Ashley Clay, MSPAS
PA-C Medcor Provider
Before we look at what can happen if your blood pressure is too high, let’s explore what blood pressure is and why it is important to monitor your blood pressure.
Blood pressure is the measure of the force of your blood against your artery walls as your blood circulates through your body. Having adequate blood pressure is important because it delivers the needed oxygen and nutrients in your blood to all parts of your body.
How is blood pressure measured?
Blood pressure is measured with a blood pressure cuff that can be inflated either manually or electronically. As the cuff inflates, pressure is placed on the artery in your arm, which temporarily stops blood flow. As the, the cuff is slowly deflated, and your blood pressure is recorded as two numbers:
- Systolic (top number): indicates how much pressure your blood is causing against your artery walls when your heart beats.
- Diastolic (bottom number): indicates how much pressure your blood is causing against your artery walls when the heart is resting (between beats).
Normal blood pressure is less than 120 mmHg (on the top) and less than 80 mmHg (on the bottom). The American Heart Association recommends that if your blood pressure is normal and you are 20 years of age or older, you should have your blood pressure checked annually. Review the chart below adapted from the American Heart Association and CDC to see where your blood pressure falls:
What is High Blood Pressure?
High blood pressure (also called HBP or hypertension) is considered a silent killer, affecting 1 in 3 Americans, and many people with this condition do not know they have it as there are not obvious symptoms, especially early in the disease. HBP does not only affect older adults: 1 in 4 men and nearly 1 in 5 women aged 35 to 44 have high blood pressure.
HBP can result in an array of medical conditions with devastating consequences including:
- Heart failure
- Sexual dysfunction
- Vision loss
- Heart attack
- Kidney disease/failure
What are risk factors associated with HBP?
A number of risk factors can lead to elevated or high blood pressure in people. Some factors are more controllable than others. Risk factors that can be controlled more easily with lifestyle changes include:
- Cigarette or e-cigarette use
- Exposure to secondhand smoke
- High cholesterol
- Obesity and being overweight
- Doing minimal or no physical activity
- Being diabetic
- Eating an unhealthy diet
Additional risk factors include male sex, certain ethnicities, family history of HBP, chronic kidney disease, increased age, obstructive sleep apnea, and stress.
How Do I Know if I have HBP?
For a proper diagnosis of HBP, you should have two or more blood pressure readings obtained at your healthcare provider’s office on different occasions.
If your blood pressure is elevated your healthcare provider will recommend lifestyle changes and will re-test you in 3 to 6 months. Examples of possible lifestyle changes include:
- Weight loss
- Adopting a heart healthy diet (e.g., DASH diet)
- Salt restriction
- Caffeine restriction (less than 2 – 3 cups of coffee per day)
- Smoking cessation
- Taking medications as instructed
- Increasing physical activity
- Limiting alcohol (women: limit to 1 drink per day; men: limit to 2 drinks per day)
- Monitoring your BP at home and setting personal goals
If your blood pressure reaches Stage 1 Hypertension (BP 130 – 139 / 80 – 89 mmHg), your healthcare provider will calculate your 10-year risk of heart disease or stroke. If your risk is greater than 10%, your provider will start you on blood pressure medication in addition to recommending lifestyle changes. At this point, you should have a monthly reassessment until your BP goal is met and then every 3 – 6 months once your BP goal is obtained. Stage 2 Hypertension(BP > 140 / > 90 mmHg) will require blood pressure medications, even if your cardiovascular risk is less than 10%, and may require additional medications. Speak with your healthcare provider to understand your treatment options.
The American Heart Association’s “Check. Change. Control.” self-monitoring BP tracker is a useful tool for monitoring your blood pressure at home in between checkups.
American Heart Association, “Consequences of High Blood Pressure,” https://www.heart.org/-/media/files/health-topics/high-blood-pressure/consequences-of-high-blood-pressure-infographic-pdf-ucm_464947.pdf?la=en&hash=4F1F283B68F398CC03A3E522C092CAF6621EDDF9
American Heart Association, “Diagnosing and Managing Hypertension in Adults,” https://www.heart.org/-/media/files/health-topics/high-blood-pressure/tylenol-hbp/aha18hyperpocketguideprint3final-approved.pdf?la=en&hash=BD37D70CEFAA0B1A57465E507F912F6B6B22800B
American Heart Association, “How High Blood Pressure is Diagnosed,” https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/how-high-blood-pressure-is-diagnosed
American Heart Association, “Hypertension and CVD Risk Factors,” http://aha-clinical-review.ascendeventmedia.com/books/aha-high-blood-pressure-toolkit/4/
American Heart Association, “The Facts About High Blood Pressure,” https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure
American Heart Association, “Treating Elevated BP or Hypertension,” http://aha-clinical-review.ascendeventmedia.com/books/aha-high-blood-pressure-toolkit/10/
Centers for Disease Control and Prevention, “5 Surprising Facts About High Blood Pressure,” https://www.cdc.gov/features/highbloodpressure/index.html
Centers for Disease Control and Prevention, “Facts About Hypertension,” https://www.cdc.gov/bloodpressure/facts.htm
Markus MacGill, “What is a normal blood pressure?,” MedicalNewsToday, https://www.medicalnewstoday.com/articles/270644
MedlinePlus, “High Blood Pressure,” https://medlineplus.gov/highbloodpressure.html
WebMd, “What is blood pressure?,” https://www.webmd.com/hypertension-high-blood-pressure/qa/what-is-blood-pressure