Blood pressure

Blood pressure is the pressure of your blood on the walls of your arteries as your heart pumps it around your body. It’s a vital part of how your heart and circulation works.

Your blood pressure naturally goes up and down all the time, adjusting to your heart’s needs depending on what you are doing. High blood pressure is when your blood pressure is persistently higher than normal.

A blood pressure reading under 120/80mmHg is considered optimal. Readings over 120/80mmHg and up to 130/89mmHg are in the normal to high normal range.

Blood pressure that’s high over a long time is one of the main risk factors for heart disease. As you get older, the chances of having persistently high blood pressure increases.

It’s very important to get your blood pressure checked regularly, and if it’s persistently high it needs to be controlled. Uncontrolled high blood pressure can lead to a heart attack or stroke. It may also affect your kidneys.

The medical name for high blood pressure over a long period of time is hypertension. 

Causes

The exact causes of high blood pressure are often not clear. Your blood pressure may be strongly influenced by:

  • family history
  • eating patterns, including salty foods 
  • alcohol intake 
  • weight 
  • how much physical activity you do.

Some medicines can also raise blood pressure.

Symptoms

You can’t feel high blood pressure. There are usually no warning signs, so you can have it and not know. That’s why it’s important to get it checked.

Diagnosis

The best way to know if you have high blood pressure is to have your blood pressure checked by your doctor or health practitioner.

They will take your blood pressure using an inflatable bag (cuff) that goes around your arm. It’s joined to a device that measures the pressure. 

Blood pressure can vary at different times of the day. Sometimes it can even go up just because someone is taking it, so it’s important to have an accurate measure of your blood pressure. Talk to your doctor or health practitioner about what your blood pressure level should be.

Controlling high blood pressure

If you have high blood pressure, talk to your doctor about the best way to control it.

Lifestyle changes

Your doctor may recommend that you make some healthier lifestyle choices, like changing the food you eat or getting more exercise.

Find out more about important lifestyle changes to manage your high blood pressure.

Medicine

Many people also need medicine to control their high blood pressure. Your doctor will tell you if you need medicine, and monitor its effects. Blood pressure medicines don’t cure high blood pressure, but they help to control it. You have to keep taking the medicines regularly, often for the rest of your life. Don’t stop taking your medicine without talking to your doctor first. 

If you take medicine for your blood pressure, it’s still important to have a healthy lifestyle.

Monitoring your blood pressure 

Your doctor may want you to monitor your blood pressure at home, or wear a monitor over a 24-hour period, to check how it varies.

Manage your heart disease risk factors

High blood pressure is a risk factor for heart disease.

2017 ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension

Blood pressure categories in the new guideline are:

  • Normal: Less than 120/80 mm Hg;
  • Elevated: Systolic between 120-129 and diastolic less than 80;
  • Stage 1: Systolic between 130-139 or diastolic between 80-89;
  • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
  • Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

The guidelines eliminate the category of prehypertension, categorizing patients as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89). While previous guidelines classified 140/90 mm Hg as Stage 1 hypertension, this level is classified as Stage 2 hypertension under the new guidelines. In addition, the guidelines stress the importance of using proper technique to measure blood pressure; recommend use of home blood pressure monitoring using validated devices; and highlight the value of appropriate training of health care providers to reveal “white-coat hypertension.” Other changes include:

  • Only prescribing medication for Stage I hypertension if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol).
  • Recognizing that many people will need two or more types of medications to control their blood pressure, and that people may take their pills more consistently if multiple medications are combined into a single pill.
  • Identifying socioeconomic status and psychosocial stress as risk factors for high blood pressure that should be considered in a patient’s plan of care.