
  blood pressure when you visit the office to check for changes in blood pressure.
  Your blood pressure is the force of blood flow against the walls of your artery.
  Arteries carry blood from your heart to your body. This is a part of your vital
  signs. Your vital signs include your blood pressure, your heart
  rate or pulse, your respiratory rate (how fast or slow you are breathing in a minute),
  and your temperature. These alert your healthcare provider to certain diseases or
  conditions that may be present.
• To measure your blood pressure, your healthcare provider will place your arm (it
  is also possible to measure blood pressure using the wrist, finger or any extremity)
  into an inflatable cuff. If an electric monitor is being used, the cuff will inflate
  and automatically record your blood pressure readings.
• If your healthcare provider is measuring your blood pressure by hand (manually),
  the cuff usually will be positioned on your arm, and the stethoscope placed in the
  bend of your elbow. The cuff will be slowly inflated and deflated, and your healthcare
  provider will be able to determine your blood pressure readings in the form of a
  top number your systolic blood pressure reading and a bottom number, your diastolic
  blood pressure reading.

Causes of Blood Pressure Changes:

• Recent intake of caffeine, alcohol or cigarette smoking. This potentially causes
  an increase in your blood pressure.
• When you have your blood pressure taken, rest in a comfortable and relaxed position
  for at least 5 minutes, if possible.
• If the blood pressure cuff is too large, it is possible that your blood pressure
  changes to a falsely lower reading. Also, if the blood pressure cuff is too small,
  it is possible that your blood pressure changes to a falsely elevated reading. Your
  healthcare provider should measure the diameter of your arm, and use the appropriate
  sized blood pressure cuff.
• If you are using your arm for a blood pressure reading, your healthcare provider
  should ensure that the lower edge of the cuff is at least 1 inch above the bend
  of your elbow.
• If you take your blood pressure at home, and you purchase a monitor, make sure that
  your blood pressure cuff gives a similar reading to the cuff in your doctor’s office.
  Electronic blood pressure cuffs need to be checked periodically, to ensure that
  they are giving an accurate reading.

What is a normal blood pressure?


When your blood pressure is taken, there are two readings given. These are the
systolic and the diastolic blood pressure readings.
Your systolic blood pressure is the top number that you get. This
refers to the pressure of the blood, on the walls of your arteries, when the heart
muscle contracts. This is when the blood pressure is the greatest. The bottom number,
or your diastolic reading, refers to the pressure in your arteries
at all times, when the heart is resting in between heartbeats.

The normal blood pressure is 120/80, although most people do not have blood pressure
of exactly 120/80.Low blood pressure is much less common than high blood
pressure.

• People with high blood pressure, or hypertension, are at risk for organ damage (kidney,
  and heart especially), in the long term. Most people with high blood pressure do
  not have any symptoms. High blood pressure over a long period of time potentially
  causes extra stress on your heart muscle. If you have a blood pressure of 140/90,
  on 2 or more checks, you may be diagnosed with high blood pressure.
• Even if you have a normal blood pressure of 120/80, your healthcare provider may
  want the bottom (diastolic) number to be lower, if you have certain diseases. This
  includes diabetes, especially if you have protein in your urine. Protein in your
  urine from diabetes means that you have kidney damage, and you are at risk for worsening
  function of the kidneys in the future. Lower blood pressure can reduce stress
  on the kidneys, and reduce the chance of kidney damage.
• There are many causes of low blood pressure as well. If you have low blood
  pressure, you are at risk for fainting, or “passing out.” If lower blood
  pressure is due to a more serious condition, such as acute blood loss or infection,
  your doctor will focus on treating the underlying condition.

Common Blood Pressure Problems:

Hypertension (High Blood Pressure)

What is hypertension?

• Hypertension is when the blood pressure changes to an elevated rate in your arteries.
  Most of the consequences of hypertension occur over a long period of time. When
  your blood pressure changes to an elevated rate for many months, or years, damage
  to your internal organs may occur as a result.

There are 2 main types of hypertension: Primary and secondary

• Primary hypertension occurs as a result of problems in your body,
  or electrolyte imbalances. This is also called essential hypertension. It also can
  occur if you are overweight, take in too much sodium, alcohol, or due to cigarette
  smoking.
• Primary hypertension is the most common type of high blood pressure, however
  in 95% of cases, no causes can be found.
• Secondary hypertension may occur as a result of many diseases and
  conditions, including medications, heart problems from birth, kidney disease, estrogen
  use, or other diseases of the endocrine system.
• “White coat” hypertension is a category of hypertension, when the
  blood pressure changes to an elevated rate in the doctor’s office, and the individual
  has normal blood pressure readings at home. High blood pressure readings in the
  office were once considered unimportant, as the blood pressures returned to normal
  at home. Now, many researchers conclude that people with white coat hypertension
  should be treated the same as those with regular hypertension. High blood pressure
  is high blood pressure, no matter what causes it when the reading was
  taken.
• Fifty million Americans have elevated blood pressure, but only a little more than
  half of them are aware of their diagnosis.
• The percentage of individuals who have elevated blood pressure levels increases
  with age, and is greater in individuals who are of African American heritage.

Risk factors: Causes of hypertension are many. The risk factors
for high blood pressure that you can change, also called modifiable, include:

• Obesity
• Lack of physical activity.
• Sodium intake
• Alcohol and drug use, caffeine intake.

Factors for high blood pressure that you cannot change, include:

• Genetics
• Age
• Race
• Other diseases and conditions.

What are some high blood pressure symptoms to look for?

• Most people do not notice any symptoms of high blood pressure. This is why high
  blood pressure is known as “the silent killer,” because most people do not notice
  symptoms immediately.
• Some individuals may experience headaches when blood pressure changes
  to an elevated rate.
• If you are having an “acute” or suddenly serious event, you may experience nausea,
  dizziness, and loss of vision, severe headaches, or confusion. If these symptoms
  occur, seek emergency assistance.

Things you can do to manage high blood pressure:

The American Heart Association recommendations for elevated blood pressure:

With any elevated blood pressure readings, your doctor or healthcare provider
may suggest that you:

• Quit smoking
• Exercise most days of the week, for at least 20 to 30 minutes at a time.
• Try to reduce the amount of stress in your life by following relaxation techniques.
• Eat a diet that is low in saturated fat and cholesterol, low in sodium, with lots
  of fresh fruits and vegetables.
• Lose weight if you are overweight.
• Avoid alcohol use. Limit caffeine intake.
• Again, with low blood pressure, safety and treating the underlying cause is the
  greatest concern.
• Try to reduce the amount of stress in your life. Use relaxation techniques to decrease
  the amount of anxiety you have. If you feel anxious, place yourself in a quiet environment,
  and close your eyes. Take slow, steady, deep breaths, and try to concentrate on
  things that have relaxed you in the past.
• If you have hypertension, you may be told to reduce the amount of salt you are eating
  in a day. Many times, it may be restricted to about 2 grams of sodium per day. A
  diet lower in salt potentially causes a decrease in the amount of work that is placed
  on your heart. You should discuss this with your healthcare provider how you can
  specifically use your diet to stimulate changes in high blood pressure. Also, eat
  a diet that is low in saturated fat, cholesterol, sodium, and with lots of fresh
  fruits and vegetables.

Other things you can do to stimulate changes in high blood pressure:

• Make sure you tell your doctor, as well as all healthcare providers, about any other
  medications you are taking (including over-the-counter, vitamins, or herbal remedies).
• Remind your doctor or healthcare provider if you have a history of diabetes, liver,
  kidney, or heart disease.
• Keep a diary of your any abnormal symptoms, to report to your healthcare
  provider. These may include excessive fatigue, shortness of breath or chest pain.
• Questions to ask yourself, may include:
  • Did my symptoms of blood pressure changes occur gradually, or did this episode come
    on all of a sudden?
  • Was I feeling anxious?
  • Did I perform any kind of activity, or was I resting?
• If you are ordered a medication to treat your high blood pressure, do not stop taking
  it unless your healthcare provider tells you to. Take the medication exactly as
  directed. Do not share your pills with anyone.
• If you miss a dose of your medication, discuss with your healthcare provider what
  you should do.
• If you experience symptoms or side effects, especially if severe, be sure to discuss
  them with your health care team. They can prescribe medications and/or offer
  other suggestions that are effective in managing problems that high blood pressure
  causes.
• Keep all your appointments for your treatments.

Drugs and recommendations that may be prescribed by your health care provider:

Your doctor or healthcare provider may prescribe certain drugs to treat your hypertension. Diuretics
and beta-blockers are the most common types of medications used to treat high blood
pressure initially, upon diagnosis.

Some other drugs that are commonly used to treat high blood pressure may
include:

• ACE inhibitors – These drugs work by opening, or dilating,
  your arteries. They will lower your blood pressure, which causes improved blood
  flow to your kidneys, and throughout your body. Your healthcare provider may also
  prescribe these medications if you have diabetes or protein in your urine, to protect
  your kidneys. Some examples of this medication may include: Enalapril maleate (Vasotec^®), Lisinopril (Zestril^®),
  and fosinopril sodium (Monopril^®)
• Beta-blockers – can be used to slow down your heart rate,
  which causes improved blood flow through your body. You may take this drug if you
  have been diagnosed with irregular heartbeats, palpitations, heart failure, or high
  blood pressure. Some examples of this medication may include: Metoprolol (Lopressor^®), propanolol (Inderal^®),
  and atenolol (Tenormin^®).
• Calcium Channel Blockers – These medications may be given
  to treat chest pain, high blood pressure, or irregular heartbeats. A few common
  drugs include Verapamil HCL (Calan^®), and Diltiazem
  (Dilacor^®XR).
• Diuretics – may be known as “water pills” as they work
  to prevent or treat high blood pressure by making you urinate out extra
  fluid. Some examples of this medication may include furosemide (Lasix^®),
  and Hydrochlorthiazide. You may receive this medication alone or in combination
  with other medications.
• Digoxin – Also called digitalis, this medication causes
  the heart rate to slow down, making it beat more effectively. This will pump blood
  throughout the body better. It is also called Lanoxin^®.
• Vasodilators – are drugs that work by opening up or “dilating”
  the vessels. These may include isosorbide dinitrate (Isordil^®).
• Do not stop any of these medications abruptly, especially if you
  are prescribed any anti-arrhythmia drugs or beta blockers, as serious side effects
  may occur.

When to call your doctor or health care provider about symptoms of blood pressure
changes:

• Shortness of breath, chest pain or discomfort; swelling of your lips or throat should
  be evaluated immediately- especially if you are taking new medications, or have
  a history of elevated blood pressure.
• If you are having an “acute” or suddenly serious event, you may experience nausea,
  dizziness, and loss of vision, severe headaches, or confusion. If these symptoms
  of blood pressure changes occur, seek emergency assistance.
• Feeling your heart beat rapidly (palpitations).
• Bleeding that does not stop after a few minutes, blood in your urine or stool.
• Any new rashes on your skin, especially if you are taking new medications.
• Any unusual swelling in your feet and legs, weight gain of greater than 3 to 5 pounds
  in 1 week.

Note: We strongly encourage you to talk with your health care professional about
your specific medical condition, including blood pressure changes, causes and treatments.
The information contained in this website about blood pressure changes and other
medical conditions is meant to be helpful and educational, but is not a substitute
for medical advice.

Hypotension (Low Blood Pressure)

What is hypotension?

• 
  Hypotension may be defined as a lower than normal blood pressure readings. There
  are many causes for hypotension. Some of the main causes may include:

  • Some chemotherapy or biological drugs may cause low blood pressure, such as bleomycin
    or interleukin. Adverse effects of other drugs, such as rituxamab (Rituxan^®) or paclitaxel (Taxol^®),
    may cause blood pressure changes in either direction, higher or lower.
  • You may have low blood counts (anemic), from causes such as recent chemotherapy
    treatments, or your disease.
  • Certain physical conditions – such as orthostatic hypotension. Orthostatic hypotension
    is often a result of a disease state, or dehydration.
  • As you get older, or as a result of certain conditions, the central nervous system
    has a more difficult time regulating blood pressure levels. When you change from
    a lying to a standing position rapidly, you may feel “faint” or lightheaded, as
    your blood pressure changes to a level below normal.
  • Orthostatic hypotension may also occur if you are anemic, or dehydrated, as the
    fluid volume levels in your body are low.
  • Medications – If you are taking certain medications to control
    your high blood pressure or heart rate, for example, these may cause changes in blood
    pressure to a lower level.
  • Irregular heart rhythm changes – if your heart is beating irregularly,
    it potentially causes your blood pressure to be low as a result. The blood is not
    pumping through your body very effectively, and your body is unable to compensate.
  • Shock – “Shock” may occur from many causes that are related to
    your heart, lungs, trauma, infection or other diseases. This happens when the circulation
    of blood is not able to meet your body’s needs of oxygen, fluid and nutrients. For
    example, if you have a severe blood infection, you may develop low blood pressure as
    a result. Treatment of shock consists of identifying the causes, and trying to correct
    it.
  • Bleeding – if you are bleeding from your gastrointestinal track,
    or from some other location, you may be at risk for low blood pressure. This is
    because you are losing fluids, and fluid levels work to maintain normal blood pressure
    readings. Severe bleeding may lead to a form of “shock.”

  
  What are some symptoms of blood pressure changes to look for?

  • You may be overly tired, or very weak (fatigued). It may be hard for you to do any
    kind of your normal activities.
  • You may feel dizzy or “faint” when you stand up, or change positions slowly. You
    may feel like you are going “pass out.”
  • You may feel sweaty or nauseous, if you think you may faint or lose consciousness.
  • If your low blood pressure changes to a lower rate due to a heart problem,
    you may feel your heartbeat, or palpitations.
  • You may have a fever, chills or feel ill, if an infection causes your low pressure.
  • You may notice that you are pale in color, or have blood in your stool. This may
    be due to bleeding from your gastrointestinal tract, or anemia from your disease
    or chemotherapy treatments.

  
  Things you can do to manage hypotension:

  • If you have low blood pressure, changes in position must be performed slowly.
    Rest for a few minutes in between lying, sitting and standing.
  • Avoid hot environments, such as a shower or a bath, which may cause your blood pressure
    to be reduced.
  • Avoid alcohol and certain drugs that may cause low blood pressure. Discuss these
    causes of low blood pressure with your healthcare provider.
  • Drink lots of fluid. Drink 2 to 3 liters of fluid every 24 hours, unless you were
    told to restrict your fluid intake. This will decrease your chances of being dehydrated,
    and developing low blood pressure.
  • Monitor for signs of bleeding. If you have tarry black stools, or maroon stools,
    notify your healthcare provider immediately.
  • Make sure you tell your doctor, as well as all healthcare providers, about any other
    medications you are taking (including over-the-counter, vitamins, or herbal remedies).
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver,
    kidney, or heart disease.

  
  Drugs that may be prescribed by your doctor:

  
  Treatment of low blood pressure is based on correcting the underlying causes.

  • If anti-cancer medication causes your low blood pressure, you will be monitored
    closely and corrective actions will be taken based on that medication.
  • If you are prescribed a medication for your high blood pressure, and your blood
    pressure changes too dramatically your dose may be decreased.
  • If you are bleeding, or are dehydrated, your fluid and blood volumes may be low.
    This potentially causes low blood pressure. Your doctor or healthcare provider will
    treat this by giving you fluids, plasma, or blood.
  • If you have an infection that causes your low blood pressure, your healthcare providers
    will correct this with identifying and treating the source of infection in your
    body. Depending on the source of the infection, the type of antibiotics you will
    receive may vary.
  • Aspirin – depending on your overall health status, your
    healthcare provider may prescribe aspirin as a “blood thinner.” Aspirin works by
    preventing platelets in your blood from forming blood clots (anti-platelet). This
    may be prescribed if you have had a blood clot, irregular heart rhythm, or
    a heart attack.
  • Beta-blockers – If your low blood pressure changes to
    a lower rate due to your heart beating irregularly, your doctor will prescribe medications
    to control your heart rate. Beta-blockers can be used to slow down your heart
    rate, and improve blood flow through your body. You may take this drug if you have
    been diagnosed with irregular heartbeats, palpitations, heart failure, or high blood
    pressure. Some examples of this medication may include: Metoprolol (Lopressor^®), propanolol (Inderal^®),
    and atenolol (Tenormin^®).
    • A side effect of beta-blockers is low blood pressure. If you are given this
      medication to control your heart rate, your blood pressure should return to normal.
      However, you must be careful, and take the medication exactly as directed by your
      healthcare provider.

  • Digoxin – Also called digitalis, this medication works
    by slowing down the heart rate, and making it beat more effectively. This will pump
    blood throughout the body better.
    • Your doctor or healthcare provider should be testing your blood for the levels of
      digoxin in your blood stream.

  • Midodrine Hydrochloride – This medication may be given
    to you by your cardiologist or specialist, if you have low blood pressure when you
    stand up. You will likely receive this medication if your blood pressure changes
    to a low level when you change positions, and this causes you to feel dizzy, faint,
    or even “pass out.”
    • If you are taking this medication for your low blood pressure, make sure to take
      it exactly as directed. If your blood pressure changes to a level too high when
      you lay down as a result of this medication, your healthcare provider may suggest
      that you sleep on one or two pillows, with the head of the bed elevated.

  
  When to call your doctor or health care provider about symptoms of blood pressure
  changes:

  • Notify your doctor or health care provider immediately and seek emergency help if
    you have chest pain, chest tightness, or sudden shortness of breath.
  • Notify your doctor or health care provider immediately and seek emergency help if
    you have a sudden severe headache, slurring speech or weakness on one side of your
    body and not the other.
  • Shortness of breath, chest pain or discomfort; swelling of your lips or throat should
    be evaluated immediately- especially if you are taking new medications.

  
  Notify your doctor or health care provider within 24 hours if you experience:

  • Fever of 100.5° F (38° C), chills, sore throat (possible signs of infection, especially
    if you are undergoing chemotherapy).
  • If you “pass out” or lose consciousness as a result of your low blood pressure.
  • Feeling your heart beat rapidly (palpitations).
  • Monitor for signs of bleeding. If you have tarry black stools, or maroon stools,
    notify your healthcare provider immediately.
  • Any new rashes on your skin, especially if you are taking new medications.

  
  Note: We strongly encourage you to talk with your health care professional
  about your specific medical condition including blood pressure changes, causes and
  treatments. The information contained in this website about blood pressure changes
  and other medical conditions is meant to be helpful and educational, but is not
  a substitute for medical advice.

“No“ working pressure ”. 140/90 is already hypertension. ” A cardiologist in a big interview about blood pressure

45% of Belarusians have arterial hypertension. More than half of them do not take medication. Why do you need to be constantly treated with high blood pressure, what will happen if you do not do this, and how to understand that you have hypertension and then not lose heart? Tamara Tyabut, Professor of the Department of Cardiology and Rheumatology of BelMAPO, Doctor of Medical Sciences, spoke about why so many Belarusians die from cardiovascular diseases and what to do with high blood pressure.

“We do not treat high blood pressure, but we prevent damage to target organs”

– Cardiovascular diseases rank first among the causes of death in Belarus. Why?

– We are dying from already developed diseases and their complications, forgetting that it is better to be engaged in their prevention. That is, do something that will not allow the disease to arise or slow down its development and the occurrence of complications. The first Russian professor Matvey Yakovlevich Mudrov said: “In diseases, one must start from the roots.”What did he mean by roots? Risk factors. Yes, the phrase “the correct way of life” is sometimes jarring, because people are not absolutely correct. But if our priorities are such a value as health, and not money, then we will have a completely different attitude to how to live.

It seems to me that none of the highest technology will solve the problem of mortality from cardiovascular diseases. Belarus does not differ from European countries in terms of the level of high-tech assistance.We are talking about stenting, bypass grafting, heart transplantation, heart-lungs complex. Nevertheless, mortality rates from cardiovascular diseases have not changed significantly in our country, so today Belarusian doctors are trying to focus on primary prevention of diseases.

What are the roots of cardiovascular diseases? By itself, arterial hypertension is the cause of the development of atherosclerosis, coronary heart disease, myocardial infarction, strokes, sudden death.And even if acute vascular catastrophes do not occur, a person with heart disease will end his life with chronic heart failure.

Professor of the Department of Cardiology and Rheumatology of BelMAPO, Doctor of Medical Sciences Tamara Tyabut.

– Can this be influenced?

– Yes, you can. It is necessary to engage in prevention – and in this sense, the fight against stress is one of the first places. Our life today is filled with stress. Stress is generally needed for life, but when there is a lot of it, it turns into distress – a destructive process that worsens the course of psychophysiological functions.

In this state, the body’s regulatory systems work very hard. We are talking about the sympathetic nervous system, the renin-angiotensin system, which are responsible for regulating the level of pressure. A person does not feel how the work of his regulatory systems changes under stress, but such a feature of his life will lead to their dysregulation and to an increase in pressure.

Another problem is that you and I have stopped moving. Now our lives are filled with computers, gadgets, work, two jobs, three … In the 18th-19th centuries, a person moved much more, and this led to the fact that the flow of energy and its consumption were balanced.Today everything is available, there is no hunger, and you can buy any food in stores. But how do we use this energy? Sometimes patients who want to lose a little weight say: “I don’t eat anything, but I am not losing weight.” “What else are you doing?” – I ask. “I sit in front of the TV and watch serials,” they answer. You can not eat anything, but gain weight.

Now let’s turn our attention to our nutrition. Take a look at what is now located on Independence Avenue in Minsk – fast food restaurants.Eating on the go, food that contains a lot of fast-digesting carbohydrates will not lead to anything good. The problem of obesity in Belarus has already been identified by experts from the World Health Organization. Approximately 27% of the country’s inhabitants are overweight and obese. Our pediatricians tackled this problem, and it turned out that this figure is even higher in adolescents and children – about 37%. Therefore, today we have a problem of arterial hypertension in children and adolescents. In their case, the risk factors are heredity and food.Besides, what are our children drinking?

– Soda.

– Yes, and there is monosodium glutamate. This is a substance that belongs to the enhancers of taste and aroma, but contributes to the development of dependence on this taste. I drank this water now, and in an hour I want to drink more, and there are fast-digesting carbohydrates in the composition. This is where the problem arises.

All these factors also contribute to an increase in pressure. With obesity, the hormonal balance in the body is disturbed – adipose tissue is hormonally active.It produces many hormones that will increase appetite, promote the development of insulin resistance, and affect vascular tone. And if our vessels are spasmodic, then the intravascular pressure will change.

Quite often, material well-being is in the first place among life goals: a career, a good car, branded clothes. Unfortunately, this list does not include the value and prestige of health. When this becomes the main value, you and I will be able to say that we have achieved success.

– Why is arterial hypertension dangerous?

– It is not dangerous because of high blood pressure. Today, doctors clearly understand that they not only treat high blood pressure, but also prevent damage to target organs. The most important target organs for hypertension are the heart, brain, blood vessels and kidneys. The kidney function has suffered against the background of high pressure, the release of regulating hormones has changed – and the pressure can already increase due to these violations, a vicious circle is formed.

Our patients need to understand that we are not treating high numbers, we are protecting the target organs.

Photo: Daria Buryakina, TUT.BY

– It used to be said that 140/90 is the working pressure.

– There is no concept of working pressure now. 140/90 is already hypertension, 130-139 / 80-89 is high normal blood pressure, the norm is 120/80. And even with high normal blood pressure in people who belong to a very high risk group, have a comorbid pathology in the form of coronary heart disease, heart attack or stroke, it is necessary to start treatment.

Now the approaches to people with a “tender” age have changed – 80-90 years. If they tolerate higher levels of pressure well, then it can be kept at numbers – 140-160 mm Hg. Due to atherosclerotic changes in the vessels of the brain, low blood pressure can cause brain disorders. This is the only category for which pressure numbers can be higher.

“We do not have a safe dose of alcohol, everything is dangerous for Belarusians”

– How to choose a drug that will reduce blood pressure?

– Very often, both doctors and patients want everything to be at once – here and now.And therefore, after the appointment of sufficiently high doses of antihypertensive drugs, the pressure can decrease within one to two days. However, you need to reach the target pressure level within three months. Why? Because the body is already accustomed to working in other conditions and the restructuring must also take place slowly, so that the adaptation processes are formed and begin to work. These three months are still needed in order for the patient to develop adherence to treatment, control and to assess the condition of the target organs at least once a year.

– Medicines that lower blood pressure, should hypertensive patients drink every day and until the end of their life?

– Yes, this is a permanent cure. Let me explain why. If the regulatory system is already broken, and we added the medicine and restored everything (that is, if we compare with a technical device, they built a tablet into the broken mechanism like a new part, and then they took it away), then for another two or three months the pressure may be normal, but this will not affect the prevention of target organ damage.Let me remind you that the goal of treatment is to protect the target organs.

A large number of multicenter studies have shown that if certain drugs are taken for two to three years, left ventricular hypertrophy of the heart can be reduced. If they quit taking it, in two or three months everything will return to the initial level. It turns out that the first stage of treatment was useless.

Patients sometimes say that they have been taking the medicine for three to four years and, probably, have become accustomed to it. But there is no addiction to antihypertensive drugs and they need to be taken constantly.For patients with arterial hypertension, there are additional (in addition to blood pressure) risk factors for the development of cardiovascular accidents.

Low risk – when the blood pressure is normal or slightly elevated, but the person does not smoke, has normal cholesterol levels, eats right, he does not have other chronic diseases. There are very few such patients. During this period of time, nothing bothers them, so why go to the doctor? And if a person, along with arterial hypertension, has coronary heart disease, this is already a high risk.And if you have diabetes mellitus, stroke and heart attack, this is a very high risk.

Starting treatment, first of all, a person with high blood pressure must change his lifestyle. Without this, none of the best drugs will give 100% the desired result.

– What can be changed at least?

– Salt consumption. A teaspoon without a top is a daily requirement, it is less than five grams that are allowed. You can cook unsalted food and then add salt to it.And believe me, if you add some salt to your taste, then a person will consume less than these five grams per day. I’m not in favor of not using salt at all. We are well aware of the history and military situations when everything was sold for salt, because a salt-free diet led to edema, fainting. It’s about measure.

Secondly, we can play sports and move more, thirdly, quit smoking and alcohol abuse.

In 2009-2010, Belarus was in the red zone for alcohol consumption in the WHO atlas of cardiovascular risks.And this is from 11 to 23 liters per capita. In 2016, in one of the theses defended by psychiatrists, I came across figures characterizing the consumption of alcohol by adolescents and young people – an average of 14.3 liters. And if the consumption is more than 8.3 liters, then we practically go to the fact that the gene pool of the nation will suffer.

It is impossible to limit alcohol consumption only by regulating its sales in stores. There must be a culture of drinking.In the 80s and 90s, there was a position on safe doses of alcohol – 30 grams of pure ethanol per day, when calculated for various drinks, up to 100 ml of strong alcoholic drinks, or 250 ml of wine, or 500 ml of beer for men, for women – half were obtained. from this dose.

Subsequently, this dose was further reduced by half: 15 g of pure ethanol per day for men and 7.5 g for women.

But WHO draws attention to the fact that in countries where there is no culture of drinking alcohol, the recommendation about safe doses of alcohol should not be given.Because some patients come and say: “I don’t have time to drink this safe dose every day, but can I collect everything in a week and drink on the weekend?” This suggests that there is no culture of drinking. We do not have a safe dose of alcohol, everything is dangerous for Belarusians.

You need to pay attention to your diet and high cholesterol levels. What do we like to eat? Sometimes they laugh that Belarusians like to eat a lot of bacon and potatoes. Lard, by the way, does not significantly raise cholesterol levels.But carbohydrates, along with foods containing animal fats, such as pork, will be.

Our eastern neighbors eat a lot of lamb, and their atherosclerosis is less common. Lamb contains more unsaturated fatty acids. Have you noticed that mutton fat quickly freezes? And this is due to its unique composition. However, you shouldn’t use this fat to treat cardiovascular disease, although it has many different medical uses.

The way of cooking is also important.It’s one thing to fry meat or fish to a crust in a skillet, and another to grill or stew. When using these cooking techniques, less fat remains in the cooked dish.

Photo: Vadim Zamirovsky, TUT.BY

– If a person has arterial hypertension, but he removed the risk factors: he began to eat right, play sports, lost weight, he does not smoke. Can you skip daily blood pressure pills?

– I think if this happened in the early stages, when there was no damage to target organs and the person will be committed to such a lifestyle, then yes.If this happened when hypertrophy of the heart muscle, angiopathy of the retinal vessels, nephroangiosclerosis, changes in the vessels had already developed, then no.

“Anxiety, fear, depression can be superimposed on hypertension”

– I know that many hypertensive patients still do not take pills every day. What then can happen to these people?

– Gradually, atherosclerosis of large vessels, aorta, coronary arteries, vessels of the lower extremities and brachiocephalic vessels (vessels of the neck.- Approx. TUT.BY). The development of atherosclerosis is the accumulation of lipids in the vascular wall. Just imagine: an even and smooth vascular wall – and suddenly some protrusions begin to appear there.

An atherosclerotic plaque may become unstable at some point, its lining stretches and may rupture. This is already a vascular damage, and the body will definitely respond to this: cells that have the ability to close vascular defects – platelets – are activated, they will start the formation of a blood clot, the vessel will close and a heart attack will occur.Here is the result. The same can be in the cerebral vessels – and a stroke will occur.

The payback for untreated hypertension will come anyway. Someone earlier, someone later.

One more aspect can be taken: now we are talking about bodily illnesses, but a person’s soul is also ill. This means that any psychopathological syndromes – anxiety, fear, depression – can be superimposed on arterial hypertension. And they, in turn, can launch a new round of development of arterial hypertension.Sometimes we have to prescribe not just antihypertensive drugs, but add drugs with psychotropic effects – antidepressants, anti-anxiety drugs. This is necessary in order for the soul and body to heal at the same time.

– What examinations do you need to undergo to understand that a person has arterial hypertension? Of course, in addition to the fact that he measures the pressure and sees increased numbers.

– There is a difference in where a person measures blood pressure. It is believed that if at home he has numbers of 130/80 mm Hg and above, then he already needs to think about hypertension.For a polyclinic, this figure is 140/90 mm Hg and above. In this case, it is necessary to be examined to identify the risks of developing the disease.

It is imperative to do an electrocardiogram, an ultrasound of the brachiocephalic vessels, and this examination has been included in the mandatory standards since 2018. You also need a fundus examination by an ophthalmologist, an ultrasound of the heart, and a biochemical blood test.

Photo: Daria Buryakina, TUT.BY

In the blood test, one should pay attention not to ordinary cholesterol, but to low-density lipoprotein cholesterol.It is more aggressive and can trigger a cascade of immune responses. There is also high-density lipoprotein cholesterol – these are protective lipoproteins, and their level also needs to be analyzed. It is important to calculate the coefficient of atherogenicity, which indicates a favorable or unfavorable ratio of lipid fractions.

The glucose level must also be determined. Today all over the world there is a problem of the incidence of type 2 diabetes mellitus, so blood glucose must be assessed without fail. You also need to analyze the indicators of kidney function – this is the level of urea and creatinine, look at liver enzymes.

Our patients are very afraid for their liver. One of the reasons why the treatment of high blood pressure is stopped: “so I will” plant “my liver.” But the liver is more likely to eat alcohol that is drunk once a week than a properly selected drug.

And since 2018, according to the approved protocols in patients with arterial hypertension, attention should be paid to the level of uric acid.

All these examinations need to be done once a year to see what happens to the target organs and risk factors.

– Is it necessary to carry out daily monitoring of blood pressure (ABPM) when a person wears a special device during the day that automatically measures blood pressure at certain time intervals?

– Blood pressure in a healthy person has certain circadian or circadian rhythms. The body adapts to a certain rhythm of life: during the day – work, at night – rest. It can be disrupted in arterial hypertension, in people who work in shifts.

There are people who seem to be doing well during the day, but at night this decrease in pressure is not, it remains high. And another very significant indicator, determined by daily monitoring, is the rate of morning rise. Measuring the pressure on our own, we will not estimate it, but when performing the ABPM it is visible.

When do vascular accidents happen? Most often in the early morning hours. Who? In people who have a very high rate of early morning pressure rise. Therefore, to assess the characteristics of the daily rhythm, the effectiveness of treatment, ABPM is performed.

– How to measure pressure correctly?

– If this is not some kind of emergency, then you need to measure the pressure ten minutes after being at rest. Then the blood pressure is measured for the first time, it is recorded, for example, it is 150/90 mm Hg. Two minutes have passed, the pressure is measured again, it is 142/88 mm Hg. What is the correct pressure? We measure the third time – 140/88 mm Hg. This will be correct. The difference between two measurements should be no more than two millimeters.But if the third time was measured and the pressure became 136/80 mm Hg, you need to measure the fourth time. Measured the fourth time, it is 126/75 mm Hg, measured the fifth, it is the same. So what’s the right pressure? First or last? Last thing.

– That is, you do not need to display the arithmetic mean?

– No. There are some pressure measuring devices that automatically display the average, but according to the WHO criteria, it is worth measuring the pressure until the difference between the two measurements is no more than two millimeters, that is, the pressure becomes stable.

“It happens that headaches in a patient with hypertension decrease after a cup of coffee”

– Should you pay attention to the pulse?

– There is a definite relationship between blood pressure and pulse. The lower the pressure, the higher the pulse can be. This is especially clearly seen when the pressure drops sharply, and the pulse begins to build up. Heart rate, like blood pressure, depends on the function of the autonomic nervous system.
The autonomic nervous system consists of two divisions – the sympathetic and the parasympathetic.The sympathetic stimulates the body’s activity – the “flight response”. They are accompanied by an increase in the intensity of work. If we saw a bus and want to run up, then we don’t say: “Listen, heart, I’ll run now, let’s start working more often.” Our internal regulatory systems start to work on their own.

A person with predominantly sympathetic nervous system activity under stress may have a high heart rate. The normal rate of heart rate is 60-90 beats per minute.But the closer the figure is to 60, the more economically and longer your heart will work. Therefore, it is necessary to control the rhythm, especially for those who have atrial fibrillation (atrial fibrillation). In these cases, drugs are prescribed to bring the frequency closer to the standard values ​​- 60-70.

There are people whose pulse is rare – 45-50 beats per minute. If the parasympathetic nervous system prevails or a person regularly sports, then at rest he may have just such a pulse.Such a patient needs to be further examined in order to understand: this is the norm for him or signs of the disease. In this case, you need to do Holter monitoring. To do this, the patient is put on a device and an electrocardiogram is recorded during the day.

– Is low pressure not as dangerous as high?

– We refer to people with low blood pressure as hypotonic. Such pressures may be genetically determined and may not be particularly problematic for some people.Unfortunately, today we do not have medicines for the planned increase in blood pressure, except for herbal remedies or physical activity.

But if a hypertensive person becomes hypotensive during treatment, the situation may be unfavorable. The blood supply to the internal organs, especially the brain, will be disrupted, the state of health will worsen, weakness, and a low level of performance will disturb.

– Can people with hypertension drink coffee?

– A person can do anything, but he must know his measure.Coffee no longer affects arterial, but venous vessels. It happens that headaches in a patient with arterial hypertension decrease after a cup of coffee. But a cup of coffee is one situation, and a cup of coffee three times a day is another. In principle, there are studies that say that during the day you can drink two or three cups of coffee, but you need to understand what kind of cups and what kind of coffee: it is stronger or less.

– At the beginning of the conversation, you talked about stress, but it seems to me that they cannot be avoided.How to work on yourself?

– We must realistically assess the situation: what depends on us and what does not, where we must accept it and try to change it, and where we accept it.

But you need to increase your resistance to stress. You and I mainly talked about the interests of the patient, but I will also talk about the other side of the coin – the interests of the doctor. Research carried out in the world has shown that the most stressful are the professions where there is a “person-to-person” type, and among them are doctors and teachers. Today there is a lot of literature on how to overcome stress, BelMAPO has courses for doctors, which teach medical psychology, conflict management, and prevention of professional burnout.

A physician has traditionally enjoyed a special status in any society; high ethical and legal requirements are imposed on him. The doctor deserves respect from the patient’s side, which is not always received. In recent years, the attitude of patients to the doctor has changed, disrespect, rejection of doctor’s recommendations (and sometimes even assault) are encountered more and more often, the stream of complaints does not dry out, and they are not always fair.

We must understand that we have a Constitution of the country that protects the interests of our citizens.The Law “On Health Care”, which has two very important sections: the rights and obligations of the doctor and the rights and obligations of the patient. The patient should treat the doctor as a person who has chosen to help him as his profession, and not as a whipping boy or someone he will constantly complain about.

I am very sad: good, talented doctors are leaving medicine, they cannot withstand the stresses of their specialty, which they once chose with love and a desire to be useful.You can talk about the stressfulness of this world and protect patients, but you no longer need to talk about protecting a doctor, but shout.

Read also

90,000 What is normal blood pressure at what age?

Blood pressure is a purely individual indicator and depends on many factors. And, nevertheless, there is a certain average medical norm. That is why deviations from the accepted indicators allow the doctor to suspect malfunctions in the body’s systems.However, the indicators change depending on the time of day and the age of the person.

Continuation of the article is under advertising

Advertising

Normal pressure in an adult should be determined only at rest, since any stress (both physical and emotional) has a huge impact on his performance.The human body independently controls blood pressure, and with a moderate load, its indicators rise by about 20 mm Hg. This is due to the fact that the muscles and organs involved in the work require a better blood supply.

According to the “Newest Reference Book of Necessary Knowledge”, normal blood pressure in newborns is 70 mm Hg. Normal blood pressure in a child who is one year old: boys – 96/66 (upper / lower), girls – 95/65. Reported by poradamamu.in.ua

Normal blood pressure in a 10-year-old child: 103/69 in boys and 103/70 in girls.

Normal blood pressure in young people 20 years old: in boys – 123/76, in girls – 116/72.

Normal blood pressure for those who are about 30 years old: for men – 126/79, for young women – 120/75.

In a middle-aged person: in 40-year-old men 129/81, in 40-year-old women 127/80.

For fifty-year-old men and women: Pressure is considered normal for men 135/83 and for women 137/84.

For elderly people:
The following pressure is considered normal: for 60-year-old men 142/85, for women of the same age 144/85.

For seniors who have turned 70: normal pressure is 145/82 for men and 159/85 for women. What is the normal blood pressure of an old or elderly person? For 80-year-old people, pressure 147/82 and 157/83 for men and women, respectively, is considered normal. For elderly ninety-year-old grandfathers, normal pressure is 145/78, and for grandmothers of the same age – 150/79 mm. rt. pillar. Blood pressure consists of two numbers, the upper number is the renal pressure, the lower number is the heart pressure.

How to measure pressure?

There is a special device for measuring blood pressure – a tonometer. At home, it is most convenient to use an automatic or semi-automatic device.

To obtain correct results, the following recommendations must be observed:

• physical activity must be completely eliminated before measuring pressure;
• smoking is prohibited;
• measuring blood pressure immediately after eating will also give incorrect results;
• measure blood pressure while sitting in a comfortable chair;
• the back must be supported;
• The hand on which the measurement is taken must be located at the level of the heart, i.e.e. pressure is measured while sitting at the table;
• when measuring pressure, you must remain motionless and not talk;
• readings are taken from both hands (measurement interval 10 minutes)

What to do if the pressure is high (help):

1. Pour hot water with a temperature of 37-40 ° C into a basin or a bucket and immerse your feet in the water. While the water cools down – it will take about 20 minutes – the pressure will drop by 15-20 mm. If a person has varicose veins on the legs, you can lower your elbows into the water.

2. Dill seeds reduce blood pressure. You need to steam them with boiling water, taking 2 tbsp. spoons for 0.5 liters of boiling water, drink 1-2 teaspoons at a pressure of up to 200 mm and 3-4 tsp. at higher pressure.

3. Add 1 tsp to kefir. cinnamon, drink this drink in 1 glass for 3 months. The pressure should stabilize. There is one very simple and incredibly effective recipe for traditional medicine that will help bring blood pressure back to normal, well, at least for a couple of years.And besides, it doesn’t cost a dime. So the composition of the broth: take 5 tablespoons of pine needles, 2 tablespoons of rose hips and 2 tablespoons of onion husks. Pour all this with 1 liter of cold water, bring to a boil and cook over low heat, covered for 10 minutes. Let it brew and strain. You can add a little water. Drink it all in 2 days. The course of such treatment is 4 months. Improvement can come within 5 days – the headaches will go away, and after a month you can try to gradually cancel antihypertensive drugs.The stool will become regular, which means that the intestines and liver are also cleansed. This broth has immuno-strengthening properties, is a prophylactic agent against influenza. It has a good diuretic effect. It will help with painful bleeding of the gums.

Disproportionality of the circadian rhythm of blood pressure in patients with arterial hypertension and type 2 diabetes mellitus | Kotovskaya

1.Mancia G Gamba PL Ombom S et al. Ambulatory bloodpi essure monitoring ing J Hypertens 1996 14 (suppl2) S61-S66

2.O Brien E Shendan J O Malley K Dippers and non dippers Lancet 1988 n 397

3. Ohkubo T Imai Y Tsuji I et al. Relation between nocturnal decline in blood pressure and mortality The Ohasama study AmJ Hypertens 1997 10 1201-7

4.Timio M Venanzi S Lolli S et al. Non dipper hypertensive patients and pro gresswe renal insufficiency a 3 year longitudinal study Clin Nephrol 1995 41 382-7

5. Pickenng TG Clinical Significance of diurnal blood pi essure variations Dippers and non dippers Circulation 1990 81 700-2

6. Verdecchia P Schilacci G Porcelatti C Dippers i ersus non dippers J Hy pertens 1991 9 (suppl 8) S42-S44

7.Verdecchia P Schilacci G Borgiom C et al. Altered circadian blood pressure pro file and prognosis Blood Press Momt 1997 2 347-52

8. yakano S Fukuda M Hotta F et al. Rei ersed circadian blood pressure rhythm is associated with occw ance of both Jatal and non fatal vascular ents in NIDDMsubjects Diabetes 1998 47 1501-6

9. Guidelines Subcommittee 1999 World Health Organization International Society of Hypertension guidelines for the management of hypertension J Hypertens 1999 17 151-83

10.Joint National Committee on Detection Evaluation and Treatment of High Blood Pressure The Sixth Report of the Joint National Committee on Prevention Detection and Treatment of High Blood Pressure QNL VI) Arch Intern Med 1997 157 2413-46

11. Imat Y Ohkubo T Ambulator blood pressure noi mality expenence in the Ohasama Study Blood Press Momt 1998 3 185-8

12.Butkevich A Phillips RA Sheinart KF Tuhnm S The effects of vanous definitions of dipping and daytime and night time on charactenzation of 24h profiles of blood pressure Blood Pess Momt 2000 5 19-22

13. Staessen JĄ, Celts H De Cort P et al. Methods Jor describing the diumal blood pressure curve J Hypertens 1991 9 S16-S18

14. Staessen JA FagardR Thys L AmeryA Founei analysis of blood pressure pro files AmJHypertens 1993 6 184S-187S

15.Dawson SL EvansSN Manktelow BN et al. Diurnal blood pressure change vanes with stroke subtype in the acute phase Stroke 1998 29 1519-24

16. Kano K Matsuo T Kobayashi H et al. Nocturnal fall of blood pressure and silent cerebrovascular damage in elderly patients adi anced silent cerebroi ascu Iar damage in extreme dippers / Nupertension 1996 2.130 5

17.Staessen JA Biemaszewski L OBnen E et al. Nocturnal blood pressure Jall 0n ambulatoiy momtonng in a large international database Hypertension 1997 29 30-9

18. Verdecchia P Schilaci G Reboldi G et al. Different pi ognostic impact oj 24 hour mean blood pressure and pulse pressure on stroke and coronary artery dis ease in essential hypertension Circulation 2001 103 2579-84

19.Zanchetti A Bond MG Henmg M et al. Calcium antagonist lacidipine slows down progression of asymptomatic catotid atherosclerosis pnncipal results of the EuropeanLactdipme Study on Atherosclerosis (ELSA) a landomized double blind long terminal Circulation 2002 106 2422-7

Blood pressure during exercise

Authors: Currie KD, Floras JS, La Gerche A, Goodman JM.

Translation – Sergey Strukov.

Current guidelines defining indicators for exercise testing and the predictive importance of overreaction of blood pressure to exercise are missing contextual references and need to be updated.

• The magnitude and rate of change in blood pressure varies with age, gender, baseline, fitness level, heart rate, comorbidities, and exercise protocol.
• The clinical benefit of exercise blood pressure measurement can be enhanced by setting target ranges that combine similar variables and determine models with better predictive values ​​for cardiovascular events.

Introduction

Measurement of blood pressure (BP) during clinical exercise testing (CST) is a necessary addition to electrocardiography (ECG) and heart rate (HR) assessment, since abnormal reactions can reveal hidden pathology.Given the complexity of BP measurement during exercise, an accurate measurement technique is required to ensure optimal clinical interpretation (1). Widespread contraindications to the continuation of CST for safety include upper blood pressure (2, 3). However, the definition of “normal” exercise BP and a safe “upper limit” is based on few studies from the early 1970s (4, 5). Since then, our knowledge of phenotypic variations and possible links to the pathology of abnormal BP responses has evolved significantly.Despite this, blood pressure reactions in CST that exceed the recommended limits are often dilemmas due to unclear clinical consequences, especially when other tests are normal. There is strong evidence that an excessive increase in systolic blood pressure (SBP) or diastolic blood pressure (DBP) with CST, called hypertensive reaction (2, 3), is associated with an increased risk of cardiovascular events and mortality by 36% (6), latent hypertension, despite clinically normal blood pressure (7), and an increased risk of latent hypertension in normotonic people (8-18).These observations highlight the potential clinical diagnostic and prognostic benefits of measuring blood pressure during exercise, but they are still not widely used in clinical practice due to the limitations of previous studies (19), the lack of a standardized methodology, and limited empirical data for the general population.

The purpose of this review is to critically analyze the data contained in the current CST AD guidelines. We will show that the criteria used to define “normal” and “abnormal” responses are largely arbitrary and based on insufficient empirical evidence.We will also identify the key factors affecting BP responses during exercise and how to increase their explanatory value in the case of an individual response to CST. Finally, we will provide recommendations for future studies on exercise BP measurement to broaden the evidence base and facilitate its adoption in clinical practice.

“Normal” reactions of blood pressure to CST

SBP rises linearly with increasing physical activity, mainly due to the increase in cardiac output to satisfy the demand from the working muscles.Sympathetic-mediated vasoconstriction reduces splanchnic, hepatic and renal blood flow (this increases vascular resistance), the local vasodilator action suppresses vasoconstriction (“functional sympatholysis”), allows the redistribution of cardiac output to working skeletal muscles and reduce the total peripheral vascular resistance. These opposite reactions contribute to the maintenance or a slight decrease in DBP with CST. A detailed discussion of the regulatory mechanisms of these reactions is beyond the scope of our review; they are widely discussed in other works (20).The American College of Sports Medicine (ACSM) and the American Heart Association (ANA) define a “normal” response as an increase in SBP of about 8 to 12 mm Hg. Art. (2) or 10 mm Hg. Art. (3) by metabolic equivalent (MET – 3.5 ml / kg / min). The source of these values ​​is a study published in a 1973 textbook, where healthy men (with unknown sample size and age) showed mean and peak increases in SBP of 7.5 and 12 mm Hg. st./MET, respectively. An abnormally increased (“hypertensive”) response to physical activity was defined as an excess of these values ​​(12 mm Hg).st. / MET) (5). Thus, the widespread and long-standing guidelines defining a “normal” response to CST are limited to data from one study of men with a poorly described phenotype. Below we will present information about the significant effect of the blood pressure response to CST depending on gender, level of fitness, concomitant diseases and associated drug intake.

Influence of age and gender

In a study of 213 healthy men (4), an increase in changes in SBP was found in response to an increase in exercise intensity with each decade of life.The greatest increase in SBP per MET was observed in the oldest group (50 – 59 years old; 8.3 ± 2.3 mm Hg / MET), compared with an average increase of 5.7 ± 2.3 mm Hg. Art./MET in the youngest group (20 – 29 years old). The slope of the reaction graph increased with age (p <0.001) (Fig. 1a).

There are limited data on the effect of gender on BP response in CST. A group of healthy women 20 – 42 years old reacted with an average increase in SBP of 5.0 ± 1.1 mm Hg. art / MET (21). The slope of the graph should be less than that of men of a similar age (Fig.1b, p <0.001). It is noteworthy that the average increase in the groups of men and women was much lower than the "normal" reaction range of 8 - 12 mm Hg. Art. / MET. In contrast, according to modern studies of the influence of age and sex, in older women, the hypertensive response to physical activity occurs due to the limited ability to reduce systemic vascular resistance (22). Unfortunately, there are no data on the BP response to exercise in the elderly (> 65 years), which limits our clinical interpretation of the BP response to CST.

Effects of health status and medication

The level of fitness in CST behaves as an independent factor influencing blood pressure. According to Fick’s rule, the maximum oxygen consumption (VO _2max ) depends on the cardiac output and the arteriovenous oxygen difference. A higher VO _2max corresponds to a higher cardiac output, which means a greater increase in SBP. Therefore, when interpreting the maximum SBP obtained with CST, the level of fitness should be taken into account (VO _2max ).The rate of SBP change can also change with the level of fitness. In a study of young men, 16 weeks of endurance training increased VO _2max and peak SBP (Fig. 2a) at CST (23). When we plotted the increase in SBP at CST versus VO _2max , the post-workout slope was steeper (Fig. 2b; p = 0.019). In women, there are also differences in SBP at CST, depending on the level of fitness. With an increase in fitness, the SBP at CST is lower than that of sedentary peers.Young trained women achieve higher SBP at the end of the test compared with sedentary peers (24).

Fig. 1. The reaction of systolic blood pressure (SBP) to the test with
a gradual increase in the load in healthy people.

The values ​​are presented
as changes (Δ) SBP compared with the initial values, with an increase
exercise intensity expressed in metabolic equivalents
(MET):

• a) data of healthy men, divided by decades of life;
• b) data of healthy men (20 – 39 years old) and women (20 – 42 years old).

The figure is based on previously published values ​​(4, 21). For each
gender regression equations are presented.

* p <0.001 for intergroup differences in the slope of the SBP response curve.

Fig. 2. Reaction of systolic blood pressure (SBP) before and after 16
weeks of endurance training in healthy men: 90,360

• a) the maximum SBP was obtained in the test with a gradual increase in load;
• b) increase in SBP on test is shown as percentage of maximum
  oxygen consumption (VO _2max ).

The figure is based on previously published values ​​(23). Shown
regression equations before / after.

* p <0.05 for differences in the slope of the SBP response curve.

Concomitant diseases, especially those affecting blood pressure and its regulation, or other indicators of cardiovascular diseases also affect the blood pressure response during exercise. In people with normal and high blood pressure without treatment (without established violations of baroreflex sensitivity), a similar increase in SBP and mean blood pressure occurs with increasing exercise intensity, but a higher baseline blood pressure in people with hypertension leads to higher values ​​with maximum effort (25, 26).Conversely, in people with hypertension and impaired sensitivity of the arterial baroreflex, a greater absolute increase in blood pressure is observed during veloergometry (27). Individuals with altered autonomic nervous system function also differ in their BP response to exercise, since injuries to the cervical spinal cord (eg, tetraplegia) are usually associated with changes in cardiovascular activity due to the absence or decrease in sympathetic tone below the injured level (28). Some studies have shown a decrease in SBP during exercise in people with tetraplegia, compared with healthy controls and people with paraplegia (partial or completely preserved sympathetic tone below the injury level) (29, 30).Similarly, in people with diabetes and autonomic neuropathy, SBP increases less from baseline and reaches lower maximum values ​​(37 ± 6 mmHg and 158 ± 7 mmHg, respectively) compared with people without autonomic neuropathy ( 55 ± 8 mm Hg and 176 mm Hg) (31). In addition, in patients with ischemic heart disease, dyslipidemia, and diabetes, aerobic exercise can increase DBP (32, 33). All these reactions differ from pathological conditions associated with hypotension of physical stress (decrease in SBP by 10 mm Hg.Art. with increasing load) (2, 3), including ischemic heart disease and left ventricular dysfunction (34 – 36). Medicines prescribed to this clinical population also reduce BP during exercise: nitrates, calcium channel blockers, diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and β-blockers (37). With regard to β-blockers, by registering SBP directly in the brachial artery during bicycle ergometry, Floras et al (38) showed a significant weakening of SBP response by chronic blockade of cardioselective β1-adrenergic receptors; however, nonselective blockade of β1 and β2-adrenergic receptors did not alter this BP response.

Impact of the CST protocol

The type of CST also influences the blood pressure response. In healthy men, four treadmill protocols with increasing load resulted in a similar maximum SBP (39), while in women there was a significant difference in the slope of the SBP response curve and the maximum SBP observed in the Bruce and Balke protocols on the treadmill (21). Varieties on a treadmill and a bicycle ergometer, with a stepwise and continuous increase in load, caused a similar maximum SBP in men (40).However, veloergometry results in greater maximal SBP in the clinic (41) and in trained individuals (42), possibly due to the addition of isometric work (hand grip) or increased activation of the quadriceps muscles (and hence sympathetic afferent activity). Therefore, when interpreting the response of blood pressure to CST, the type of exercise must be taken into account.

Upper limits of blood pressure at CST

As mentioned above, the characteristics of the human phenotype affect the maximum SBP obtained in the CST.In a large group of healthy people, the maximum SBP in men was higher than in women, and in older people it was higher than in younger people (Fig. 3) (43). Also, the maximum SBP is higher in trained people than in their sedentary peers (23, 44), in people with hypertension than in normotonic people (25, 26) and in people with reduced sensitivity to baroreflex (27). ACSM and ANA recommend discontinuing CST when SBP and DBP exceed 250 and 115 mm Hg. Art., respectively (3, 45). This criterion has not changed for decades (46), starting with the study presented in Fig.1 (4), where the authors recommended without justification: “… Exercise testing should be completed if SBP exceeds 250 mm Hg. Art. “. Similarly, the grounds for the DBP criterion and the relationship of these upper BP values ​​with an increase in negative effects during exercise are not known (19).

Fig. 3. Maximum values ​​of systolic blood pressure (SBP; a)
and diastolic blood pressure (DBP; b) obtained in the test
Bruce on a treadmill for men (black circles) and women (gray squares).

Mean ± SD is presented for each decade of life. Relevant
the black and gray lines below and above represent the 10th and 90th percentiles for men
and women, respectively. The figures use data from Daida et al (43).

The widespread upper values ​​for CST discontinuation are based on data from a small sample of men of unknown age. Therefore, the applicability in different populations is limited.Extreme increase in SBP and DBP exceeding 320 and 250 mm Hg. Art. accordingly, it was observed in healthy men with two-leg presses (47). Unlike aerobic exercise, resistance exercise secondarily increases intra-aortic pressure from straining with a closed glottis, and this somewhat reduces the increase in transmural pressure (48). There is no direct evidence that exercise increases the risk of adverse outcomes in people with hypertension (49), but this does not exclude the possibility of an adverse event from an increase in blood pressure during exercise (eg, coronary or aortic dissection, hemorrhagic cerebral events).However, elevated blood pressure during exercise is transient and returns to baseline or less after cessation of exercise (50, 51). Compliance with the existing criteria for discontinuation of CST, based only on maximum blood pressure, is more of a warning than an evidence-based recommendation.

Excessive reaction of blood pressure to KST

In addition to the established upper blood pressure threshold for cessation of exercise, the ANA established an excessive blood pressure response to exercise> 210 mm Hg.Art. for men and> 190 mm Hg. Art. for women, as well as an increase in DBP> 10 mm Hg. Art. compared to a resting value or above a value of 90 mmHg. Art., regardless of gender (3). Confirmation of the systolic criterion appears to be based on the data described in the review (52), while the criteria for an abnormal DBP response arose from a series of studies predicting an increase in DBP at rest (53). Currently, the ACSM detects excessively elevated blood pressure as an absolute SBP> 250 mm Hg. Art. or a relative increase> 140 mm Hg.Art. (2), however, the source of these values ​​is unknown, and the criteria have changed over time. For example, the ANA confirmed the clinical need for excessive BP values, but refrained from proposing cut-off values ​​(54), whereas in previous recommendations from the ACSM, systolic and DBP> 225 and> 90 mm Hg were cited as criteria for response. Art., respectively (55).

Many studies linking overreaction of BP to exercise with latent hypertension did not use the recommended thresholds, but used arbitrary thresholds (8, 14, 15, 53, 56 – 59), values> 90th or 95th percentile (11 – 13) or the meanings of people from the upper tertile (10, 60).Figure 4 presents a summary of the BP thresholds used in previous studies related to hypertension in people with excessive BP. To date, the lowest threshold was established by Jae et al (17) – 181 mm Hg. Art. – as the most selective SBP threshold for predicting hypertension in men at a five-year follow-up. Several studies have used the magnitude of change rather than the absolute value to determine excessive blood pressure. Matthews et al (9) used a change in SBP> 60 mm Hg.Art. at 6.3 METs or> 70 mmHg Art. at 8.1 MET; Lima et al (61) used an increase in SBP> 7.5 mm Hg. Art. / MET. For DBP, several studies have used an increase of> 10 mm Hg. Art. (9, 53, 56) or 15 mm Hg. Art. (61) at KST. It is not surprising that the lack of consensus in the definition of excessive blood pressure led to discrepancies in the assessment of incidence ranging from 1% to 61% (59, 62).

Fig. 4. Generalized thresholds of systolic blood pressure (SBP; a) and
diastolic blood pressure (DBP; b), which are used to
detecting an excessive reaction of blood pressure.

Dotted lines –
gender-specific thresholds recommended by the American Cardiology
Association (ANA) (3) and the American College of Sports Medicine (ACSM)
(2). Source studies are listed at the bottom of each column.

Most studies evaluating excessive blood pressure during exercise have involved a narrow age group of men (middle-aged), which limits the applicability of the results to all people.In a single study of young adults (25 ± 10 years), with the participation of 76 – 77% of competing male athletes, they concluded that BP with exercise is the best predictor of future BP (53). Several studies have evaluated men and women, and similar thresholds have been applied to both genders (8, 13, 59). Only one study examined age- and sex-specific criteria for excessive blood pressure based on values ​​above the age / sex 95th percentile (12). The values ​​used were obtained from the second stage of the Bruce protocol, for both sexes, only excessive blood pressure was associated with an increased risk of hypertension.

In addition to the emphasis on the importance of DBP in predicting future events, this study raises two key questions: is it the best criterion for blood pressure, and how to get BP values ​​during exercise? There is little evidence that excessive increases in blood pressure seen early in CST may be more clinically significant. Holmqvist et al (16) observed people who achieved maximum BP at the late stage of the CST, who did not have the same risk of hypertension as people who achieved this BP at the early stage of the test.To date, studies have been performed by manual auscultation with various sphygmomanometers or using automated oscillometric devices. Auscultation is complicated by movement artifacts and ambient noise, and oscillometric devices have assessed DBP by measuring mean arterial pressure (63). In all cases, numerous errors and assumptions are possible, including the validity and reliability of the data for each device, which were usually obtained in a homogeneous population and not valid for others (64), as well as the use of DBP estimates for attributing risk.

Although there is sufficient evidence to support an association between overreaction of BP to exercise and the risk of latent hypertension, a more rigorous methodology for identifying “abnormal” responses for additional factors of age, gender, fitness, and comorbidities is required, in particular the use of a single value at peak exercise. The rate of BP change, presented as the slope of the curve in Figure 5, provides the most reliable approach for classifying people with normal or overreaction.However, the hypertensive response to exercise will help uncover abnormalities (eg, coarctation of the aorta), improve risk stratification, increase the sensitivity of exercise imaging, and improve the definition of strategies in cases of borderline hypertension.

Fig. 5. Changes in systolic blood pressure (SBP) relative to
metabolic equivalent (MET) – shown by lines of different colors for three
hypothetical respondents.

The dotted lines show the specific sex thresholds recommended
American Heart Association (ANA) (3) and American College
sports medicine (ACSM) (2). Red and green reactions are stopped for
similar levels defined by ANA. However, a theoretical reaction,
shown in green appears to be more clinically relevant. Similarly, although
red and blue lines reach similar values ​​of the MET level
(fitness), there are clear differences in the nature of the reaction.

Generalization and directions for further research

Many clinicians express concern when SBP response exceeds the “normal” range, but in such cases there is insufficient empirical evidence to guide clinical recommendations. Moreover, the same disadvantage in the arbitrarily set upper blood pressure values ​​for the termination of CST. We argue that the clinical utility of BP measurements can be improved under the following conditions:

In addition to the maximum / peak values ​​obtained with CST, consider the rate of change in blood pressure (slope of the curve), and establish the level of agreement between the two measurements.

Possibility of the influence of age, sex, health status, drugs and CST protocol on the blood pressure values ​​obtained in the test.

Standardize blood pressure measurements according to the Sharman and LaGerche guidelines (1):

• Measure at the end of each stage of the CST.
• Measure before completing the test, and if not possible, immediately after
  termination.
• Use an automated device capable of measuring in
  motion (65).This limits the variability of the results from different observers.
  Prefer DBP data from auscultatory devices over
  oscillometric. However, caution is needed, as
  there is little reliable data for these devices: they are obtained mainly
  in small studies of healthy people.
• Manual measurements are suitable for experienced appraisers. There is no empirical evidence for
  informing about the threshold effects of training, but measuring blood pressure regularly
  during physical exertion, it is probably more useful than sporadic.

Future studies need to record and report the BP values ​​at which acute cardiovascular events occur during CST in order to properly assess the risk and establish scientifically based upper limits.

Conclusions

Hypertension is the leading cause of cardiovascular mortality and morbidity, but clinical measurements of blood pressure alone underestimate their prevalence in healthy people, who are considered normotensive at these rates (66).We argue that blood pressure measurements at CST serve as an additional assessment for the clinical and outpatient assessment of hypertension and CVD risk, diagnosis and prognosis. Nevertheless, this approach continues to be hampered by the unreasonableness of previously proposed values ​​and the lack of empirical diagnostic indicators of blood pressure. To facilitate an accurate classification of normal and excessive BP responses, existing guidelines need to be reinterpreted. Clinically significant abnormalities in BP response should be measured in terms of rate of BP change relative to workload or cardiac output, in addition to exercise maxima.It is important to note the modulating effects of age, gender, fitness level, health status, and medications taken, which may be due to an adaptive state (higher fitness level) rather than pathology. And finally, without positive clinical results, it is not necessary to stop CST at the upper blood pressure thresholds, since there is no scientific evidence of the relationship of such a reaction with adverse events.

Source: https: // link.springer.com/

90,000 Blood pressure: the norm by age in the table, the reasons for the deviations of the upper and lower indicators

Until you have this parameter within the normal range, you do not think about it. Interest in this parameter appears from the moment when its failures become a tangible health problem. At the same time, there is a popular and scientific approach to assessing this indicator – blood pressure, for brevity, called the abbreviation blood pressure.

What is HELL

Still the immortal hero of Petrov and Ilfa Ostap Suleiman Berta Maria Bender-Zadunaisky subtly noted that “a column of air presses on every citizen with a force of 214 kilos.” To prevent this scientific and medical fact from crushing a person, atmospheric pressure is balanced by blood pressure. It is most significant in large arteries, where it is called arterial. The blood pressure level determines the volume of blood pushed out by the heart per minute and the width of the vascular lumen, that is, the resistance to blood flow.

• When the heart contracts (systole), blood is pushed into large arteries under a pressure called systolic pressure. It is popularly called the upper one. This value is determined by the strength and frequency of heart contractions and vascular resistance.
• Pressure in the arteries at the time of cardiac relaxation (diastole) gives an indicator of the lower (diastolic) pressure. This is the minimum pressure fully dependent on vascular resistance.
• If you subtract the diastolic blood pressure from the systolic blood pressure, you get the pulse pressure.

Blood pressure (pulse, upper and lower) is measured in millimeters of mercury.

Measuring devices

The earliest pressure measuring devices were Stephen Gales’s “bloody” devices, in which a needle was inserted into a vessel connected to a tube with a scale. The Italian Riva-Rocci put an end to the bloodshed by proposing to attach a mercury monometer to the cuff over the shoulder.

Nikolai Sergeevich Korotkov in 1905 suggested attaching a mercury monometer to a cuff placed on the shoulder and listening to the pressure with the ear.The air was pumped out of the cuff with a pear, the vessels were compressed. Then the air slowly returned to the cuff, and the pressure on the vessels was relieved. With the help of a stethoscope, pulse tones were heard on the vessels in the elbow bend. The first shocks indicated the level of systolic blood pressure, the last – diastolic.

Modern monometers are electronic devices that allow you to do without a stethoscope and record the pressure and pulse rate.

How to measure blood pressure correctly

Normal blood pressure is a parameter that changes depending on a person’s activity.For example, with physical exertion, emotional stress, blood pressure rises, with a sharp rise, it can fall. Therefore, to obtain reliable blood pressure parameters, it must be measured in the morning without getting out of bed. In this case, the tonometer should be located at the level of the patient’s heart. The arm with the cuff should lie horizontally at the same level.

Such a phenomenon as “white coat hypertension” is known, when a patient, regardless of treatment, steadfastly gives an increase in blood pressure in the presence of a doctor. Also, blood pressure can be raised somewhat by running the stairs or by straining the muscles of the legs and thighs while measuring.To have a more detailed idea of ​​the blood pressure level of a given person, the doctor may recommend keeping a diary, where the pressure is recorded at different times of the day. They also use the method of daily monitoring, when with the help of an apparatus attached to the patient, the pressure is recorded for a day or more.

Pressure at adults

Since different people have their own physiological characteristics, fluctuations in blood pressure levels in different people may differ.

There is no concept of the age norm for blood pressure in adults.In healthy people at any age, the pressure should not cross the threshold of 140 to 90 mm Hg. Normal blood pressure values ​​are 130 to 80 mm Hg. The optimal numbers “like an astronaut” are 120 to 70.

Upper pressure limits

Today, the upper pressure limit, after which the diagnosis of arterial hypertension is made, is 140 by 90 mm Hg. Higher numbers are subject to identification of the causes of their occurrence and treatment.

• First, a change in lifestyle, smoking cessation, feasible physical activity is practiced.
• When the pressure rises to 160 to 90, drug correction begins.
• If there are complications of arterial hypertension or comorbidities (coronary artery disease, diabetes mellitus), drug treatment begins at lower levels.

During the treatment of arterial hypertension, the rate of blood pressure, which they are trying to achieve, is 140-135 by 65-90 mm Hg. In persons with severe atherosclerosis, the pressure is reduced more smoothly and gradually, fearing a sharp decrease in blood pressure due to the threat of a stroke or heart attack.For renal pathologies, diabetes and those under 60, the target numbers are 120-130 per 85.

Lower pressure limits

The lower limits of blood pressure in healthy people are 110 to 65 mm Hg. At lower numbers, the blood supply to organs and tissues worsens (first of all, to the brain, which is sensitive to oxygen starvation).

But some people live with a BP of 90 to 60 all their lives and feel great. Former athletes with hypertrophied heart muscle are prone to low blood pressure.It is undesirable for older people to have too low blood pressure due to the risks of brain catastrophes. Diastolic blood pressure in those over 50 should be kept within 85-89 mm Hg.

Pressure on both arms

The pressure on both hands should be the same or the difference should not exceed 5 mm. Because of the asymmetrical development of the muscles on the right arm, the pressure is usually higher. A difference of 10 mm indicates probable atherosclerosis, and 15-20 mm indicates stenosis of large vessels or anomalies of their development.

Pulse pressure

Black rectangles are pulse pressure in different parts of the heart and large vessels.

Normal pulse pressure is 35 + -10 mm Hg. (up to 35 years old 25-40 mm Hg, at an older age up to 50 mm Hg). A decrease in it can be caused by a drop in the contractile ability of the heart (heart attack, tamponade, paroxysmal tachycardia, atrial fibrillation) or a sharp jump in vascular resistance (for example, in shock).

High (more than 60) pulse pressure reflects atherosclerotic changes in the arteries, heart failure.It can occur with endocarditis, in pregnant women, against the background of anemia, intracardiac blockages.

Specialists do not use a simple subtraction of the diastolic pressure from the systolic pressure, the variability of pulse pressure in humans is of greater diagnostic value and it should be within 10 percent.

Table of blood pressure norms

Blood pressure, the rate of which varies slightly with age, is reflected in the table above.BP is slightly lower in women at a young age against the background of less muscle mass. With age (after 60), the risks of vascular catastrophes are compared in men and women, therefore, blood pressure rates are equal in both sexes.

Pressure in pregnant women

In healthy pregnant women, blood pressure does not change until the sixth month of pregnancy. Blood pressure is normal in non-pregnant women.

Further, under the influence of hormones, some increases may be observed, not exceeding 10 mm from the norm.In pathological pregnancy, gestosis with jumps in blood pressure, kidney and brain damage (preeclampsia), or even the development of seizures (eclampsia) can be observed. Pregnancy against the background of arterial hypertension can worsen the course of the disease and provoke hypertensive crises or a persistent increase in blood pressure. In this case, correction of drug therapy, observation by a physician or treatment in a hospital is indicated.

Norm of blood pressure in children

For a child, the blood pressure is higher, the older his age.The blood pressure level in babies depends on the vascular tone, the working conditions of the heart, the presence or absence of malformations, and the state of the nervous system. For a newborn, the normal pressure is 80 to 50 millimeters of mercury.

What blood pressure rate corresponds to a particular childhood age can be seen from the table.

Pressure norm in adolescents

Adolescence begins at the age of 11 and is characterized not only by the rapid growth of all organs and systems, a set of muscle mass, but also by hormonal changes that affect the cardiovascular system.At 11-12 years old in adolescents, blood pressure ranges from 110-126 to 70-82. From 13-15 years old, it approaches, and then equals with adult standards, amounting to 110-136 to 70-86.

Causes of high blood pressure

• Essential arterial hypertension (hypertension, see drugs with high blood pressure) gives persistent increases in pressure and hypertensive crises.
• Symptomatic hypertension (adrenal tumors, renal vascular disease) gives a clinic similar to hypertension.
• Vegeto-vascular dystonia is characterized by episodes of spikes in blood pressure not exceeding 140 to 90, which are accompanied by autonomic symptoms.
• An isolated increase in the lower pressure is inherent in renal pathologies (developmental anomalies, glomerulonephritis, atherosclerosis of the renal vessels or their stenosis). If the diastolic pressure exceeds 105 mm Hg. for more than two years, the risk of cerebral disasters has increased by 10, and the risk of a heart attack by five times.
• Systolic pressure more often increases in the elderly, those with thyroid pathologies, patients with anemia and heart defects.
• Increased pulse pressure is a serious risk of heart attack or stroke.

Causes of pressure drop

Low blood pressure is called hypotension and its causes lie in the weak work of the heart or the peculiarities of the autonomic vascular tone (see how to increase the pressure).