Know Your Numbers: Blood Pressure
What Is Blood Pressure?
Blood pressure is a measurement of the force or pressure of the blood on the walls of your arteries as it is being pumped by your heart throughout your body. When your blood pressure is measured you are always given two numbers: the systolic pressure and diastolic pressure. Both are very important numbers to know. Throughout any given day your blood pressure will fluctuate a lot to accommodate your body’s needs at the moment. Your pressure may rise if you are exercising or exerting yourself in any way or if something upset you and sent your heart beating at a faster rate. Your pressure may decrease if you’re relaxing or hanging out on the couch just watching a movie.
What Do Blood Pressure Numbers Mean?
The systolic pressure, or the first number in your blood pressure reading, is the pressure on your artery walls when the heart is contracting or beating. This number is the higher of the two numbers because it’s a measurement of when your heart is creating the most force in your arteries to get your blood moving. The diastolic pressure is the second number and it is the measurement of the force on your artery walls when the heart is in between pumps. When the heart rests between beats, it is refilling with blood and oxygen to be pushed through your body on your next heartbeat. The measurement of these two numbers together is what determines your blood pressure reading. All blood pressure readings are given in the format of mm Hg which stands for millimeters of mercury. The first blood pressure gauges created used mercury and it’s become the standard unit of measure even though we no longer use mercury.
How to Take Your Blood Pressure
I’m sure everyone is familiar with having your blood pressure taken in the doctor’s office. They pull out the blood pressure cuff or sphygmomanometer (I wish I could hear you all sounding out this word right now because it’s a fun one!) and their stethoscope, pump up the cuff, and then listen to the blood flowing in the crease of your elbow. As with most things in medicine, when I really stop to think about things, I often wonder how the heck someone figured that out?! Like who decided to use an arm tourniquet, some columns of mercury, and a device to amplify sound from your elbow to figure out blood pressure? Fascinating…and I digress…
The best way to take your blood pressure at home is with an automatic cuff for your arm. A wrist or finger monitor is also acceptable but they may be less accurate because the arteries there are narrower and closer to the surface of the skin. Read the directions before using any kind of blood pressure monitoring device then follow the steps below to properly take your blood pressure at home.
Steps To Take Your Blood Pressure At Home
Do not smoke, drink caffeine, or exercise for 30 minutes prior to taking your pressure. Make sure your bladder is empty too before you sit to take your blood pressure.
Find a comfortable chair at a table that you can rest your arm on that will make it level with your heart. Sit quietly for 5 minutes with both your feet flat on the floor.
Move your clothing out of the way and place the cuff around your upper arm, just above the bend in your elbow. Tighten the cuff until you can fit 2 fingers in between the upper edge of the cuff and your arm. The tubing for the machine should fall over the center of your arm, down the middle of your elbow crease.
Rest your arm on the table at heart level with your hand open and relaxed, palm facing upward.
Pause briefly to allow yourself to relax again then press the start button on your machine. Do not move or talk while the cuff is inflating and reading your blood pressure.
If you feel that you need to retake your pressure or the cuff could not give you a measurement, try slightly repositioning the cuff, rest for another minute or two, and then press start again.
The Mayo Clinic has put together a short video to watch if you find visuals to be more helpful.
What Are The Best At Home Blood Pressure Monitors?
With virtual doctor visits becoming more and more popular, being able to accurately take your blood pressure at home is a necessity. At home monitors are available in a range of prices all depending on the bells and whistles you’d like it to come with. Most monitors can be purchased at your corner pharmacy, but buying online or from a medical supply store is an option if you’d like more variety and functionality. Some features you’ll want to pay attention to are if the monitor is battery or AC powered, how many readings it will store for you either in the machine itself or on an app for your phone, does it have wireless capability to connect to your phone, how many users it will store info for and, what size arm the cuff will accommodate. It’s also a good idea to check with your insurance company before you buy because some companies will reimburse you for a particular brand or provide you with a certain dollar amount towards purchasing a monitor. Many monitors are FSA eligible.
Omron Blood Pressure Monitors – Omron is a reliable name when it comes to at home automatic blood pressure monitors and I’ve recommended them to my patients countless times. They provide monitors in a range of price points and functionality features so there is a monitor for whatever your budget or needs may be. They have a Bronze, Silver, Gold, and Platinum series with prices from $40 - $80 dollars depending on what kind of features you’d like your monitor to provide. If you want a basic monitor from Omron that’s more budget friendly you can go with their 3 series monitor. It’s currently listed for less than $30.
LifeSource Upper Arm Blood Pressure Monitor with Extra Large Cuff – This is a great option for people with a larger upper arm who require an appropriately sized cuff for accurate readings. The cuff will accommodate arms with a circumference of 16.5” to 23.6”. This monitor can be AC or battery powered and stores up to 60 of your last readings. Right now it’s about $100 on Amazon.
What Is Normal Blood Pressure?
For the average Jane or Joe, a blood pressure reading of less than 120/80 is considered normal. Below you’ll find the American Heart Association’s blood pressure chart. The numbers on this chart are the standard for determining if someone has normal, elevated, or hypertension (stage I, II, or if you’re in crisis).
In some cases, depending on your age and certain health conditions you may have, your doctor may have different blood pressure goals for you. The circumstances in which that may happen are too nuanced to really explain in detail but just know that if your doctor sets a different blood pressure goal for you, she has a very good reason for doing so.
What Is High Blood Pressure?
High blood pressure, or hypertension, is when you are consistently seeing blood pressure readings of greater than 120/80. If you are monitoring your blood pressure at home and start to see those high numbers you’ll want to contact your doctor to make an appointment to see them. If you see a reading greater than 180/120 you’ll want to talk to your doctor right away or head to the emergency room. Numbers that high are considered a hypertensive crisis and it puts you at serious risk of a stroke, heart attack, and other organ damage.
What Are The Symptoms Of High Blood Pressure?
In most cases there are no symptoms. Many people do not know when their blood pressure is high, even when it reaches a dangerous level. In some cases, you may experience a headache, shortness of breath, or nosebleeds but these are often not good indicators and may only occur once your blood pressure has reached a life-threatening level.
What Causes High Blood Pressure?
The causes of high blood pressure are broken down into 2 categories: primary (essential) hypertension and secondary hypertension. In primary hypertension there is no single identifiable cause for the high blood pressure. This is the category that most people fall into. Primary hypertension is something that develops gradually over time and may be due to a genetic disposition, poor eating habits, lack of exercise, obesity, or age. Secondary hypertension is caused by some underlying condition and tends to appear suddenly. Conditions like kidney disease, pregnancy, sleep apnea, and even some medications can cause a spike in blood pressure.
What Problems Can High Blood Pressure Cause?
Over time, the excessive pressure on the walls of your arteries can lead to damaged blood vessels and internal organs. If you have uncontrolled high blood pressure you are at a greater risk of a heart attack, stroke, aneurysm, vision loss, kidney damage, and even certain forms of dementia. The longer you wait to seek treatment and the higher your blood pressure goes, the greater the damage you may be doing.
How Can I Prevent High Blood Pressure?
The silver lining to hypertension is that we know there are ways to successfully prevent it from happening or reduce the severity. Lifestyle changes or self-care routines are the biggest factors in preventing and reducing hypertension. Some self-care routines you should start to implement:
Eat a healthy diet and lower your salt intake.
Get out and exercise
Maintain a healthy weight
Do not smoke and limit your alcohol intake
Get enough sleep
Reduce stress (easier said than done, I know!)
For some people there is a hereditary factor when it comes to hypertension. It’s in their genes and eventually it’s going to rear its ugly head. However, your genes do not always have the ultimate and final say in your blood pressure readings. We know that implementing the lifestyle changes above can affect the outcome of your gene expression. So even though “it runs in the family”, that doesn’t mean you are destined to follow in your relatives’ hypertensive footsteps.
Treatment for High Blood Pressure
If you are diagnosed with primary hypertension, depending on how elevated your blood pressure readings are, your doctor is going to talk to you about implementing those self-care lifestyle changes as well as potentially adding on some daily medication. In some cases, you may even need a combination of medications to bring your pressure down to a normal level. Just because you’ve been placed on medication does not mean that you will end up taking these drugs until the day you die. There are lots of people who are able to come off of medication or take a reduced dose if they start exercising and watching what they eat.
If you are diagnosed with secondary hypertension, typically treatment will be aimed at caring for the underlying disease which in turn may reduce your blood pressure. If taking a certain medication is causing your hypertension, your doctor may look to switch or stop that medication all together if possible.
What Is Low Blood Pressure?
Sometimes, people experience the opposite of high blood pressure and have blood pressure that is too low. This is called hypotension. Blood pressure readings of less than 90/60 are typically diagnosed as hypotension.
What Are The Symptoms Of Low Blood Pressure?
Dizziness
Feeling faint
Blurred vision
Fatigue
Confusion
Nausea
Having low blood pressure is not always a cause for concern for most people but your doctor should rule out if there are any underlying causes. Dehydration is a very common denominator in hypotension. If you are experiencing any of the symptoms above and your blood pressure is low or you’ve had a sudden drop in blood pressure, you should give your doctor a call. Always seek immediate medical help if someone is exhibiting the signs of shock.
What Is Shock?
Shock is a life-threatening medical emergency and is brought on by a severe, quick drop in blood pressure. The signs of shock are extreme confusion, a weak and rapid pulse, rapid and shallow breathing, and cold, clammy, pale skin. Shock may be caused by trauma, blood loss, severe dehydration, heatstroke, allergic reaction, a severe infection, severe burns, or poisoning. If someone is experiencing symptoms of shock get them to the hospital ASAP!
Treatment for Low Blood Pressure
Most cases of low blood pressure do not require treatment unless you are experiencing symptoms and are at risk of fainting or falling and hurting yourself. Since dehydration is the most common cause of symptomatic low blood pressure, drinking more fluids and increasing your salt intake can typically help resolve that issue. Some medications may also cause hypotension so switching therapy may help. Your doctor may also perform some tests to determine the cause of your hypotension which can include blood work, and electrocardiogram (ECG) to look for heart and blood flow abnormalities, and a tilt table test to determine if there are faulty brain signals causing your symptoms. Wearing compression stockings can help with blood flow in some cases. Medications may also be prescribed by your doctor to help increase blood volume or restrict the dilation of blood vessels which can improve you blood pressure.
Know Your Numbers
Whether you’ve ever been diagnosed with high blood pressure or not, it’s a good idea to keep a monitor at home to occasionally check yourself. As we age, our arteries become less flexible and plaque buildup can slow blood flow. This can cause a slow and steady increase in blood pressure that can go undetected, especially if you are not routinely visiting with your doctor. It’s important to know your numbers so you can work towards sustaining your lifestyle as you know it and reduce your risk of experiencing a life-altering or life-ending cardiac event.
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