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Learning to understand your blood pressure readings is certainly not rocket science but not simple either. If you’re not into reading medical or clinical journals or not very fascinated with the workings of the human body, terms like ‘systolic’ or ‘diastolic’ might overwhelm you a bit. Your healthcare provider may take your blood pressure reading while you go for periodic health checkups. The healthcare professional may recommend you to take a BP reading once every four months just to ensure that the same is normal (1).
In the event of your visiting the office of the healthcare provider or the doctor, you’ll hear the words systolic and diastolic mentioned frequently. Although understanding the intricacies involved with the words are not exactly mandatory, having a fair idea about the terms will enable to you to comprehend whether your reading is normal or not (2). Getting acquainted with the expressions and other details about BP will let you take a reading unassisted as well as understand the same (3)
You don’t need to undertake any professional training or complete any medical program to understand the nitty-gritty of hypertension. Just being in the know about the fundamental concepts will suffice when it comes to figuring out the real significance and implications of your blood pressure numbers.
Every individual would like to stay in the pink of their health and that’d mean having a blood pressure that is considered as normal by healthcare experts and general practitioners. How is your blood pressure measured or recorded? What are the different medical instruments used for gauging blood pressure? What reading would be regarded as normal and what’d be considered aberrant or high? These are the basic questions that arise in your mind when you try to gain a better understanding of hypertension (3).
For a start, the blood pressure reading is actually a ratio or proportion of two numbers. The first number or the denominator called the ‘systolic’ actually represents the numerical value of the pressure created on the arterial walls as your heart muscles contract to pump out blood. The force with which blood flows through the arterial passage is known as systolic pressure and is recorded in units of millimeters of Hg or mercury (4).
The denominator or the lower number is referred to as diastolic represents the normal pressure of the arterial walls when your heart rests for a fleeting moment in between two beats. During this extremely brief interregnum, the muscles of the heart relax as it is refilled with blood. The diastolic figure or rather its numerical value is always less than the systolic number simply because the former records pressure when the heart is in a resting phase while the latter registers pressure when your heart is in active stage (5).
The Sphygmomanometer is the instrument doctors extensively use for noting your blood pressure. The contraption comprises of a cuff attached to a graduated or calibrate pressure gauge. The doctor first tries to feel the pulse of the brachial artery in your upper left or right arm cuff and then wraps the cuff around the medial region.
The cuff can also be wrapped around the wrist or the forearm if the healthcare professional doesn’t find a strong enough pulse in the upper arm. While taking your blood pressure reading, the physician will try to catch the sound of the blood flowing through the artery using a stethoscope.
The doctor pumps up a rubberized ball to inflate the tube and builds up a pressure that is more than the reading of systolic reading. As the physician releases the cuff, his ears pick up a dull rushing sound and the mercury line comes to settle at a point which is the systolic pressure number. When the sound completely fades away, the mercury further drops and comes to rest finally at a number which reveals the diastolic pressure. The higher number i.e. the systolic number always precedes the diastolic reading.
For instance, the reading is either 120/80mmHg or 130/85mmHg and so on (4).
Your blood pressure is said to be normal if the reading is 120/80mmHg or below this ratio. This signifies that your maximum systolic pressure is 120 millimeters of mercury and your diastolic pressure is 80mm of mercury. A reading slightly below this proportion is considered as perfectly normal. However, all impressions much higher than the aforementioned standard range signify that you’re either pre-hypertensive or hypertensive. When and if your systolic reading is between 120 and 139mm and diastolic reading falls within 80 and 89mm, then you’re diagnosed as pre-hypertensive.
Though these readings do not put you under the category of individuals suffering from HBP, the numbers certainly indicate that your blood pressure has moved beyond the normal range. Once you’re in the pre-hypertensive zone, your blood pressure becomes susceptible to graduate to the hypertensive range that eventually makes you highly vulnerable to suffer from a stroke or heart attack (6).
In order to maintain your BP in the prehypertensive range or better still, if you could lower it much further, you’d need to analyze as to what is making you hypertensive. It could be because you’re leading a very erratic lifestyle that is causing you undue stress. You’d need to bring about a change in your wayward habits. In case you’re a habitual drinker and smoker, you’d have to cut down on both these detrimental habits or give these up totally.
Your physician might also put or start you on some blood pressure medication. So that your blood pressure remains within controllable range, you’d have to take your medicines on time without missing any dosage but also adopt and stick to a more disciplined lifestyle (5).
In case your blood pressure falls within the 140/90-159/99mmHg range, then you’ve high blood pressure. Your doctor puts you in the first stage of hypertension.
However, a single high reading certainly doesn’t label you as acutely hypertensive rather the elevated readings have to remain consistent for a protracted period for you to be diagnosed with high blood pressure. You’d have to get your BP checked at least once every month so that the doctor can decisively conclude whether you’re hypertensive or not.
You could be facing a grave health issue if your blood pressure reading is beyond 180/110mm Hg and your healthcare provider or medical practitioner will certainly recommend emergency treatment in such an eventuality. AHA regards such acutely high readings as a sign of ‘hypertensive crisis’ that demands or calls for immediate management and/or hospitalization of the individual (5).
However, it could happen that you’ve only a single reading which is this high and in due course your BP sub-sides to the normal range. For the sake of confirmation, the physician will certainly take another reading after 5-10 minutes. If this reading is as high as the previous one, then you’ll surely need emergency medical intervention.
|Blood Pressure Category||Systolic mmHg (upper number)||Diastolic mm Hg (lower number)|
|Normal||Less than 120||&||Less than 80|
|High Blood Pressure
(hypertension) Stage 1
|HBP (Stage 2)||160-higher||Or||100 or higher|
|Hypertensive crisis||Higher than 180||or||More than 110|
In case your blood pressure falls within the normal range that is 120/80mm Hg or below, you should visit your doctor for taking a ready once in two years or maybe once in a year. Your physician will be able to tell you how often to get your BP checked if it is normal.
If the systolic and diastolic numbers of your BP lies within 120-139/80-89mm of Hg which is considered as pre-hypertensive, then you should report to the doctor at least once in a year for knowing the numbers. Depending upon the state of your health, your physician might ask you to get your BP measured more frequently. And if the reading is 140/90 or more, then the situation is undoubtedly serious and you’d need to discuss with your physician about the same who’ll offer his or her suggestions on what precautionary or preventive measures to take (6).
It does not need to be emphasized that you’d have to take adequate steps to bring your blood pressure to normal or controllable levels if you’re pre-hypertensive or hypertensive. Your doctor will recommend you to follow a healthy lifestyle besides prescribing one or more of blood pressure medications. Obviously, there’s much that you’d have to do in order to keep a tight leash on your BP and not allow it to stay at elevated levels which might be damaging for you from the viewpoint of your overall health and wellbeing.
If your blood pressure persistently remains in the 140-160/90-100mm Hg range, then there is always the attendant risk of your suffering a fatalistic heart attack or stroke. There is also a high probability of your becoming paralyzed or incapacitated because of a brain stroke or heart failure (7).
So that you can put off or avert such an eventuality, you’ll have to strictly abide by specific steps. For a start, you’ll have to take medicines on a regular basis without missing even a single doze. If required, you may even have to keep on taking medications for a lifetime in order to stay fit and healthy.
Initially, you may have trouble adjusting to the medicines because of the side-effects but in the long run, your body will get used to them. Missing a dose because of the uncomfortable side-effects may not be conducive for your health. If you’re inconvenienced because of the side-effects, it is better to get in touch with your doctor who may change your medication and prescribe another as a replacement or decrease the dosage (8).
On the other hand, you’d have to stick to a healthy diet by including more fruits and vegetables in your everyday square meal and drastically reduce consumption of red meats. Consumption of sugar foods, high-fat dairy products and processed foods should also be curtailed to make a difference. You should minimize your alcohol intake as much as you can and cut down on smoking or give it up altogether. Exercising regularly for at least 30-45 minutes on a daily basis is also suggested.
Taking blood pressure readings at home have become a necessity for most individuals with pre-hypertension and hypertension due to unavoidable circumstances. Firstly, most HBP individuals are leading very busy lives these days that leave them with practically very little or no time to visit a doctor. Then again, pre-scheduling a checkup appointment with your physician may lead to your being given a date that is 3-4 months away (9).
You might feel stressed out while waiting for your turn at the doctor’s chamber which may ultimately further increase your blood pressure. It is largely for this reason alone that a majority of doctors and healthcare professionals advise their patients to get their blood pressure self-examined in the comfort of their homes. These days, a range of medical equipment and blood pressure monitors are available that enable an individual to take a blood pressure reading without the assistance of a medical professional.
Choosing a blood pressure monitor with a cuff that fits or wraps comfortably around your brachium (upper arm) is significant. A cuff that does not fit properly or appropriately might result in faulty reading even though your pressure is normal. The physician is perfectly placed to recommend the right cuff size according to the dimension of your upper arm. Before buying a sphygmomanometer from a scientific and/or medical instruments outlet, don’t forget to drape the cuff and check out whether it fits your arm effortlessly (10).
A wide variety of BP monitors is also available that have cuffs which could be made to fit around your forearm or wrist. Regardless of the gadget you ultimately settle for, you’d be better off taking the same to your physician’s chamber. Thereafter, take readings using both the doctor’s own sphygmomanometer and your monitor as well. If you see that both the readings are more or less the same then you can conclude that your monitor is good for taking accurate readings.
You’ll have to follow some guidelines and take some precautions before you can test your BP at home. Refrain from smoking, drinking alcohol or coffee and exercising for nothing less than 1 hour before fitting the cuff around the arm. Sit in a chair in an upright or erect position with both your feet touching the floor and place your arm on the hand rest of the chair or on the table or on any flat surface. The nurse or the doctor’s apprentice will be able to demonstrate the right way of positioning the arm (11).
So that your blood pressure assessments at home are steady over an extended time period, try taking readings at daytime at around the same hour of the day. Also, take multiple readings within a short timeframe, for instance, every five minutes in a half-hour interval and note down the ratios in a diary or notebook.
Closing up, it can be inferred that you should not take your hypertensive condition casually or ignore it. Hypertension has been dubbed the ‘silent killer’ as it masquerades without any symptoms. Therefore, you should do everything you can to keep your BP within permissible limits lest you may have a heart attack, suffer kidney damage or get bogged down with a severe stroke.