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Low Blood Pressure (Hypotension) | CS Mott Children’s Hospital

Topic Overview

What is low blood pressure?

Low blood pressure means that your blood pressure is lower than normal. Another name for low blood pressure is hypotension (say “hy-poh-TEN-shun”).

In most healthy adults, low blood pressure does not cause problems or symptoms. In fact, it may be normal for you. For example, people who exercise regularly often have lower blood pressure than people who are not as fit.

But if your blood pressure drops suddenly or causes symptoms like dizziness or fainting, it is too low. It can cause shock. Shock can be dangerous if it is not treated right away.

Blood pressure is a measure of how hard the blood pushes against the walls of your arteries as it moves through your body. Blood pressure consists of two numbers: systolic and diastolic.

  • The systolic (higher) number shows how hard the blood pushes when the heart is pumping.
  • The diastolic (lower) number shows how hard the blood pushes between heartbeats, when the heart is relaxed and filling with blood.

Someone with a systolic pressure of 120 and a diastolic pressure of 80 has a blood pressure of 120/80, or “120 over 80.” Normal blood pressure is lower than 120/80.

Low blood pressure does not have a specific number where it is too low. Most doctors consider blood pressure to be too low when it causes symptoms or drops suddenly. In general, low blood pressure symptoms happen when blood pressure is less than 90/60.

What causes low blood pressure?

Some of the causes of low blood pressure include:

  • Getting up after you sit or lie down. This can cause a quick drop in blood pressure called orthostatic hypotension.
  • Standing for a long time.
  • Not drinking enough fluids (dehydration).
  • Medicines, such as high blood pressure medicine or other heart medicines.
  • Health problems such as thyroid disease, severe infection, bleeding in the intestines, or heart problems.
  • Trauma, such as major bleeding or severe burns.

What are the symptoms?

Many people with low blood pressure don’t have any symptoms.

Symptoms to watch for include:

  • Feeling dizzy, lightheaded, or faint.
  • Feeling sick to your stomach or vomiting.
  • Feeling more thirsty than usual.
  • Having blurry vision.
  • Feeling weak.
  • Being confused.
  • Being tired.
  • Having cold, clammy skin.
  • Breathing very fast.

If you have symptoms of low blood pressure, especially dizziness or fainting, call your doctor.

Watch for symptoms of low blood pressure. Tell your doctor when the symptoms happen so he or she can treat them.

How is low blood pressure diagnosed?

Often people learn that they have low blood pressure when their doctor checks it. Or you may find that you have low blood pressure when you check it at home.

To check for the causes of your low blood pressure, your doctor will ask about your past health, your symptoms, and the medicines you take. He or she will do a physical exam and may do other tests. Your doctor may check for another health problem that could be causing your low blood pressure.

Will your doctor treat low blood pressure?

You will likely get treated for low blood pressure only if it is causing symptoms or if your blood pressure drops suddenly. Treatment depends on your symptoms, how severe they are, and the reasons for the low blood pressure.

Your doctor may have you:

  • Add more salt to your diet.
  • Get fluid through an intravenous (IV) line if you are very dehydrated.
  • Change or stop medicines that lower your blood pressure.
  • Take medicine to treat the problem that is causing low blood pressure. For example, you may need antibiotics to treat infection or medicines to stop vomiting or diarrhea.

Be sure to talk with your doctor before you add more salt to your diet or make any changes in your medicines.

How can you prevent low blood pressure symptoms?

If you have orthostatic hypotension, your doctor may suggest that you try some simple ways to prevent symptoms like dizziness. For example, you can:

  • Stand up slowly.
  • Drink more water.
  • Drink little or no alcohol.
  • Limit or avoid caffeine.
  • Wear compression stockings.

If you feel dizzy or lightheaded, sit down or lie down for a few minutes. Or you can sit down and put your head between your knees. This will help your blood pressure go back to normal and help your symptoms go away.

Blood Pressure Numbers: When to Get Help

Topic Overview

If you check your blood pressure, you may wonder when an abnormal reading means you should call your doctor. This information can help you understand what your blood pressure numbers mean and when you need to call for help.

What do blood pressure numbers mean?

Your blood pressure consists of two numbers: systolic and diastolic. Someone with a systolic pressure of 117 and a diastolic pressure of 78 has a blood pressure of 117/78, or “117 over 78.”

It’s normal for blood pressure to go up and down throughout the day. But if it stays up, you have high blood pressure. Another name for high blood pressure is hypertension.

High blood pressure increases the risk of stroke, heart attack, and other problems. You and your doctor will talk about your risks of these problems based on your blood pressure.

Your doctor will give you a goal for your blood pressure. Your goal will be based on your health and your age.

In general, the lower your blood pressure, the better. For example, a blood pressure reading of less than 90/60 is healthy as long as you feel okay.

What can cause a short-term change in blood pressure?

Things like exercise, stress, and sleeping can affect your blood pressure. Some medicines can cause a spike in blood pressure, including certain asthma medicines and cold remedies.

A low blood pressure reading can be caused by many things, including some medicines, a severe allergic reaction, or an infection. Another cause is dehydration, which is when your body loses too much fluid.

When should you get help for an abnormal blood pressure reading?

One high or low blood pressure reading by itself may not mean you need to call for help. If you take your blood pressure and it is out of the normal range, wait a few minutes and take it again. If it’s still high or low, use the following guidance.

911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

  • Your blood pressure is much higher than normal (such as 180/120 or higher).
  • You think high blood pressure is causing symptoms such as:
    • Severe headache.
    • Blurry vision.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your blood pressure measures higher than your doctor recommends at least 2 times. That means the top number is higher or the bottom number is higher, or both.
  • You think you may be having side effects from your blood pressure medicine.

High blood pressure (hypertension) – Diagnosis

High blood pressure does not usually have any symptoms, so the only way to find out if you have it is to get your blood pressure checked.

Healthy adults aged over 40 should have their blood pressure checked at least once every 5 years.

If you’re at an increased risk of high blood pressure, you should have your blood pressure checked more often, ideally once a year.

Having this done is easy and could save your life.

Where to get a blood pressure test

You can ask for a blood pressure check. You do not have to wait to be offered one.

Blood pressure testing is available:

  • at your GP surgery – by a GP, practice nurse, healthcare assistant or self-service machine
  • at some pharmacies
  • at an NHS Health Check appointment offered to adults aged 40 to 74 in England
  • in some workplaces
  • at a health event

You can also test your blood pressure at home using a home testing kit.

Having a blood pressure test

A stethoscope, arm cuff, pump and dial was normally used to measure your blood pressure, but automatic devices with sensors and digital displays are commonly used nowadays.

It’s best to sit down with your back supported and legs uncrossed for at least 5 minutes before the test.

You’ll usually need to roll up your sleeves or remove any long-sleeved clothing so the cuff can be placed around your upper arm.

Try to relax and avoid talking while the test is carried out.

During the test:

  • you hold out one of your arms so it’s at the same level as your heart, and the cuff is placed around it – your arm should be supported in this position with a cushion or the arm of a chair, for example
  • the cuff is pumped up to restrict the blood flow in your arm – this squeezing may feel a bit uncomfortable, but only lasts a few seconds
  • the pressure in the cuff is slowly released and detectors sense vibrations in your arteries – a doctor will use a stethoscope to detect these if your blood pressure is measured manually
  • the pressure in the cuff is recorded at 2 points as the blood flow starts to return to your arm – these measurements are used to give your blood pressure reading

You can usually find out your result straight away, either from the healthcare professional carrying out the test or on the digital display.

If your blood pressure is high, you may be advised to record your blood pressure using a 24-hour (ambulatory) monitoring kit or a home blood pressure monitoring kit to confirm whether you have high blood pressure.

Ambulatory (24-hour) blood pressure monitoring

Having a raised blood pressure reading in 1 test does not necessarily mean you have high blood pressure.

Blood pressure can fluctuate throughout the day. Feeling anxious or stressed when you visit your GP can also raise your blood pressure.

If you have a high reading, you may be asked to take some readings with a 24-hour monitor that checks your blood pressure throughout the day.

This will confirm whether you have consistently high blood pressure.

It’s known as 24-hour or ambulatory blood pressure monitoring.

Home blood pressure testing

Blood pressure tests can also be carried out at home using your own blood pressure monitor.

Like 24-hour or ambulatory monitoring, this can give a better reflection of your blood pressure.

It can also allow you to monitor your condition more easily in the long term.

You can buy a variety of low-cost monitors so you can test your blood pressure at home or while you’re out and about.

Measure your blood pressure twice a day, ideally in the morning and the evening, while you’re sitting down.

Each time take 2 readings, 1 minute apart. Continue to measure your blood pressure twice a day for 7 days.

Your doctor or nurse will use this information to work out your average blood pressure.

It’s important to make sure you use equipment that’s been properly tested.

The British Hypertension Society (BHS) has information about validated blood pressure monitors that are available to buy.

Understanding your blood pressure reading

Blood pressure is measured in millimetres of mercury (mmHg) and is given as 2 figures:

  • systolic pressure – the pressure when your heart pushes blood out
  • diastolic pressure – the pressure when your heart rests between beats

For example, if your blood pressure is “140 over 90”, or 140/90mmHg, it means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg.

As a general guide:

  • high blood pressure is considered to be 140/90mmHg or higher (or an average of 135/85mmHg at home) – or 150/90mmHg or higher (or an average of 145/85mmHg at home) if you’re over the age of 80
  • ideal blood pressure is usually considered to be between 90/60mmHg and 120/80mmHg, while the target for over-80s is below 150/90mmHg (or 145/85mmHg at home)

Blood pressure readings between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you do not take steps to keep your blood pressure under control.

Page last reviewed: 23 October 2019
Next review due: 23 October 2022

Early-stage High Blood Pressure- WebMD

One night back in May, I went to sleep with perfectly normal blood pressure, an unremarkable 120/80. The next day, I woke up in a blood pressure danger zone. What happened? My blood pressure didn’t spike overnight; instead, government officials issued revised blood pressure guidelines that included a new category: prehypertension.

Anyone with a systolic (top number) reading of 120 or over, or a diastolic (bottom) reading of 80 or over, now has prehypertension, which means we’re at increased risk of heart disease and stroke.

Between those of us with newly-minted prehypertension (some 23% of the population), and people who have full-blown hypertension (at least another 25%), danger-zone blood pressure is an emerging epidemic in this country. Nearly half of all American adults over 18 are in one category or the other.

Are so many of us really so unhealthy? I’m only 36. I run three miles every other day. (Well, okay, sometimes I skip a day.) I almost never eat fried foods. I’m just one of thousands of people in their 30s, 40s and 50s who thought we were paragons of health until the new numbers were released. Are the doctors just trying to scare us?

A Wake-Up Call

“This is a wake-up call. We’ve changed what normal is, because we now know that blood pressure in the prehypertension range is not normal,” says Sheldon Sheps, MD, medical editor of MayoClinic. com’s High Blood Pressure Center. He served on the committee that drafted the new guidelines.

“There is increasing evidence of the relationship between an elevated blood pressure and future problems with heart attack and stroke. With each level of increase in pressure, you get increased risk,” he tells WebMD. Consider these startling statistics:

Starting as low as 115/75, the risk of heart attack and stroke doubles for every 20-point jump in systolic blood pressure or every 10-point rise in diastolic blood pressure.

  • People with blood pressure levels between 120/80 and 140/90 – levels once considered normal – have twice the risk of heart disease as those with low blood pressure.
  • And people with blood pressure above 140/90 – the definition of high blood pressure -have four times the risk of heart disease as people with low blood pressure.

“We’ve also learned that people age 55 and older, who currently have normal blood pressure, have a 90% risk of developing high blood pressure down the road,” says Aram Chobanian, MD, Dean of Boston University School of Medicine, who chaired the guidelines committee.


“We have a lot of concern about this rise in blood pressure over the course of our lifetimes, and to try to prevent that from happening, we have identified a ‘prehypertension’ group in which lifestyle changes can make a difference,” Chobanian says.

But if so many people are already likely to go on to develop high blood pressure, can we really avoid it? Maybe high blood pressure is just an inevitable consequence of aging. Not so, says Chobanian.

“There are populations in the world where age-related rises in blood pressure are minimal. In areas of Mexico, certain areas of the South Pacific, and other parts of the world with very low salt intake, there’s not anywhere near the age-related rise in blood pressure that we see in the United States.”

The Name of the Game: Prevention

So if rising blood pressure and aging don’t — or shouldn’t — go hand in hand, what should the millions of us who now have prehypertension do about it? The good news: we shouldn’t be looking for a new pill. “Unless you have diabetes or kidney disease, people with prehypertension don’t need to be on medication,” says Sheps.

That’s also the bad news. Preventing high blood pressure means lifestyle changes, which is usually harder than popping a pill. Number one on the blood pressure reduction hit parade: preventing or treating obesity. As our pants sizes get smaller, so do our blood pressure numbers. Of course, the opposite is true as well. With our nation on a supersizing binge and a growing percentage of adults and children becoming overweight or obese, it’s no surprise that rates of high blood pressure have skyrocketed as well.

The DASH Diet

You can get your weight down by any number of methods, but ultimately, staying healthy means choosing a plan you can live with long-term. Of the trendy high-protein, low-carb plans like Atkins and South Beach, Sheps says, “If you want to try them to get a jump-start on weight loss, go ahead for a month or two months. That’s about all people can stand before they get bored to tears.

“But for life, the diet you need to be on for life is the DASH diet, which is not specifically designed for weight loss. The Holy Grail is a healthier lifestyle and we know from untold numbers of studies that if you follow a diet rich in fruits and vegetables and low in fat, you’ll live longer and better.”

High in whole grains, fruits, and vegetables, and low in total saturated fats, DASH (Dietary Approaches to Stop Hypertension) has been found to be as effective in reducing blood pressure as blood pressure medication. “It’s not clear what it is about DASH that works, but it’s high in potassium and calcium and low in saturated fat and sodium,” says Chobanian. “It’s a sensible diet that you can realistically follow for the rest of your life.”

Studies have also shown that DASH is even more effective in controlling weight and reducing blood pressure when combined with a regular exercise program. If you can’t fit in the newly-recommended one hour of physical activity a day, half an hour daily still beats never breaking a sweat.

Ultimately, say experts, those of us with prehypertension need to be more aware of our changing blood pressure rates. Sheps suggests monitoring your blood pressure on your own between doctor’s visits, using a home blood pressure device. “Just make sure the cuff size is appropriate,” he says. “It needs to cover at least 80% of the circumference of the arm.”

Putting the brakes on the high blood pressure epidemic won’t be easy. “It’s always an uphill battle to get people to change their lifestyles,” says Chobanian. Yet these days, when half of American adults are at risk for heart attack or stroke because of their blood pressure, doctors say it’s time for a major public health effort.

Low blood pressure during pregnancy

Published: February 2020

Many women experience low blood pressure, defined as below 90/60, while they’re expecting a baby. This is not usually a problem, doesn’t normally require medication, and will start returning to its previous level during the third trimester. Your doctor will monitor your blood pressure throughout the pregnancy.

Low blood pressure during pregnancy happens because your body secretes hormones, and progesterone in particular, which help to relax the walls of your blood vessels and increase the flow of blood to you and your baby.

Occasionally, low blood pressure may be indicative of some other problem. It may be the result of an ectopic pregnancy, in which a fertilised egg becomes implanted outside your uterus. And if it’s very low, it may cause falls, or shock, in which your brain and other vital organs don’t get enough blood to work properly.

Low blood pressure has a variety of symptoms. If you experience any of these, you should mention them to your doctor.

  • Dizziness
  • Nausea
  • Weakness
  • Fatigue and sleepiness
  • Fainting
  • Rapid heartbeat
  • Confusion and inability to concentrate
  • Blurry vision
  • Pale, clammy skin

Can low blood pressure harm your baby?

We know a lot less about the effects of low blood pressure on babies than the effects of high pressure. Some research suggests that it may lead to stillbirth and low birth weight, but this correlation is difficult to establish because there are so many other variables and risk factors involved during pregnancy. In the vast majority of cases, low blood pressure at this time is nothing to worry about.

Is there anything you can do to deal with low blood pressure when you’re pregnant?

Although medication is not normally needed when this happens, there are some simple changes you can make that may reduce the likelihood of its happening.

Take it easy. Try to slow down, avoid making sudden movements, and don’t stand up too quickly. If you do feel faint or dizzy, lie down on your left side, which may help to increase the blood flow to your heart.

Drink lots of water. As well as preventing dehydration, this increases your blood volume, and thus your blood pressure.

Eat a healthy diet. Your doctor may also recommend that you increase your salt intake, though it’s important not to overdo this.





High Blood Pressure – HealthyWomen

This article has been archived. We will no longer be updating it. For our most up-to-date information, please visit our heart disease information here.


What Is It?

Blood pressure is the amount of force your blood exerts against the walls of your arteries. High blood pressure, or hypertension, occurs when your blood pressure is elevated over time. Left untreated, it can damage your small blood vessels and organs and lead to heart attacks, stroke, kidney failure and circulatory problems.

Blood pressure is the amount of force your blood exerts against the walls of your arteries. Normal blood pressure effectively and harmlessly pushes the blood from your heart to your body’s organs and muscles so they can receive the oxygen and nutrients they need.

Blood pressure is variable—it rises and falls during the day. When blood pressure stays elevated over time, however, it is called high blood pressure or hypertension.

According to the American Heart Association, about 85.7 million Americans have high blood pressure. High blood pressure was a primary or contributing cause of death for 410,000 Americans in 2014, according to the U.S. Centers for Disease Control and Prevention.

Hypertension can occur in both children and adults, but it is more common in adults, particularly African Americans and the elderly. People with other conditions such as diabetes and kidney disease are likely to become hypertensive. In addition, being overweight, drinking alcohol excessively (defined as more than two drinks a day for men and one drink a day for women) and taking oral contraceptives may increase blood pressure.

About half of Americans with high blood pressure are women. More men than women have hypertension, until women reach menopause, when their risk becomes greater than men’s. About 30 percent of women have high blood pressure. ‘

Blood pressure is typically expressed as two numbers, one over the other, and is measured in millimeters of mercury (noted as mm Hg). The first number is the systolic blood pressure, the pressure used when the heart beats. The second number, diastolic blood pressure, is the pressure that exists in the arteries between heartbeats.

Depending on your activities, your blood pressure may increase or decrease throughout the day. If you are not acutely ill, are over 18 years of age and are not taking antihypertensive drugs, a blood pressure reading of less than 120 mm Hg systolic and less than 80 mm Hg diastolic (<120/80) is considered normal.

If your systolic blood pressure is 120 to 129 mm Hg systolic and your diastolic pressure is less than 80 mm Hg, you have elevated blood pressure.

A blood pressure level of 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic is considered stage 1 hypertension (high blood pressure). Levels of 140 mm Hg or greater systolic or 90 mm Hg or greater diastolic are classified as stage 2 hypertension. If you have systolic and diastolic readings that fall in two categories, you will be designated with the higher blood pressure category.

These new classifications, released by the American College of Cardiology and the American Heart Association in 2017, reflect growing evidence that the risk of cardiovascular disease progressively increases from normal blood pressure to elevated to stage 1 and 2 hypertension. The new guidelines also include specific instructions for getting accurate blood pressure readings, which involves using proper measuring devices, taking several readings in the health care provider’s office and confirming the readings with out-of-office measurements.

If you have cardiovascular disease, including coronary heart disease, congestive heart failure or stroke, your health care provider may recommend treating your blood pressure with medication and lifestyle modifications even if you are not diagnosed with hypertension.

The cause of approximately 90 percent to 95 percent of all hypertension isn’t known. This type of hypertension is called primary or essential high blood pressure. Secondary hypertension is somewhat different because it represents all of the specific diseases that cause elevated blood pressure. It is important to diagnose this type of hypertension because the treatment differs from primary hypertension. While there is no cure for primary hypertension, it is easily detected and is usually controllable.

Still, many people who suffer from high blood pressure don’t know they have it, and people can have high blood pressure for years without knowing they have it. That’s why high blood pressure has been called “the silent killer.”

Of those with hypertension, only about half have the problem under control, defined as a level below 130/80 mm Hg. Left untreated, hypertension can result in permanent damage to the small blood vessels of the body, which can damage organs such as the heart, brain and kidneys, leading to heart attacks, stroke and kidney failure. It can also cause acute or chronic circulatory problems.

Elevated blood pressure levels significantly increase your risk for coronary heart disease, including heart attack and stroke. Consistent high blood pressure also increases your risk for congestive heart failure and can lead to other problems such as:

  • Atherosclerosis: Plaque collects on the walls of hypertension-damaged blood vessels, which can eventually lead to blockages that may result in a stroke or heart attack. Although this plaque builds up for many reasons as you age, high blood pressure hastens the process.
  • Eye damage: High pressure in blood vessels can cause tiny hemorrhages in the retina, the light-sensitive membrane in the back of your eye on which images are formed. If this happens, you may lose some of your vision.
  • Heart enlargement or failure: There are two types of heart failure. In the first, the walls of the heart are weak and thin as a result of being stretched by increasing amounts of pooling blood in the heart. In the second, commonly seen in people with hypertension, the heart muscle enlarges in response to the higher pressure and increased workload. It becomes so big it begins to close off the ventricular chamber, decreasing the amount of blood that can fill the heart. This is called diastolic dysfunction, because the heart muscle can’t relax normally and allow blood to fill the chamber.
  • Kidney damage and failure: Hypertension causes arteries going to your kidneys to become constricted, making them less efficient at filtering waste from your body. According to the National Kidney Foundation, high blood pressure caused more than 33,000 new cases of kidney failure in the United States in 2013. African Americans are particularly at risk. Early treatment of hypertension can help prevent kidney damage.

You should have your blood pressure checked whenever you see a health care professional. Because blood pressure can be variable, it should be checked on several days before a high blood pressure diagnosis is made. One elevated blood pressure reading doesn’t necessarily mean you have high blood pressure, but it does warrant repeated measurements and means you have to watch your blood pressure carefully.

Dietary and lifestyle changes may help you control high blood pressure. If you have mild hypertension, you may be able to lower your blood pressure by reducing the amount of sodium (salt) in your diet, reducing fat intake, eating a diet high in fruits, vegetables and low-fat dairy (such as the DASH diet) and reducing alcohol consumption. If you are overweight, losing weight may reduce your blood pressure. Increasing your physical activity, even if you don’t lose weight, can also reduce blood pressure.

For some people, lifestyle changes aren’t enough to lower blood pressure. Luckily, high blood pressure can be successfully treated with long-term medication.

Commonly prescribed drugs include diuretics, beta blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers (ARBs), direct renin inhibitors (DRIs), calcium channel blockers (CCBs), vasodilators, alpha-beta blockers, central-acting agents and alpha blockers. Because there is no cure for most hypertension cases, treatment generally must be carried out for life to prevent blood pressure from rising again.

Many of these drugs are also available to treat ISH to reduce your risk of coronary heart disease and stroke.

Causes of Hypertension

The 90 percent to 95 percent of hypertension cases in which the cause can’t be determined are called essential or primary hypertension cases. Hypertension may also be a symptom of an identified problem (see below) that generally corrects itself when the cause is corrected. This type of high blood pressure is called secondary hypertension.

Possible causes of secondary hypertension include:

  • Renal artery stenosis (narrowing of the arteries leading to your kidneys)
  • Adrenal gland disease (Cushing’s disease) or adrenal tumors
  • Kidney disease
  • Preeclampsia (hypertension and increased urine protein levels sometimes caused by pregnancy)
  • Thyroid disease

Other factors affecting blood pressure include:

  • Use of birth control pills
  • Psychologic stress
  • Severe pain
  • Drug or alcohol withdrawal
  • Use of amphetamines, cocaine or other stimulants
  • Use of steroids
  • Overuse of nicotine nasal sprays, gum, patches and lozenges designed to help smokers kick the habit
  • Sleep apnea

Your health care professional should monitor your blood pressure if you are taking oral contraceptives. Your blood pressure should also be carefully monitored if you’re pregnant, because some women develop preeclampsia-related hypertension during pregnancy. One of the leading causes of maternal death, preeclampsia is hypertension combined with protein in the urine and/or swollen hands and feet. It typically occurs after the 20th week of pregnancy. It can lead to premature and low-birth–weight babies.


Your health care professional should check your blood pressure at least once every two years, and more often if it’s high. A high blood pressure diagnosis is usually based on at least the average of two or more readings per visit, taken at two different visits after an initial screening.

The only way to properly check your blood pressure is to measure it with a device called a sphygmomanometer, commonly called a blood pressure cuff. This is a quick and painless test in which a rubber cuff is wrapped around your upper arm and inflated. As the cuff inflates, it compresses a large artery, stopping the blood’s flow through that artery. When your health care professional releases the air in the cuff, he or she can listen with a stethoscope for the blood to start flowing through your artery again. Your health care professional can watch the sphygmomanometer gauge to determine systolic pressure—the pressure when the first sound of pulsing blood is heard—and the diastolic pressure, the pressure when the last sound of pulsing blood is heard.

In November 2017, the American College of Cardiology and the American Heart Association issued new guidelines for classification of high blood pressure—or hypertension. A normal reading, for people not at high risk, is less than 120 mm Hg systolic and less than 80 mm Hg diastolic (<120/80).

If your systolic blood pressure is 120 to 129 mm Hg systolic and your diastolic pressure is less than 80 mm Hg, you have elevated blood pressure.

A blood pressure level of 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic is considered stage 1 hypertension, and readings of 140 mm Hg or greater systolic or 90 mm Hg or greater diastolic are stage 2 hypertension. When systolic and diastolic pressures fall into different categories, your health care professional should select the higher category to classify your blood pressure.

These new classifications reflect growing evidence that the risk of cardiovascular disease progressively increases from normal blood pressure to elevated to stage 1 and 2 hypertension.

If you have cardiovascular disease, including coronary heart disease, congestive heart failure or stroke, your health care provider may recommend treating your blood pressure with medication and lifestyle modifications even if you are not diagnosed with hypertension.

If you are hypertensive and have begun receiving initial medication therapy, you will probably need to return for follow-up and adjustment of medications once a month until your blood pressure goal is reached. More frequent visits may be necessary for those with stage 2 hypertension.

A small number of people experience “white coat hypertension,” which is very elevated blood pressure when visiting their health care professional while blood pressure at home is normal. At home, you can check your blood pressure in a setting that’s more comfortable for you to get a more accurate reading.

Home blood pressure monitoring also gives you the opportunity to measure your own blood pressure when your health care professional’s office is not open. Inexpensive devices for home blood pressure monitoring are available at most pharmacies. Be sure to have your health care professional check your home blood pressure device when you start using it to make sure it’s providing accurate readings.

Also, don’t make any changes in your medication based on home blood pressure readings without first consulting your health care professional. Home blood pressure monitoring is an excellent adjunct to monitoring by your health care professional, but should it not be done in lieu of professional monitoring.

In addition to taking blood pressure readings from both arms, your health care professional may conduct the following during a hypertension exam:

  • A complete medical history. Make sure you tell your doctor about any alternative medicines you’re taking such as herbs, over-the-counter drugs and supplements. The American Heart Association notes that some may be life-threatening when combined with medicines to treat high blood pressure.
  • A physical examination. This includes checking your retinas and abdomen, listening to your lungs and heart, taking your pulse in several areas, including your feet, and looking for swelling in your ankles.
  • A urinalysis. The urine is tested for elevated protein, sugar, white blood cells or other abnormalities.
  • An electrocardiogram. Your health care professional will position a number of small contacts on your arms, legs and chest to connect them to an ECG machine. The results will be analyzed for any abnormalities indicating an enlarged heart or other abnormality.
  • A kidney profile. The blood is tested for abnormalities such as elevated creatinine.
  • A thyroid profile. The blood is tested for abnormalities such as an elevated level of thyroid hormone, and the thyroid gland is physically felt for enlargement.

Risk Factors for Hypertension

Although there are several risk factors for hypertension, family history is the primary one. High blood pressure tends to run in families.

African Americans and Hispanic Americans are more likely to develop high blood pressure than Caucasians. Studies find that having “Type A” qualities—being very driven, being a perfectionist who doesn’t cope well with stress or know how to relax and having a quick temper—increases the risk of hypertension in men and may increase the risk for women.

Other risk factors for hypertension include:

  • Increasing age
  • Salt sensitivity
  • Obesity
  • Heavy alcohol consumption, defined as more than two drinks a day for men and more than one drink a day for women.
  • Use of oral contraceptives
  • An inactive lifestyle
  • Regular smoking or use of smokeless-tobacco, like snuff or chewing tobacco
  • High uric acid levels (anything over 7 mg/ml of blood)

Unfortunately, there is no proven method of preventing preeclampsia or pregnancy-induced hypertension and no tests to diagnose or predict these conditions. The only way to ensure a safe pregnancy is with regular visits to your health care professional for checks of the level of protein in your urine and your blood pressure.

You also should do everything you can on your own to prevent pregnancy-induced high blood pressure, including regular physical activity and limiting salt intake.


There are several drug classes to choose from when selecting a high blood pressure medication, including hundreds of single medications and combinations. Generally, all can lower your blood pressure, but often people respond differently to each drug.

You will probably have to try a few of them before finding the one that works the best for you with the fewest side effects.

The drug classes are:

  • Diuretics. Diuretics, which rid the body of excess fluids and salt, are the most frequently used drugs to treat high blood pressure. However, in large doses, some diuretics may deplete the body of potassium, which can lead to irregular heartbeat and reduce your glucose tolerance, which can cause diabetes. There are, however, potassium-sparing diuretics that don’t cause this problem.

    Overall, diuretics are inexpensive and, in small doses, boost the effectiveness of many other antihypertensive drugs. National guidelines recommend that diuretics alone should be the first agent of choice provided you don’t have any other conditions that prohibit their use. Some commonly prescribed drugs in this class include amiloride (Midamar), bumetanide (Bumex), chlorthalidone (Hygroton), chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide, Esidrix, Hydrodiuril), metolazone (Mykrox, Zaroxolyn) and indapamide (Lozol).

  • Beta-blockers. These drugs reduce your heart rate and blood pressure and therefore your heart’s output of blood. You should not be on one of these drugs if you already have a low heart rate, an airway disease such as asthma or peripheral vascular disease.

    Beta blockers can also mask hypoglycemia, or low blood sugar, so you should use with caution if you have diabetes and take insulin or sulfonylurea drugs.

    Common side effects include fatigue, breathlessness, depression and cold hands and feet. Other, milder side effects can include sleep problems and numbness or tingling of the toes, fingers or scalp. On the plus side, beta blockers can reduce your risk for second heart attack, irregular heartbeat, angina and migraines. Some commonly prescribed drugs in this class include atenolol (Tenormin), betaxolol (Kerlone), bisoprolol (Zebeta), carteolol (Cartrol), acebutolol (Sectral), metoprolol (Lopressor, Toprol-XL), nadolol (Corgard), propranolol (Inderal), sotolol (Betapace) and timolol (Blocadren).

  • Angiotensin-converting enzyme inhibitors (ACE inhibitors). These drugs interfere with the body’s production of angiotensin II, a hormone that causes the arteries to constrict. The drugs enable muscles in your arteries to relax so they can open wider.

    The most common side effect is a dry, persistent cough. An added benefit of ACE inhibitors is that they slow the rate at which your kidneys deteriorate if you have diabetes-related kidney disease. For people with high blood pressure and diabetes or kidney disease, national guidelines recommend that initial drug treatments include ACE inhibitors. However, you should not be on ACE inhibitors if you are pregnant because they can cause life-threatening complications in the baby. Some commonly prescribed drugs in this class include captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivel, Zestril), benazepril (Lotensin), fosinopril (Monopril), moexipril (Univasc), perindopril (Aceon), ramipril (Altace) and trandolapril (Mavik).

  • Angiotensin II receptor blockers. Angiotensin II receptor blockers work similarly to ACE inhibitors to block the hormone angiotensin II, which normally causes blood vessels to narrow. As a result, the blood vessels relax and become wider, causing blood pressure to go down. They’re more effective if you also take a diuretic. These drugs do not cause any cough like ACE inhibitors. Some commonly prescribed drugs in this class are candesartan (Atacand), eprosartan (Teveten), irbesarten (Avapro), losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan).
  • Calcium channel blockers (calcium antagonists). Calcium channel blockers relax artery muscles and dilate coronary arteries and other arteries by blocking the transport of calcium into these structures, thus lowering blood pressure. There are two classes of calcium blockers—the dihydropyridines and the non-dihydropyridines—which may be used to treat high blood pressure and angina. One dihydropyridine, fast-acting nifedipine (Adalat, Procardia and others), may increase your risk of heart attack when used for acute hypertension; therefore, nifedipine should only be used in the treatment of chronic high blood pressure. It is unclear whether other calcium channel blockers share this risk, so discuss this and other potential risks with your health care professional if you receive a prescription for a calcium channel blocker. Dihydropyridines also may cause ankle swelling, rapid heartbeat and headaches and may make you flush.
  • Alpha-blockers. These drugs work by relaxing certain muscles to help small vessels remain open. Alpha blockers work by stopping the hormone norepinephrine from constricting small arteries and veins, which improves blood flow and lowers blood pressure. Alpha blockers may increase your heart rate and can cause you to retain fluid, so they may be combined with diuretics or beta blockers. Other side effects include a drastic drop in blood pressure when you stand up—often seen after only one dose—and headache. However, some studies suggest alpha blockers have added benefits if you have high blood cholesterol levels or glucose intolerance. Some commonly prescribed drugs in this class include doxazosin (Cardura), prazosin (Minipress) and terazosin (Hytrin).
  • Alpha-beta blockers. Alpha-beta blockers reduce nerve impulses to blood vessels, thus decreasing vessel constriction, and they slow the heartbeat to reduce the amount of blood that must be pumped through the vessels. They are typically used as an IV drip for patients in hypertensive crisis. They may be prescribed for outpatient high blood pressure treatment if a patient is at risk for heart failure. Alpha-beta blockers include caredilol (Coreg) and labetolol hydrochloride (Normodyne). Potential side effects of alpha-beta blockers include fatigue, decreased sex drive, anxiety and insomnia. More serious side effects include difficulty breathing, depression, feeling faint and swelling of the lips, tongue, throat or face.
  • Vasodilators. Vasodilators work to relax the muscles in the walls of the blood vessels, which helps the vessels widen. Some commonly prescribed vasodilators include hydralazine hydrochloride (Apresoline) and minoxidil (Loniten). More serious potential side effects of vasodilators include difficulty breathing; swelling in your face, throat, lips, tongue, feet or hands; and joint pain. Less serious side effects include nausea, vomiting, diarrhea, headache and anxiety.
  • Central-acting agents (or central agonists). These medications work by preventing your brain from telling your nervous system to increase your heart rate and narrow blood vessels. Some commonly prescribed drugs in this class include alpha methyldopa (Aldomet), clonidine hydrochloride (Catapres), guanabenz acetate (Wytensin) and guanfacine hydrochloride (Tenex). Potential side effects of central agonists include dizziness, dry mouth, nausea, vomiting and sleep problems. More serious side effects include allergic reaction, fast, pounding heart rate and confusion.


Because we don’t know the cause of most cases of high blood pressure, it’s hard to say how to prevent it. However, diet and lifestyle changes can be key. You should consider these tips:

  • Increase the amount of exercise you get. Regular aerobic physical activity can enhance weight loss and reduce the risk for cardiovascular disease. You can reduce your blood pressure with moderately intense physical activity, such as a 30- to 60-minute brisk walk most days. If you have cardiac or other serious health issues, you should have a thorough medical evaluation, and perhaps have a cardiac stress test, before beginning any exercise program.
  • Lose weight. Losing just 10 pounds can help lower your blood pressure. Some obese people also have sleep apnea, in which they stop breathing dozens or hundreds of time a night, snore loudly and suffer from daytime sleepiness. Sleep apnea is linked with high blood pressure.
  • Reduce alcohol consumption. Most men with high blood pressure shouldn’t drink more than two drinks per day, and women shouldn’t have more than one alcoholic drink per day. A drink is equal to 12 ounces of beer, five ounces of wine or one and a half ounces of 80-proof liquor.
  • Reduce stress. When you relax, your heart rate slows, which reduces the amount of oxygen your body needs, reducing your pressure.
  • Quit smoking. Even more than lowering your blood pressure per se, it will reduce your overall cardiovascular disease risk more than any other single move.
  • Reduce your sodium intake. Salt can cause fluid retention so don’t add salt to foods. For optimum heart health, the American Heart Association recommends a limit of 1,500 mg of sodium per day. Because the average sodium intake is so excessive, even cutting back to 2,400 mg (the amount contained in about one teaspoon of salt) or less will help improve blood pressure and overall heart health.

    To cut down on sodium, steer clear of processed foods (sauces, mixes and “instant” products such as flavored rice, cereals and pasta). Get in the habit of checking labels for sodium content. If one portion has more than 300 mg, choose a lower-salt brand. Eat more vegetables that are fresh, frozen without sauce or canned with no salt. Salt substitutes may work for you, but check with your health care professional because they can be harmful if you have certain medical problems.

  • Increase dietary potassium. An analysis of several studies indicates that potassium can reduce blood pressure by combatting the effects of sodium. Bananas are naturally high in potassium, and the mineral can also be purchased in supplement form. According to the American Heart Association, the average adult should aim for 4,700 mg of potassium a day. Increasing potassium intake is not recommend for patients with kidney disease, however. Ask you health care professional before increasing your potassium intake.
  • Eat a healthy diet. Aim for a diet rich in fruits, vegetables and low-fat dairy products, and low in saturated and total fat.

You can make all of your lifestyle changes at the same time. Studies find the best results come from adopting the DASH diet, which is rich in fruits, vegetables and low-fat dairy products.

Fish oil (omega-3 polyunsaturated fatty acids) and calcium supplements lower blood pressure only slightly in those with hypertension. Additionally, herbal and botanical supplements, which get very little scrutiny from the FDA, have not been proven to safely lower blood pressure and may, in fact, dangerously interact with some medications.

Finally, if you have high blood pressure, be sure to inform your health care professional about all medicines you are taking, including over-the-counter drugs. It is particularly important that you mention drugs such as steroids; nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen; nasal decongestants and other cold remedies; appetite suppressants; cyclosporine; erythropoietin; antidepressants; and monoamine oxidase (MAO) inhibitors.

You should take care when choosing over-the-counter drugs for colds. Many cold remedies contain decongestants that may raise your blood pressure. These medicines can also interfere with your blood pressure drug’s effectiveness. Check with your health care professional before taking any over-the-counter drug if you have high blood pressure.

You should take care when choosing over-the-counter drugs for colds. Many cold remedies contain decongestants that may raise your blood pressure. These medicines can also interfere with your blood pressure drug’s effectiveness. Check with your health care professional before taking any over-the-counter drug if you have high blood pressure.

Facts to Know

  1. About 85.7 million Americans have high blood pressure. It is a contributing factor in an estimated 410,000 deaths per year.
  2. More men than women have hypertension until women reach menopause, when a woman’s risk becomes greater than a man’s.
  3. About half of the 80 million Americans with high blood pressure are women, with the incidence becoming greater in women as they get older. About 30 percent of women have high blood pressure, and the risk is higher in older women and African American women.
  4. Your blood pressure consists of two numbers—the systolic pressure and the diastolic pressure. The higher number, the systolic pressure, represents the pressure while the heart is beating. The lower number, the diastolic pressure, represents the pressure when the heart is resting between beats.
  5. Blood pressure can fluctuate with eating, sleeping and changes in posture, but a normal blood pressure reading should be less than 120 mm Hg systolic and less than 80 mm Hg diastolic. Blood pressure between 120–129 mm HG systolic and less than 80 mm HG diastolic is considered elevated. A level of 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic is considered stage 1 hypertension (high blood pressure). Levels of 140 mm Hg or greater systolic or 90 mm Hg or greater diastolic are classified as stage 2 hypertension. If you have systolic and diastolic readings that fall in two categories, you will be designated with the higher blood pressure category.
  6. If you have elevated blood pressure, you are more likely to develop hypertension in the future and have increased risk factors for cardiovascular disease and other conditions related to hypertension. Your risk for cardiovascular diseases progresses steadily as your blood pressure rises above the normal range.
  7. You may also have hypertension if either your systolic or your diastolic pressure is greater than or equal to 130 or 80 mm Hg, respectively. That is, you can have isolated systolic or diastolic hypertension. Isolated systolic hypertension is the most common form of high blood pressure in older Americans. An estimated two out of three people with hypertension over age 60 have ISH.
  8. Dietary and lifestyle changes may help you control high blood pressure. If you have mild hypertension, you may be able to lower your blood pressure by reducing the amount of sodium in your diet and cutting back on alcohol consumption. If you are overweight, losing weight will help, as will physical activity.
  9. Many people think high blood pressure is the result of lifestyle factors, such as stress, lack of exercise, drinking or smoking, but the cause of approximately 90 percent to 95 percent of all hypertension cases can’t be determined.
  10. There is no cure for hypertension, but it is easily detected and usually controllable.
  11. Many people who suffer from high blood pressure don’t know they have it because it usually produces no symptoms. And of those who have hypertension, less than half have the problem under control, defined as a level below 130/80 mm Hg.
  12. If left uncontrolled, high blood pressure can have very serious consequences. The condition can lead to stroke, heart attack, hardening of the arteries, congestive heart failure and/or kidney disease. In severe cases, it can lead to blindness.
  13. There are several drug classes—and hundreds of individual and combination medications—to choose from when treating high blood pressure. Generally, all can lower your blood pressure, but people often respond very differently to each drug, so you will probably have to try a few of them before finding the one that works best for you.
  14. Taking birth control pills has been linked with high blood pressure in women. The combination of birth control pills and smoking may be particularly dangerous. Ask your health care professional to take your blood pressure before you start taking the pill and have it checked every six months or so after you start taking it.
  15. If you already have high blood pressure and you get pregnant, your pregnancy could make the condition more severe, especially in the last three months. If it goes untreated, high blood pressure in pregnancy can be dangerous to both mother and baby. Therefore, health care professionals usually closely monitor blood pressure during pregnancy.

Questions to Ask

Review the following Questions to Ask about high blood pressure so you’re prepared to discuss this important health issue with your health care professional.

  1. What does my blood pressure reading mean? Why are there two numbers and what do they measure?
  2. Do I have hypertension (high blood pressure)? Am I at risk for developing it? Why?
  3. Am I taking any medicines that could increase my blood pressure? Should I stop taking them?
  4. What are the possible consequences of hypertension? How can I limit my risk for hypertension and its complications?
  5. What medications are available to help me if I have hypertension? What are their benefits and side effects? Will these drugs interact with any other medications I am taking?
  6. What if I don’t like or can’t tolerate the side effects of my medication? Is it possible for me to switch to another one?
  7. My blood pressure is high, but I don’t feel uncomfortable at all. Why not? Does this mean that my hypertension is not really harmful to me?
  8. I would never know I had hypertension except for the blood pressure readings. Should I keep taking my medication? Why?
  9. My blood pressure is only slightly above normal. Do I really have to do anything about it?
  10. Is there a cure for hypertension?
  11. How often should I have my blood pressure checked?
  12. Is it possible for me to lower my blood pressure by losing weight and living a healthy lifestyle? Is it possible for me eventually to lower it enough to stop taking medication?

Key Q&A

  1. What exactly is hypertension?
    Hypertension is also called high blood pressure. Blood pressure is the pressure inside your arteries that harmlessly pushes the blood to your body’s organs and muscles so they can receive the oxygen and nutrients they need. Blood pressure is variable—it rises and falls during the day. When blood pressure stays elevated over time, it is called high blood pressure or hypertension. A blood pressure reading at or above 130 systolic or 80 diastolic (presented 130/80 mm Hg) is considered hypertensive.
  2. What causes hypertension?
    No one knows for sure, although a number of factors are thought to contribute to it, such as family history. If you have two immediate family members who developed high blood pressure before age 60, you have two times the risk, and your risk goes up even further with each additional immediate family member with high blood pressure you have. Other risk factors include increasing age, salt sensitivity, obesity, heavy alcohol consumption, use of oral contraceptives, an inactive lifestyle, regular smoking or use of smokeless-tobacco (like snuff or chewing tobacco) and high uric acid levels.
  3. Are there different types of hypertension?
    Yes, there are two types of hypertension: Primary hypertension and secondary hypertension. Primary hypertension, the most common type, is also called essential hypertension. There is no known cause. About 5 percent to 10 percent of people with high blood pressure have it as a result of another condition or problem, such as such as kidney disease, or the use of certain medications, such as birth control pills. This is secondary hypertension.
  4. Can hypertension lead to other serious medical problems?
    Yes. All stages of hypertension are associated with risk of cardiovascular disease. Even slightly elevated blood pressure levels can double your risk for coronary heart disease. Consistent high blood pressure also increases your risk for congestive heart failure and can lead to other problems such as atherosclerosis, eye damage, heart enlargement or failure and kidney damage and failure.
  5. Who develops high blood pressure?
    African Americans and Hispanic Americans are more likely to develop high blood pressure than Caucasians. More men than women have hypertension until women reach menopause, when a woman’s risk surpasses a man’s.
  6. How often should I have my blood pressure checked?
    You should have your blood pressure checked whenever you see a health care professional&mdash;but every two years at the least.
  7. What can I do to prevent hypertension?
    Diet and lifestyle changes are key. You should increase your exercise, maintain a healthy weight and reduce alcohol consumption. Most men shouldn’t drink more than two drinks per day and women shouldn’t drink more than one drink per day. (One drink is defined as 12 ounces of beer, five ounces of wine or an ounce and a half of 80-proof liquor). You should also reduce your stress levels and lower your sodium intake, as well as follow a diet rich in fruits, vegetables and low-fat dairy products, and low in saturated and total fat.
  8. How is hypertension treated?Your health care professional has several drug classes from which to choose when selecting a hypertension drug for you. Generally, all can lower your blood pressure, but often people respond very differently to each drug. You will probably have to try out a few of them before finding the one that works the best for you, with the least amount of side effects.

Organizations and Support

For information and support on coping with Heart Disease, please see the recommended organizations, books and Spanish-language resources listed below.

American College of Cardiology (ACC)
Website: https://www.acc.org
Address: Heart House
2400 N Street, NW
Washington, DC 20037
Hotline: 1-800-253-4636
Phone: 202-375-6000
Email: [email protected]

American Heart Association (AHA)
Website: http://www.americanheart.org
Address: 7272 Greenville Avenue
Dallas, TX 75231
Hotline: 1-800-AHA-USA-1 (1-800-242-8721)
Email: [email protected]

Website: https://medivizor.com

National Heart, Lung, and Blood Institute (NHLBI) – NHLBI Health Information Center
Website: http://www.nhlbi.nih.gov
Address: Attention: Website
P.O. Box 30105
Bethesda, MD 20824
Phone: 301-592-8573
Email: [email protected]

Pulmonary Hypertension Association
Website: http://www.phassociation.org
Address: 801 Roeder Road, Suite 400
Silver Spring, MD 20910
Hotline: 1-800-748-7274
Phone: 301-565-3004
Email: [email protected]

Sister to Sister: The Women’s Heart Health Foundation
Website: http://www.sistertosister.org
Address: 4701 Willard Avenue, Suite 223
Chevy Chase, MD 20815
Hotline: 1-888-718-8033
Phone: 301-718-8033
Email: [email protected]sistertosister.org

WomenHeart: National Coalition for Women with Heart Disease
Website: http://www.womenheart.org
Address: 818 18th Street, NW, Suite 930
Washington, DC 20006
Hotline: 1-877-771-0030
Phone: 202-728-7199
Email: [email protected]

Women’s Health Initiative (WHI)
Website: https://www.whi.org/
Address: Clinical Coordinating Center
Fred Hutchinson Cancer Research Center
1100 Fairview Ave N, M3-A410
PO Box 19024
Seattle, WA 98109-1024
Phone: 800-218-8415
Email: [email protected]

Women’s Heart Foundation
Website: http://www.womensheart.org
Address: P.O. Box 7827
West Trenton, NJ 08628
Phone: 609-771-9600


Good News About High Blood Pressure: Everything You Need to Take Control of Hypertension…and Your Life
by Thomas Pickering

Healing Hypertension: Uncovering the Secret Power of Your Hidden Emotions
by Alan Rees

Heart of the Matter: The African American’s Guide to Heart Disease, Heart Treatment, and Heart Wellness
by Hilton M. Hudson, Herbert Stern PhD

High Blood Pressure: Practical, Medical, & Spiritual Guidelines for Daily Living With Hypertension
by Mark Jenkins

High Blood Pressure: The Black Man and Woman’s Guide to Living with Hypertension
by Hilton M. Hudson II MD FACS, James R. Reed

Mayo Clinic on High Blood Pressure
by Sheldon Sheps M.D.

Spanish-language resources

MedlinePlus: Hypertension
Website: http://www.nlm.nih.gov/medlineplus/spanish/ency/article/000468.htm
Address: Customer Service
8600 Rockville Pike
Bethesda, MD 20894
Email: [email protected]

High blood pressure: How to beat the invisible killer | The Independent

High blood pressure is common, mostly symptomless, and potentially lethal. Known as the silent killer, it is a direct cause of more than 100,000 strokes each year (two thirds of the total). It also increases the risk of heart disease, kidney problems and blindness. A quarter of adults have high blood pressure, and among those over 60 the proportion rises to half. But many people don’t know they have it. An estimated 18 per cent of men and 13 per cent of women with high blood pressure are not receiving treatment that could protect them from an early death.

High blood pressure is not just a problem for older people. Blood pressure can rise at any age. One in 10 men aged 25-34 years have high blood pressure compared with approximately two in five men aged 35-44 years, according to the Blood Pressure Association. Fewer women are affected at a young age, but one in 10 women in their twenties are affected.

Has thinking about blood pressure changed?

Dramatically. The old view was that high blood pressure was necessary in older people in order to pump the blood through furred arteries, which had been narrowed by fatty deposits. In the 1930s there was huge controversy over whether it would be safe to attempt to lower blood pressure. When the first trials of blood pressure- lowering medicines were carried out in the 1960s, only patients with extreme raised pressure were entered into them, because of what were perceived to be the risks. The results showed rapidly and unequivocally that lowering the pressure saved lives.

Is the problem getting worse?

Yes – because we are an ageing population and our arteries get stiffer as we get older. Modern Western lifestyles are also making high blood pressure increasingly common. It is almost unknown in parts of the world such as rural Africa, where factors such as poor diet, lack of exercise, excess salt and too little fruit and vegetables don’t apply. This is so even though Africans have an underlying genetic propensity to high blood pressure. The problem is now so widespread in the West, with half the over- sixties affected, that high blood pressure has come to represent normality.

What is high blood pressure?

As the heart pumps the blood around the body it exerts pressure on the artery walls. If you have high blood pressure, it means your heart is having to work harder to pump the blood. This can weaken the heart or damage the artery walls, resulting in a blockage or a rupture of the walls (haemorrhage). High blood pressure is defined as a sustained pressure of 140/90mm Hg or over.

What does that mean?

Blood pressure is measured in millimetres of mercury (Hg). Two measures are used, to record the maximum and minimum pressures during a single beat of the heart. The first figure – 140 – is called the systolic pressure, which is the maximum pressure as the heart contracts, pumping the blood round the body. The second figure – 90 – is the diastolic pressure, or the minimum pressure as the heart relaxes while the ventricles (chambers) of the heart fill with blood before it pumps again.

What is normal blood pressure?

A consistent reading below 120/80mm Hg is regarded as ideal. Any reading in the range 90/60 to 140/90 would be considered good in most people. However, a blood pressure level of 135 over 85 (135/85) may be “normal”, but someone with this reading is twice as likely to have a heart attack or stroke as someone with a reading of 115 over 75 (115/75). As a general rule, the lower your blood pressure the better, though it should not be so low that you experience symptoms such as passing out when you stand up because the heart is having difficulty pumping blood to your brain.

What causes high blood pressure?

In most cases there is no single cause. But lifestyle plays a part. Poor diet, lack of exercise, being overweight, drinking to excess and stress all increase the likelihood of high blood pressure. Many people can lower their blood pressure by tackling these issues. For example too much salt increases blood pressure, so it is best to eat as little as possible. Some people may be able to avoid taking blood pressure-lowering drugs by cutting down on salt. But genetics, too, plays a part – high blood pressure runs in families. People from Afro-Caribbean and South Asian communities are at greater risk – and blood pressure rises with age.

Can it cause symptoms?

Yes, but rarely – when a person has very high blood pressure. Symptoms can include headache, blurred vision, nosebleeds and shortness of breath. Get an appointment with your GP as soon as possible if you experience these. Adults over 40 should have their blood pressure checked at least once every five years, and more frequently if there are risk factors such as a family history of heart disease.

What happens when high blood pressure is diagnosed?

Your doctor will first explore if there are changes you can make to your lifestyle that might reduce the pressure. The most important are keeping to a healthy weight, eating more fruit and vegetables, cutting down on salt, taking more exercise and drinking less alcohol. You could also try yoga or meditation to reduce stress. If these fail, or if your lifestyle is already healthy, then your doctor may recommend drug treatment.

What is the “white coat effect”?

High blood pressure cannot be diagnosed from a single reading because it can vary – a series of readings is required. Many people find their blood pressure rises when it is being measured in the presence of a doctor (with or without white coat) and this has cast doubt on the accuracy of these readings. The best measure is a 24-hour reading, which can be obtained by wearing a monitor that automatically records blood pressure every half hour throughout the day.

Can occasional high blood pressure be a risk too?

Conventional thinking has been that sustained high blood pressure is what does the damage and needs to be controlled. But three studies published in The Lancet in March have cast doubt on this view. They found patients with the highest variation in blood pressure were up to 12 times more likely to have a stroke than those with the least variation. About half of all patients with high blood pressure have variable readings between visits for measurement. Leaders of the British Hypertension Society and the National Institute for Clinical Excellence are considering what impact, if any, this should have on guidance for the management of high blood pressure.

What should you do if pregnant?

Have your blood pressure checked regularly, even if it is not high, because pregnancy can raise blood pressure in some women. That way you will get early warning if you are developing pregnancy-induced hypertension, which can lead to pre-eclampsia, a serious condition which affects the placenta and can threaten the life of both mother and baby. About 6 to 8 per cent of pregnancies are affected by high blood pressure problems. Older mothers and those carrying twins or triplets are at higher risk.

Which is the best blood pressure- lowering medicine?

Everyone is different – there is no “best” drug. If you cannot reduce your blood pressure by other means, then drug treatment may be necessary. High blood pressure cannot be “cured” so it will probably mean taking pills for the rest of your life. Which ones you take is partly a matter of trial and error. What works well for one person may not work for another. For many people, one medicine alone will not lower their pressure enough – two drugs together can work in synergy, giving a greater effect than the sum of their effects when given alone.

How do I choose which drugs to take?

Each type of medicine works in a different way. People under 55 tend to respond better to drugs called ACE inhibitors, which relax and widen the arteries, making it easier for the heart to pump the blood. Those over 55 tend to do better on calcium channel blockers, which lower pressure by blocking the effect of calcium, used by the body to narrow blood vessels. Like ACE inhibitors, they relax and widen the arteries, but through a different mechanism. Many patients require both types of medicine.

What about side effects?

These are very safe drugs that have been used for decades – so long that they are out of patent (and hence relatively cheap for the NHS). The commonest side effect of ACE inhibitors is a dry cough. If this becomes bothersome, an angiotensin receptor blocker (ARB), which works in a similar way but appears to lack the side effect may be prescribed. Calcium channel blockers can cause swollen ankles. Diuretics, which are sometimes called water tablets, are also widely prescribed for blood pressure. They act on the kidneys to increase the amount of salt and water that they extract from the blood, increasing the amount of urine. Too much salt can cause extra fluid to build up in the blood vessels, raising blood pressure. Diuretics can mean you need to urinate more, so they are best taken in the morning, to avoid having to get up in the night to go to the toilet.

Can blood pressure be too low?

Usually, the lower your blood pressure the healthier you are. But if it is too low (less than 90/60) you may experience symptoms such as dizziness, fainting, blurred vision, palpitations, nausea and general weakness. Some people feel dizzy on standing up and this is known as postural hypotension, when your blood pressure falls as a result of a sudden change of movement. It usually lasts only a few minutes. Some medicines, such as beta-blockers, alpha blockers and antidepressants can cause this. In general, you only need treatment for low blood pressure if you have symptoms which worry you. Your GP will then try to find the underlying cause of your low blood pressure.

90,000 Low numbers don’t get it right. Why hypotension is dangerous for the body

How to help?

It is not so easy to help hypotonic patients, unlike hypertension, the list of drugs is small:

“A number of drugs relieve acute symptoms, and doctors advise herbal ones for constant use. Tinctures of ginseng, eleutherococcus, aralia, radiola rosea, levsia, pantocrine increase vascular tone and blood pressure, says the therapist.- The main thing is to use them for at least six months, the recommended dose of 10-15 drops can be changed, focusing on the state of health.

It is advisable to change the drug every month, since each has its own advantages. And drink it after meals, because, as the doctor’s experience shows, 90% of hypotensive patients have problems with the gastrointestinal tract. But the most effective remedy, according to Lena Kubaeva, is contrast shower .

“We have to teach the vessels to actively constrict and dilate, and the contrast shower has helped more than one of my patients,” she says.- In addition, long-term good sleep and the absence of stress are very important for the health of blood vessels, if it is, of course, possible. Walking and playing sports will help. ”

If an attack of hypotension could not be avoided, then first aid is to lie down and raise your legs. Sweet tea, coffee, chocolate and always peace. It doesn’t get any easier – call an ambulance.

It also happens in healthy people

Each hypotonic person has encountered a situation that sometimes occurs in a healthy person. The doorbell rings, you quickly get up from the sofa on which you were lying, and you feel: the room floated before your eyes.

“A sharp rise – the blood rushed from the brain to the legs, oxygen starvation led to a semi-fainting state,” the doctor explains. – The same happens when a person squats for a long time. The vessels are pinched, the blood supply is impaired. When he gets up, the blood again flows from the head, which leads to dizziness. ”

Therefore, knowing this peculiarity behind yourself, try to avoid such situations. Do not jump briskly out of bed in the morning, but do it slowly, even if you are 18 years old.If you are squatting in a garden bed, get up from time to time and stretch your legs.

There are many hypotensives among athletes who seem to be full of health, who have low blood pressure and a rare pulse is nothing more than a defensive reaction to improperly selected physical activity.

“During training, the muscles require increased blood flow. If the muscle mass grows gradually with a properly selected training regimen, then the vascular tone evens out, otherwise pressure surges cannot be avoided, ”explains Lena Alekseevna.

Therefore, do not neglect the warm-up, considering that it is needed only to warm up the muscles. Blood should flow to them gradually, otherwise, with a disturbed vascular tone, which many may not even suspect, a drop in pressure is ensured.

Photo: shutterstock.com

How to raise the dropped pressure

With low blood pressure, a person suffers from weakness, dizziness, pain in the heart.How to raise the pressure and is it dangerous to lower it, says Igor Ivanov, a cardiologist, deputy chief physician of St. George’s hospital.

It turns out that everything is not as simple with low blood pressure as with high blood pressure. With a persistent increase in blood pressure above 140/90 mm Hg. Art. we’re talking about hypertension. For low pressures, it is difficult to draw a precise boundary.

Not always a disease

As a rule, chronic arterial hypotension is called a persistent decrease in blood pressure up to 90/60 mm.rt. Art. and below. For most healthy people, this pressure will not have any negative consequences for the body. So chronic habitual hypotension is not necessarily a disease.

It is quite another matter if the blood pressure dropped sharply, quickly. Then the patient often feels bad. So, a hypertensive patient with the usual blood pressure figures of 170 and 90 mm Hg. Art. symptoms of hypotension may develop with blood pressure 140 and 80 mm Hg. Art. To be afraid of this, however, is also not worth it.

“We often see outwardly healthy people who feel great, but have low blood pressure, lower than 90 and 60 mm Hg. Art. However, most often this does not mean at all that something is wrong with them, – says Igor Ivanov. – A patient with chronic hypotension due to a particular disease will show symptoms of the disease.

If there are no symptoms, it is likely that hypotension is a constitutional feature. It is most often observed in young girls and people with low body weight.Moreover, the risks of developing serious diseases in them are not higher than in people with normal blood pressure, and much lower than in people with high blood pressure. Often, a predisposition to low blood pressure can be inherited, ”warns the doctor.

When sleepy

So, what does a person feel with a sharp drop in blood pressure?

The classic symptoms of hypotension are dizziness and weakness. They are explained by insufficient blood supply to the brain.The head is especially dizzy in an upright position of the body, since less blood is supplied.

The rest of the symptoms are most often associated with the cause that caused the pressure drop. So, if during a severe viral infection due to intoxication, pressure decreases, then headache, chills, aching muscles and joints will be a manifestation of this very intoxication.

Hypotension can develop with a variety of diseases: from myocardial infarction to gastrointestinal bleeding, as well as while taking a number of medications.

There are diseases that lead to chronic hypotension, for example, adrenal insufficiency, in which case a person gets tired quickly, he is overcome by apathy. He often yawns (due to oxygen deficiency), he wants to sleep. Sometimes hypotension is simply called sleeping sickness.

Where does this sleepy but very active disease come from? Most often, doctors note that the cause of hypotension is a violation of vascular tone.

“A sudden drop in blood pressure can be a symptom of serious illness.It is necessary to provide first aid and consult a doctor, advises Dr. Ivanov. – In case of severe dizziness, especially in case of fainting due to low pressure, it is necessary to lay the patient down and raise his legs above the level of the head, thus improving the blood supply to the brain. Even if the patient feels better, it is necessary to seek medical help, as it is required to deal with the causes of hypotension. If symptoms persist, an ambulance should be called immediately. ”

Eat spicy and spicy

If hypotension interferes with life, then it is imperative to be examined and look for the cause.And saline solutions will help raise the pressure, in particular, a sufficient intake of fluids (about 2 liters), especially mineral water, and caffeine-based stimulants (strong tea and coffee).

In case of hypotension, it is necessary to saturate the menu with proteins, vitamins and minerals. Usually in our diets we are forbidden to eat spicy foods. But hypotensive patients can! Spicy and spicy dishes stimulate appetite and stimulate digestion.

You can also afford salty: the salt will attract additional liquid and raise the pressure.It is better to eat a little 4-5 times a day. And you shouldn’t eat before bed.

Sports and dosed physical activity are important. Swimming is ideal, since in addition to physical activity, there will also be a thermal effect on the receptors. But there is no scientific information regarding cognac, which is used both to reduce pressure and to raise it.

“To avoid hypotension, it is necessary to periodically measure blood pressure, visit a cardiologist, eat right, do physical exercise, better medical, forget about smoking and alcohol, alternate work and rest, walk in the fresh air, temper using rubdowns and a contrast shower, sleep at least 10-12 hours, ”says a cardiologist of the highest category, deputy.the chief physician of the hospital of St. George, Igor Ivanov.

90,000 From 18 and older, or What you need to know about blood pressure

The Arctic anticyclone by the Defender of the Fatherland Day will bring frosts down to minus 23 degrees to Moscow. And not only them: forecasters warn that atmospheric pressure will begin to rise from the middle of the week. By Friday, it will rise to 758 millimeters of mercury. People with diseases of the cardiovascular system are especially affected by changes in pressure and temperature.

Hypertension is still the disease of the century and the big city. Stress, hard work, night shifts, and lack of sleep are serious reasons to watch your blood pressure. If you have hypertension in your family and if you are a man, there are more reasons to control blood pressure. Women, too, should not relax, especially those who are overweight or taking hormonal drugs.

Hypertension is one of the most dangerous threats. It is fraught with serious complications: acute heart attacks, strokes, renal failure, vascular and eye damage.But in most cases, it is quite possible to curb hypertension. Oksana Pesenko, a cardiologist of the highest category, organizer and lecturer of the school for patients with arterial hypertension at the city polyclinic No. 8.

Which pressure readings are considered normal?

– Blood pressure is an indicator of the pressure with which the blood presses on the walls of the arteries.It is measured in millimeters of mercury. Moreover, two indicators are taken into account: systolic pressure – at the time of contraction of the heart muscle (systole) and diastolic – at the time of relaxation of the heart muscle (diastole).

Pressure higher than 140 to 90 indicates arterial hypertension

Indicators are considered normal if the systolic pressure does not exceed 140 millimeters of mercury, and the diastolic pressure is 90. The optimal pressure is 120 to 80, normal is 120–129 to 80–84, high normal pressure is 130–139 to 85–89.A pressure higher than 140 to 90 indicates arterial hypertension.

For hypotensive patients, the indicators of normal and high blood pressure may be different. The doctor at the reception is always interested in what pressure the patient is adapted to. If for a person the usual pressure is 90 to 60, then the indicators of 120 to 80 for him may be too high and he may feel bad. In this case, the doctor prescribes additional examinations.

Hypotension can be a marker of serious complications if it occurs unexpectedly in a person who is not adapted to low blood pressure.In this case, hypotension may indicate a low hemoglobin level, vascular disease, acute bleeding situations, and so on.

Hypertension is getting younger

At what age should you start measuring blood pressure?

– Doctors recommend not to postpone monitoring your blood pressure until later. Therapists begin to monitor the patient’s blood pressure from the age of 18, which is what they advise everyone. Hypertension is getting younger, and the insidiousness of the disease is that at first it may be asymptomatic.A person learns that he is hypertensive already when some diseases appear. Even if there are no complaints, but at the same time the young man has a nervous work, a tense rhythm of life, doctors recommend at least several times a week to control his pressure after a working day.

Elderly people, as well as those with risk factors for developing hypertension, should regularly monitor their blood pressure. In case of a tendency to increase in performance, you need to see a doctor, even if you feel well.

Among the reasons for the development of hypertension are stress, unhealthy diet, smoking

– What are the risk factors for developing hypertension?

– The reasons for the development of hypertension are objective, which cannot be influenced, and subjective, which can be regulated. Objective factors include age, heredity, and male gender.

Subjective factors are obesity and unhealthy diet (an excess of fatty foods and salt), a sedentary lifestyle, smoking, alcohol and coffee abuse, stress, nervous work, taking contraceptive pills (long-term use of contraceptives increases the risk of hypertension in women).

– How to measure pressure correctly?

– At home, it is more convenient to measure pressure with either a semi-automatic or an automatic tonometer, which is fixed on the forearm. Mercury devices with a manual blower are much more difficult to use. It is not recommended to smoke or drink coffee before measuring blood pressure. You need to measure pressure in a comfortable environment, in a calm state, it is better to sit on a chair, leaning your back on its back. The legs are not crossed, the forearm is on the table, the arm is relaxed.

The pressure must be measured several times. After the first measurement, which, as a rule, is not taken into account, in the intervals from 30 to 60 seconds, we measure two or three more times and calculate the average value of blood pressure.

Hypertension may be asymptomatic, therefore blood pressure should be monitored regularly

– What are the symptoms of high blood pressure?

– The most common signs of high blood pressure are throbbing headache in the occipital region, flashing flies, tinnitus, dizziness, staggering, blurred vision.If a person has numbness of the limbs, difficulty speaking, difficulty walking, this is already a sign of a serious complication – cerebrovascular accident.

Hypertension may be asymptomatic. It is no coincidence that she is called the silent killer. Therefore, you need to monitor your blood pressure regularly, even with good health.

– What is the basis for the diagnosis of hypertension?

– The diagnosis of hypertension is made on the basis of the recorded high blood pressure and the results of the examination.What kind of research needs to be done is decided by the attending physician. As a rule, this is a general blood test, a general urine test, a biochemical blood test with the determination of the level of thyroid and adrenal hormones, echocardiography, ultrasound of the kidneys, an ophthalmologist checks the fundus. If there are changes, the doctor prescribes additional research and refers to consultations with narrow specialists. Hypertension has different faces, and it can manifest itself in different ways.

If hypertension is suspected, doctors recommend daily monitoring of blood pressure, because during the day a person’s indicators may change.In addition, there is such a phenomenon as “white coat hypertension”, when a person’s blood pressure rises when visiting a clinic, at the sight of a doctor in a white coat.

10 Steps to Health: A Memo for Patients

The most important thing is to start moving towards health. It won’t be as difficult as it sounds.

1. Control of blood pressure. Keep a diary where you write down your blood pressure readings throughout the day.

2. Proper nutrition.Limit your intake of animal fats.

3. Less salt. The daily amount of salt should not exceed a teaspoon. The salt contained in the products is also taken into account.

4. More potassium. Potassium is rich in foods such as beans, seaweed, apricots, raisins. It is also found in cod, mackerel, squid, oatmeal, onions, tomatoes, radishes, apricots and currants.

5. Weight loss. Excess weight provokes the development of hypertension and other cardiovascular diseases.

6. Running from hypertension. Exercise is essential for a fulfilling, healthy life. The main thing is to choose the optimal mode for yourself.

7. Relieve stress. Correct behavior in stressful situations can be learned. For advice, see your doctor or your hypertension school.

8. Quit smoking. “Smoking is harmful to your health” is not just words, it is a call to action. Smoking significantly increases the risk of developing hypertension, cardiovascular, cancer and other diseases.

9. Limiting the use of alcohol. Strong alcohol, cocktails and alcoholic beverages containing a large amount of sugar should be avoided. Excessive drinking of beer is also very harmful.

10. If you have been diagnosed with hypertension, strictly follow the doctor’s recommendations, including the use of medications. Their reception should be regular, without missing.

And about medicines

Do not self-medicate, do not listen to the advice of friends and neighbors.There are several groups of drugs that lower blood pressure, and only a doctor can determine which drug should be taken at the moment.

It is impossible to cure hypertension with folk remedies. Follow your doctor’s recommendations and take the drugs that he has prescribed for you.

Each Moscow polyclinic has health centers where you can get recommendations from doctors on the prevention of hypertension. In many medical institutions there are schools for patients with arterial hypertension, where qualified specialists tell about the danger of hypertension and how to treat it.

90,000 What to do if a child has low blood pressure

Low blood pressure in a child is a common problem. To solve it will help in the children’s medical center “Human Health”, which is located near the station. m. “Bibirevo”, “Otradnoe”, “Vladykino” in the North-East Administrative District of Moscow.

Normal values ​​

Optimum performance depends on the age of the child. In a one-year-old baby, the minimum value is 90/50 mm Hg. In children from 2 to 9 years old, the norm is 100/60, in adolescents – 110/70, after 16 years – 120/70.Sometimes values ​​for each age are calculated using the formula 90+ (age in years * 2) – systolic pressure; 60+ age in years – diastolic pressure.

All these figures are rather arbitrary. If the indicators differ slightly from normal, but the child feels good, vigorous and active, there is no reason for alarm. Hypotension is typical for residents of high mountain areas, athletes (during rest), it can be inherited. A decrease in indicators can be primary and secondary – due to some kind of disease.The examination will determine the causes of hypotension.


The fact that a child has hypotension can be found out during a routine examination or by accident. In this case, it is recommended to observe the changes in indicators for some time. Values ​​can change throughout the day, depending on room temperature, stomach fullness, and many other factors. It is possible to talk about reduced pressure only if the indicators constantly do not reach the borderline values ​​of the norm.You can suspect that a child has hypotension by the following signs:

  • weakness;
  • drowsiness;
  • dizziness;
  • wobbly gait;
  • fainting;
  • emotional instability;
  • pallor.

If all these signs are observed, it will be useful to use a tonometer. Based on the results of the examination, the pediatrician can issue a referral to a specialist.

Causes of secondary hypotension

Values ​​may decrease as a result of a slowdown in metabolism in certain diseases.It is recommended to consult an endocrinologist. Hypotension often occurs after traumatic brain injury. A timely visit to a neurologist will avoid complications.

Diseases of the cardiovascular system are another common cause. It is necessary to make a cardiogram, ultrasound of the heart, consult a cardiologist. Often, hypotension develops against the background of infectious diseases, intoxication, and allergic reactions. If the underlying disease is cured, then the values ​​are normalized.

Sometimes the pressure can decrease against the background of chronic blood loss.In teenage girls, this can happen due to heavy periods, in which case a consultation with a pediatric gynecologist is needed. If there are other symptoms suggestive of blood loss, it is worth being tested to detect latent bleeding. May require consultation with a gastroenterologist and other specialists.

Primary hypotension

If no diseases are detected, and the pressure remains stably low, we can talk about primary hypotension. This is a functional disorder that the child “outgrows” over time.

In case of primary hypotension, supervision of a neurologist and a cardiologist is recommended. Indicators are often unstable during adolescence, but then normalize. To improve the quality of life, such elementary measures as a well-thought-out regimen of rest and stress, proper nutrition, walking in the fresh air, and moderate exercise will help. Pharmacological drugs are usually not prescribed, it is enough to change the lifestyle for the child’s condition to improve.

90,000 Blood pressure.Norms, measurement, ABPM, treatment

Blood pressure affects our health and well-being so strongly that it is necessary to monitor it, especially in adulthood.

Blood pressure is one of the main indicators of the state of the body, and its measurement is an obligatory part of a comprehensive health examination. Even small deviations from the norm can be risky. It should be noted that problems with blood pressure occur at different ages, both in the elderly and in very young people.

Heart Health Index

The heart muscle constantly pumps blood into the veins and arteries. Passing through them, the blood exerts pressure on the walls of the vessels. Thus, blood pressure depends on the work of the heart and the elasticity of the blood vessels.

Pressure is not constant, it fluctuates depending on the heartbeat cycles. The heart muscle contracts and relaxes about 60-80 times per minute. Systolic blood pressure is the maximum pressure that is recorded at the time of heartbeat.In the interval between two contractions, when the heart relaxes, the pressure naturally decreases. The minimum pressure is called diastolic pressure.

Blood pressure is measured in millimeters of mercury (mmHg). Systolic blood pressure is always listed first, and diastolic blood pressure second. Normal blood pressure is in the range of 110 / 70-130 / 85.

In addition to problems with the heart and blood vessels, a variety of factors affect blood pressure – for example, physical activity, stress and addiction to tea and coffee increase blood pressure, and in weather-dependent people it can fluctuate due to weather changes.

High blood pressure

High blood pressure is considered 135 / 85-139 / 89. If this figure reaches 140/90, then we can already talk about hypertension.

High blood pressure is a very dangerous condition. As you know, the increase in pressure for every 10 mm Hg. Art. increases the risk of developing cardiovascular disease by a third. People with high blood pressure are 7 times more likely to develop cerebrovascular accidents (strokes), 4 times more often – coronary heart disease, 2 times more often – lesions of the vessels of the legs.In addition, hypertension can impair vision and adversely affect kidney function.

Symptoms of high blood pressure – throbbing headache in the occipital region, dizziness, flies before the eyes, insomnia, tachycardia, pain and heaviness in the heart, feeling short of breath.

Low blood pressure

Hypotension is a decrease in blood pressure to 100 / 60-110 / 70. Low blood pressure can also be dangerous and can worsen the condition.However, the good news is that hypotension is not as common as hypertension. If about 40% of the population is susceptible to hypertension, then only 4% suffer from low blood pressure. However, for patients with hypotension, this is little consolation. A decrease in blood pressure leads to weakness, fainting, shortness of breath, sweating of the palms, muscle and joint pain, loss of strength and deterioration in performance, nausea, memory disorders, and cerebrovascular accident. Hypotension can lead to ischemia, loss of vision and hearing.But it is especially dangerous for pregnant women – it can lead to miscarriage. The danger of hypotension is that it does not manifest itself so clearly and is most often discovered by chance.

Pressure measurement methods

Blood pressure measurement is one of the main diagnostic methods. However, whatever method is used, it is important to follow certain rules, otherwise the indicators will be distorted.

One hour before measuring blood pressure using one of the traditional methods (mechanical or electronic tonometer), do not smoke, consume alcohol and beverages containing caffeine, play sports and take drugs from the group of adrenomimetics (including nasal drops with vasoconstrictor substances).Measurement of blood pressure should be carried out while sitting comfortably in a chair and leaning back, resting your hand on the table at the level of your heart. During measurements, one should not move or even talk.

Sometimes the difference when measuring pressure on different hands can be 10-15 mm. rt. Art. This is completely normal. If you have never measured the pressure before, you need to do it in turn on both hands and in the future measure it on the arm where it turned out to be higher.

Korotkov’s method

Measuring blood pressure with a hand-held tonometer, or, as doctors call it, the Korotkov method, is perhaps the most common way to check blood pressure. It is based on the complete clamping of the brachial artery with the tonometer cuff and listening to the tones arising from the slow release of air from the cuff.


  • This is the official standard for non-invasive blood pressure measurement.
  • The measurement results have little dependence on the complete immobility of the hand.


  • The person taking the measurement must be very attentive and have good hearing in order to record the result correctly.
  • The mechanical tonometer is sensitive to noise in the measurement room and to the accuracy of the position of the phonendoscope head in relation to the artery.
  • It requires direct contact of the cuff and phonendoscope head with the patient’s skin, which is inconvenient or impracticable in some cases.

Oscillometric method

This method assumes the use of electronic devices. A sensitive technique captures the pulsation that occurs in the cuff when blood passes through the section of the artery compressed by it.


  • Sufficiently accurate and excludes mistakes made due to the human factor – the person who measures the pressure does not need to listen to the sound and record the readings – the use of the device does not require any special knowledge and skills.
  • The accuracy of the readings of electronic devices does not depend on extraneous noise in the room.
  • Allows you to determine blood pressure with a pronounced “auscultatory gap” – an effect that is often manifested at increased pressure and in which the sounds between systole and diastole are not heard.
  • Measurements can be taken even through thin tissue or bandage.


  • When measuring pressure with an electronic device, the hand must be motionless.
  • Relatively high cost of the device itself.

Daily blood pressure monitoring (ABPM)

In recent years, ABPM methods have been used, which make it possible to continuously monitor the blood pressure level, recording all fluctuations. This is the most accurate and efficient measurement method today. To implement it, the patient must wear a special compact device for 24-48 hours that measures the pressure every 10-15 minutes.This allows you to track the dynamics of blood pressure and see its changes throughout the day. At the same time, the patient can lead an ordinary life without significant restrictions.

ABPM allows you to choose the most effective treatment, and in patients who are already taking medications, to assess the adequacy of therapy.

Among the indications for ABPM are also regular fainting, borderline pressure increase, combination of hypertension with vascular lesions of the brain, and others.

Prevention and treatment

Surprisingly, the causes of hypertension and hypotension are sometimes the same – stress, the influence of hereditary factors, depression. In addition, overweight, smoking, alcohol abuse, addiction to salty foods and a sedentary lifestyle can lead to hypertension, and too strict and inadequate diet or a sharp change in weather conditions can lead to hypotension. Preventing pressure problems is easier than fixing them, and a few very simple rules can help reduce your risk.

Under reduced pressure

For the prevention of hypotension, good sleep (at least 8-9 hours) and a healthy balanced diet are very important, and you should eat about 4-5 times a day. Physical activity is necessary, but moderate – for example, walks and simple exercises 2-3 times a week. It is very important to refrain from nervous overstrain, and if this is not possible, take mild sedatives.

With increased pressure

As in the case of hypotension, with hypertension, you need to correctly build a daily regimen and diet, and you should give preference to light meals low in salt and fat.Moderate exercise is also beneficial. Quitting smoking is mandatory, since it has a particularly detrimental effect on the body of people with hypertension.

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90,000 Pressure in the elderly, pressure norms in old age

At 90 years old – women 150/79 mm Hg.Art., men – 145/78 mm Hg. st ..

Low blood pressure – causes and symptoms

Blood pressure may be low due to recent surgeries, blood loss. In both men and women, there are other possible causes of low blood pressure. Among them – heredity, the consequences of past diseases, prolonged bed rest, side effects of drugs taken, heart disease, dehydration, poisoning, allergies, climatic conditions.

Signs of low blood pressure are fatigue, decreased performance, increased irritability, headache and dizziness, rapid pulse, sleep disturbance, sweating, numbness of the limbs of the hands, apathy, memory impairment.

Why low blood pressure is bad

For a long time, low blood pressure in older people is fraught with danger – it can cause a heart attack. With an attack of the disease – a drop in pressure to extreme limits – serious complications are possible, there is a risk of stroke. It is associated with the fact that an insufficient amount of blood enters the brain, which means oxygen, which may cause darkening in the eyes, fainting, and an elderly person may fall. In turn, a fall is fraught with fractures and bruises.Therefore, you should be careful and visit your doctor regularly. Sometimes it is even worth refusing to take certain medications, since they are forbidden to use under reduced pressure.

How to raise the pressure

First you need to find out the reason for the drop in pressure. It can often be caused by illness or internal bleeding. But sometimes this is not the case at all – then you should consult a doctor to prescribe the necessary diagnostic procedures and medications, in particular, containing caffeine.Among them – “Piracetam”, “Citrapar”, “Citramon”, “Acepar”.

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From herbs, tinctures of valerian, eleutherococcus will help. Normalizes blood pressure and lemon balm tea. At home, you can prepare an infusion of St. John’s wort or an infusion of milk thistle.

Healthy habits and lifestyle changes also normalize blood pressure: constant morning exercises, walks in the fresh air and good nutrition, contrast shower, adherence to proper sleep patterns.

As far as nutrition is concerned, it raises the pressure … the obligatory breakfast. With hypotension, it is undesirable to abuse coffee and especially drink it in the evening.

High blood pressure – causes and symptoms

The most common and familiar events and activities of the daily life of older people can increase blood pressure. Among them – an excessive amount of salt in the diet, excitement and stress, sudden movements, including a sharp rise from bed in the morning, other diseases, hereditary predisposition, overeating and excess weight, physical inactivity, alcohol abuse.

High blood pressure is manifested by dizziness, insomnia, shortness of breath. High blood pressure is accompanied by many symptoms – heart disease, eye problems, kidney disease, dysfunction of the central nervous system, headaches, weakness, tinnitus.

How to treat hypertension

Lifestyle changes can help reduce blood pressure. The introduction of moderate physical activity – regular walks, as well as the use of at least 1.5 liters of water daily.

With a constant increase in blood pressure, the following actions should be taken: give up bad habits (smoking, drinking alcohol, overeating), start observing a diet – ensure the presence of dairy products, egg whites, cereals (best of all, buckwheat and oatmeal), lean meat, reduce consumption of sweets.

Of course, there are a lot of drugs to regulate blood pressure. Suitable – taking into account the condition and other diseases – the elderly person will be prescribed by a doctor.They are different and each solves its own problem – these are inhibitors, and blockers of angiotensin receptors, and calcium channel blockers, and beta-blockers, and diuretics, and neurotropic drugs.

Self-administration of drugs from this list is unacceptable: they have many side effects that worsen health. Normal blood pressure is very important for the body. However, to exclude a sharp jump in blood pressure, as they say, it is better to carry out prophylaxis on time.

From folk remedies, mountain ash juice – especially black chokeberry, persimmon juice, as well as garlic tincture, an infusion of dry blueberry leaves – can help reduce blood pressure.There are also more accessible and simpler ways: apply a piece of bandage soaked in vinegar to the heels, which must be removed immediately as soon as the pressure drops to the desired value.