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Blood Pressure 101: What You Need to Know

Blood Pressure 101: What You Need to Know

You wouldn’t start a road trip without knowing how much gas you had in your car, or how long it had been since you had the oil changed. But when’s the last time you checked in on your blood pressure?

Maybe you’re in your 20s or 30s (or even 40s) and still think you’re invincible, or that things like blood pressure and cholesterol are for older guys. But just like you’d take regular measurements on your car to stave off roadside assistance, checking in on your general health measurements can save you from a doctor’s visit or much, much worse.

What You Need to Know About Blood Pressure

  • Your blood pressure is the force of your blood against your artery walls.
  • High blood pressure is a risk factor for heart disease.
  • “Normal” levels are less than 120/80 mm Hg.
  • A healthy lifestyle that includes regular exercise; a diet rich in whole grains, fruits and vegetables; and not smoking can prevent high blood pressure.
  • When your numbers are high, a doctor may prescribe lifestyle changes and prescription drugs to help bring your blood pressure under control.
  • Unmanaged high blood pressure can lead to a long list of deadly health effects.

What is Blood Pressure, Anyways?

Time for some elementary health: Blood flows through your body thanks to your heart, which acts as a pump, and your arterial system, which is the plumbing. Your arteries aren’t stiff, but elastic. Between the pumping from your heart and the ability of your arteries to supply their own force against the blood within, pressure is created—your blood pressure.

Both your heart and conditions within your arteries can affect your blood pressure. Stiff or narrowed arteries—from plaque build-up called atherosclerosis—can cause that pressure to rise. Your blood pressure, therefore, is one way to measure your cardiovascular health.

High blood pressure = a risk factor for cardiovascular disease, including heart attacks and strokes.

Measuring Your Blood Pressure: Are You Normal?

When you test your blood pressure, you’re testing two types of pressure: The pressure exerted against your arteries when the heart pumps and when the heart is at rest. This results in two different numbers:

  • Systolic blood pressure: The first number in a blood pressure reading that measures the force against your arterial walls when your heart pumps.
  • Diastolic blood pressure: The second number in your reading that measures the force against your arteries in between heart beats.

Most attention is given to the first of these numbers, but a high reading in either can be used to diagnose “high blood pressure”, according to the American Heart Association.

A normal blood pressure reading is less than 120/80 mm Hg, but that varies depending on your age. What is average blood pressure by age? Well, here's a pretty good reference guide from Harvard University.

Once your levels begin climbing above 120/80, your doctor (and you!) should take note.

News Item: New Blood Pressure Guidelines

In 2017, the American College of Cardiology and the American Heart Association (ACC/AHA) released new guidelines for what constitutes high blood pressure, or hypertension. The guidelines set a new, lower limit for the diagnosis: Anyone consistently getting readings over 130/80 would now be considered hypertensive. This marked a 10-point decrease from old guidelines and lassoed millions more people into a medical diagnosis. Needless to say, there was some controversy.

Controversy in the public eye largely focused on the millions of people who would now warrant a hypertension diagnosis, and possibly be brought under medical treatment. But additional debate in the scientific community was based on more nuanced perspectives, including whether the evidence of potential benefit warranted such a sweeping change.

Despite the controversy, the guidelines remain, and your doctor will likely have them in mind when evaluating your blood pressure readings. They include:

Elevated (120-129/<80): Elevated blood pressure means you’re at risk of becoming hypertensive, but aren’t there yet. Your physician will likely recommend making lifestyle changes to bring your  levels down.

Hypertension Stage 1 (130-139/80-89): You have high blood pressure, but depending on the presence of other risk factors, treatment may not require medication.

Hypertension Stage 2 (>140/90): Your blood pressure is high enough that your doctor will prescribe medication to help manage it, and keep a close eye on your cardiovascular health, overall.

Maintaining Healthy Blood Pressure and Treating Hypertension

Lifestyle approaches can both prevent and reduce high blood pressure. This means that a healthy blood pressure is nearly entirely within your control. Considering what we know elevates your blood pressure, the following activities and tips are useful for maintaining a healthy blood pressure and reducing one that’s high:

  1. Manage your weight. Every few pounds you lose can reduce your blood pressure by one point, according to The Mayo Clinic. And because being overweight or obese are risk factors for heart disease as well, keeping at a healthy weight has a compounding, positive effect.
  2. Monitor your sodium intake. Sodium, both already-present in the foods you eat and added in the form of table salt, can raise your blood pressure. The American Heart Association recommends you get no more than 2,300 mgs of sodium per day, and less than 1,500 mgs, if possible.  
  3. Eat healthy. Maintain a healthy diet, rich in whole grains, fruits and vegetables, to prevent high blood pressure. And if you’re already hypertensive, make changes to get your levels under control. The DASH eating plan is one option—a diet created by the National Heart, Lung, and Blood Institute specifically for those with high blood pressure.
  4. Get regular exercise. Move. Even if you feel healthy. Getting regular exercise can reduce your blood pressure by 5-8 points, according to the Mayo Clinic. A mix of cardiovascular and strength training is best.
  5. Drink only moderate alcohol. There is a mountain of research on the effects of alcohol on heart health, and many of the studies don’t agree. What we do know, thanks to research studies, is this: heavy alcohol consumption can raise your blood pressure, and reducing your alcohol consumption can lower it. So, be reasonable when you drink, and if you’re managing high blood pressure currently, consider restricting your alcohol consumption to regulate your levels.
  6. If you smoke, quit. We shouldn’t even have to tell you this.
  7. Manage your stress levels. Stress can not only directly impact your blood pressure, but indirectly affect it to—particularly if it causes you to eat unhealthy foods or imbibe one too many drinks after work.
  8. Monitor your blood pressure. If you have high blood pressure, take your readings several times a day, particularly when you begin a treatment regimen. You may find that certain activities or foods reduce or raise your blood pressure, and can take immediate steps to keep it under control. If you don't know how to monitor your blood pressure, with the right equipment, it's way easier than you probably think.

Medications for High Blood Pressure

When lifestyle changes alone are not enough to keep your blood pressure down, your doctor will likely prescribe medication. The list of high blood pressure medicines is long and each comes with unique risks of side effects and unique instructions. Interestingly, diuretics, or drugs that help your body eliminate excess water and sodium, are often the first line of defense.

The Dangers of Not Treating High Blood Pressure

Hypertension is a sign that your heart is having to work too hard. It’s one of several ways your body signals that something needs to change, or else. According to Mayo Clinic, not treating high blood pressure and continuing on with the lifestyle that led your blood pressure to rise in the first place can lead to:

  • Damaged arteries
  • Aneurysms
  • Coronary artery disease
  • Enlarged heart
  • Heart attack
  • Heart failure
  • Stroke
  • Kidney failure or scarring
  • Eye damage
  • Sexual dysfunction
  • Bone loss
  • Dementia
  • Death

The stakes are high. Check your blood pressure regularly, live a heart-healthy life and if you are diagnosed with high blood pressure, take your doctor’s recommendations seriously.