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Blood pressure can be categorized into five different types include normal, elevated, hypertension stage I, hypertension stage II, and hypertensive crisis.
Blood pressure is the force applied by the blood over the inner walls of the arteries. Although the average blood pressure (120/80mmHg) for a person remains constant, it shows minor fluctuations throughout the day, declining while relaxing and momentarily increasing while being excited or under stress.
It is produced primarily by the contraction of the heart muscle. Its measurement is recorded by two numbers.
- The first (systolic pressure) is measured after the heart contracts and is highest. This tells you the force of your blood against the artery walls when your heart beats.
- The second (diastolic pressure) is measured before the heart contracts and the lowest. This tells you what your blood pressure is when your heart is at rest between heartbeats
Hence, blood pressure (BP) 120/80 mm Hg means 120 is the systolic number, and 80 is the diastolic number
Which is more important: systolic or diastolic blood pressure?
Both systolic and diastolic blood pressure are vital indicators of heart health.
- Systolic blood pressure (the above number in a blood pressure reading) measures the pressure in your blood vessels when your heart pumps blood.
- Diastolic blood pressure (the lower number) measures the pressure in your blood vessels when your heart is resting between beats.
However, some doctors or healthcare providers focus on the first (systolic pressure) number. A high systolic blood pressure reading is a major marker for heart disease if you are older than 50 years. As you age, systolic blood pressure steadily increases from the chronic buildup of plaque and stiffness of your arteries. Elevated systolic blood pressure increases your risk of cardiac and vascular diseases.
Systolic or diastolic blood pressure readings may both be used to diagnose high blood pressure. Recent studies report the risk of death for people between the ages of 40 and 89 years due to ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic reading.
Various factors, including age, diet, exercise, stress, and genetics can influence both systolic and diastolic blood pressure. Check your blood pressure regularly and work with your healthcare provider to manage it if it is too high.
What are the different blood pressure ranges (normal and high blood pressure)?
A blood pressure cuff is used to measure the pressure. Elevation of blood pressure (high blood pressure) is called “hypertension”.
Depending on your blood pressure reading, you will fall into one of the blood pressure categories, which include:
- Low
- Normal
- Elevated
- Hypertension stage 1
- Hypertension stage 2
- Hypertensive crisis
While many focus on the dangers of high blood pressure (hypertension), low blood pressure (hypotension) can also pose a threat. In cases of hypotension, a diastolic blood pressure reading of 60 mm Hg or below is considered low blood pressure. This is true even if your systolic blood pressure reading is 120 mm Hg, which is considered normal.
Your blood pressure measurement will determine which blood pressure category you belong to. The higher your blood pressure reading, the higher your risk factor for certain conditions, such as cardiovascular disease and kidney disease. High blood pressure can damage your blood vessels, kidneys, and brain if left untreated.
Blood pressure can be categorized into low, normal, high, hypertension stage I/II (heart disease, and stroke risk), and hypertension crisis.
Blood pressure can be categorized into five different types, namely:
Table 1. Blood pressure readings chart
| Category | Systolic (mm Hg) | Diastolic (mm Hg) | Management |
|---|---|---|---|
| Dangerously low | ≤50 | ≤33 | A critical condition that requires emergency medical attention with IV fluids |
| Very low | ≤60 | ≤40 | Lifestyle modifications with medications |
| Low | Less than 90 | Less than 60 | Lifestyle modifications and regular checkups |
| Normal | Less than 120 | Less than 80 | Active lifestyle |
| Elevated | 120-129 | 80 or more | Doctors may recommend lifestyle changes at this stage |
| Hypertension stage I | 130-139 | 80-89 | Doctors may prescribe blood pressure medications and some lifestyle changes to reduce the risk of heart disease and stroke. |
| Hypertension stage II | 140-159 | 90-99 | Doctors may prescribe a combination of medications and lifestyle changes; they may treat complications that may have increased due to high blood pressure. |
| Hypertensive crisis | 180 or higher | 120 or higher | A critical condition that requires emergency medical attention |
Blood pressure is measured in mm Hg (millimeters of mercury)
Contact your healthcare provider or Call 911 immediately if the following symptoms are experienced:
- Shortness of breath
- Chest pain
- Back pain
- Numbness/weakness
- Change in vision
- Difficulty speaking
What are the normal blood pressure readings by age and gender?
The chart shows normal blood pressure according to age both male and female. Diastolic blood pressure (DBP) and Systolic Blood Pressure (SBP) are included in the chart.
| Age | SBP (mm Hg) | DBP (mm Hg) | |
|---|---|---|---|
| Male | 21-25 | 120.5 | 78.5 |
| 26-30 | 119.5 | 76.5 | |
| 31-35 | 114.5 | 75.5 | |
| 36-40 | 120.5 | 75.5 | |
| 41-45 | 115.5 | 78.5 | |
| 46-50 | 119.5 | 80.5 | |
| 51-55 | 125.5 | 80.5 | |
| 56-60 | 129.5 | 79.5 | |
| 61-65 | 143.5 | 76.5 | |
| Female | 21-25 | 115.5 | 70.5 |
| 26-30 | 113.5 | 71.5 | |
| 31-35 | 110.5 | 72.5 | |
| 36-40 | 112.5 | 74.5 | |
| 41-45 | 116.5 | 73.5 | |
| 46-50 | 124 | 78.5 | |
| 51-55 | 122.55 | 74.5 | |
| 56-60 | 132.5 | 78.5 | |
| 61-65 | 130.5 | 77.5 |
In 2017, the American College of Cardiology and American Heart Association updated their guidelines to recommend men and women ages 65 or older aim for a blood pressure lower than 130/80 mm Hg. As of 2022, however, the ideal blood pressure for seniors is considered to be 120/80 (systolic/diastolic), which is the same for younger adults. The high blood pressure range for seniors starts at hypertension stage I, ranging between 130/80 and 139/89.
| Guidelines | 18 to 59 years of age (mm Hg) | 60 to 69 years of age (mm Hg) | 70 to 79 years of age (mm Hg) | Older than 80 years (mm Hg) |
|---|---|---|---|---|
| 2022 American Academy of Family Physicians | <140/90 | <140/90 | <140/90 | <140/90 |
| 2022 National Institute for Health and Care Excellence | <140/90 | <140/90 | <140/90 | <150/90 |
What time of the day is blood pressure highest?
Blood pressure tends to be highest in the morning (morning hypertension) because the body releases stress hormones such as adrenaline when waking up, which can cause blood pressure to increase. It is thought to be related to the body’s natural circadian rhythms, as well as the fact that you have been lying down for several hours and are starting to move around again.
Blood pressure is also usually higher when standing up than when sitting or lying down because gravity causes more blood to flow to your lower body. Additionally, blood pressure can increase in response to physical activity, stress, and certain medications. However, if blood pressure remains consistently high throughout the day, it may be a sign of hypertension or high blood pressure.
Other factors may impact blood pressure readings:
- Physical activity: Blood pressure tends to increase during periods of physical activity due to the increased demand for blood flow to the muscles. Therefore, it is generally recommended to check your blood pressure before engaging in physical activity.
- Stress: Stress and anxiety can also lead to an increase in blood pressure because your body’s “fight or flight” response, which is activated in response to stress, causes the heart to beat faster and the blood vessels to constrict.
- Medications: Some medications, such as stimulants and decongestants, can cause an increase in blood pressure. If you are taking any medications that can affect your blood pressure, it is essential to discuss this with your healthcare provider.
Blood pressure can vary throughout the day and can be affected by various factors. Checking your blood pressure at different times of the day can give you a more accurate picture of your overall blood pressure profile.
What are the signs and symptoms of high blood pressure?
Heart and blood pressure is the force applied by the blood over the inner walls of the arteries.
High blood pressure can damage the blood vessels, heart, and other organs if left untreated. In most cases, high blood pressure does not have noticeable symptoms, which is why it is often referred to as a “silent killer.” However, there are some signs and symptoms that may indicate that a person has high blood pressure:
- Headaches: People with high blood pressure may experience frequent or severe headaches, especially at the back of the head. Persistent or severe headaches can be a sign of high blood pressure, especially if they are accompanied by other symptoms such as dizziness or blurred vision.
- Dizziness: High blood pressure can cause dizziness, especially when standing up suddenly or after physical activity. Dizziness or light-headedness is usually due to reduced blood flow to the brain.
- Chest pain: Also known as angina and may be a sign of high blood pressure, chest pain can occur when the heart is not getting enough blood and oxygen. Chest pain can also be a sign of high blood pressure if it is accompanied by other symptoms such as shortness of breath, nausea, and sweating.
- Shortness of breath: High blood pressure can cause shortness of breath, especially during physical activity.
- Fatigue: People with high blood pressure may feel tired or exhausted even after a good night’s sleep. Chronic high blood pressure can lead to fatigue due to the extra strain on the heart and other organs.
- Nosebleeds: Nosebleeds may be a sign of high blood pressure, especially if they occur frequently. High blood pressure can cause the blood vessels in the nose to become fragile and prone to bleeding.
- Vision problems: High blood pressure can cause damage to the blood vessels in the eyes, leading to blurred vision. High blood pressure can cause changes in vision or even temporary vision loss.
- Nausea: Some people with hypertension may experience nausea or vomiting. If it is severe, high blood pressure can cause damage to organs such as the liver or kidneys.
- Flushing: Some people with high blood pressure may experience flushing or a feeling of warmth in the face.
- Trouble sleeping: High blood pressure can cause sleep problems such as insomnia or sleep apnea.
- Persistent coughing: High blood pressure can cause a persistent cough, especially at night.
- Irregular heartbeat: Hypertension can cause an irregular heartbeat or palpitations.
- Blood in the urine: In rare cases, high blood pressure can cause blood in the urine.
These signs and symptoms may not necessarily be caused by high blood pressure but be a result of other conditions. If you experience any of these symptoms, it is important to consult a healthcare professional for a proper diagnosis and treatment.
What causes high blood pressure?
There are many potential causes of high blood pressure (hypertension):
- Genetics: High blood pressure can run in families, so if you have a family history of hypertension, you may be more likely to develop it.
- Age: Blood pressure tends to increase with age because your blood vessels become less flexible.
- Lifestyle factors: Certain lifestyle factors can contribute to high blood pressure, including:
- Poor diet (high in salt, fat, and processed foods)
- Lack of physical activity
- Smoking
- Excessive alcohol consumption
- Stress
- Being overweight or obese
- Medical conditions: Some medical conditions can also cause or contribute to high blood pressure, including
- Diabetes
- Kidney disease
- Sleep apnea
- Thyroid problems
- Adrenal gland disorders
- Certain medications: Some medications can increase blood pressure, including certain types of birth control pills, decongestants, and steroids.
- Race: Some racial and ethnic groups, such as African Americans, are at higher risk of high blood pressure.
How to treat high blood pressure?
Ultimately, high blood pressure (hypertension) can damage the blood vessels in your kidneys and prevent them from working properly. Additionally, untreated hypertension can result in numerous health conditions, such as cardiovascular disease.
Lifestyle changes and regular exercise can help to treat high blood pressure.
Some of the suggested lifestyle changes by the physicians are as follows:
- Quit smoking
- Lose weight
- Avoid alcohol or at least limit the intake
- Eat a low-sodium and low-fat diet such as the DASH diet
- Avoid too much stress
- Eat foods rich in potassium, magnesium, and calcium such as bananas and milk
- Regular monitoring of blood pressure after reaching the age of 35 years
- Practice meditation and other stress-relieving exercises
- Cut back on caffeine
The physicians may prescribe the following medications:
- Diuretics
- ACE inhibitors
- Alpha-blockers
- Beta-blockers
- Calcium channel blockers
- Vasodilators
How to treat low blood pressure?
Low blood pressure (Hypotension) can be prevented or treated using the following methods:
- Consume lots of fluids
- Limit alcoholic drinks
- Stay hydrated, especially during hot weather or during viral flu
- Drink more nonalcoholic drinks
- Exercise regularly to encourage blood flow
- Avoid sitting or standing quickly
- While rising, take care to sit upright for a few seconds and then get off the bed
- Stay away from heavy lifting
- Avoid standing still for a prolonged time
- Avoid straining while passing stools
- Avoid prolonged exposure to hot water such as saunas, hot water springs, and spas
- Compression stocking covering the thigh and calf restricts the blood flow to the lower part of the body
- Try eating smaller, more frequent meals to avoid post-meal dizziness
- Any consumption of over-the-counter medications should be reported to the physician.
Medications such as fludrocortisone or midodrine may also help to treat low blood pressure
What is high blood pressure? What is normal blood pressure?
- High blood pressure (hypertension) is defined as high pressure (tension) in the arteries, which are the vessels that carry blood from the heart to the rest of the body.
- Blood pressure readings are given as two numbers:
- The systolic blood pressure (the top number) equals the pressure in the arteries as the heart contracts.
- The diastolic pressure (the bottom number) is the pressure in the arteries as the heart relaxes.
- Normal blood pressure is below 120/80.
- In 2017, the American College of Cardiology released new guidelines for high blood pressure.
- Blood pressure between 120/80 and 129/80 is elevated blood pressure, and blood pressure of 130/80 or above is considered high.
- The American Academy of Cardiology defines blood pressure ranges as:
- Hypertension stage 1 is 130-139 or 80-89 mm Hg, and hypertension stage 2 is 140 or higher, or 90 mm Hg or higher.
- Complications of high blood pressure include heart disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage).
- Hypertension is a major public health problem. With the new guidelines for defining high blood pressure, The American Heart Association estimates high blood pressure affects nearly half of all adults (46%) in the United States.
What do blood pressure readings mean? (blood pressure readings chart)
Blood pressure readings can vary in a single person throughout the day depending on the situation. Factors such as stress, anxiety, foods are eaten (caffeine or salt intake), smoking or exercise can cause pressure to rise.
The American Heart Association defines
- normal blood pressure as less than 120/80,
- elevated blood pressure ranges between 120/80 and 129/80, and
- high blood pressure is 130/80 and higher.
- In pregnancy, normal blood pressure should be below 120/80.
If your blood pressure reaches the high range, you should see your doctor about lifestyle changes, and possibly medication especially if you have other risk factors, such as diabetes or heart disease.
High blood pressure (for example, 180/110 or higher) may indicate an emergency situation. If this high blood pressure is associated with chest pain, shortness of breath, headache, dizziness, or back or abdominal pain, seek medical care immediately. If you are experiencing no associated symptoms with a high blood pressure reading such as this, re-check it again within a few minutes and contact your doctor or go to an emergency room if it is still high.
If your blood pressure is lower than about 100/60 you may have low blood pressure, depending on the associated symptoms. If you are unsure, check with your doctor.
There are five different types or categories of blood pressure. The chart below defines systolic, diastolic, and required management.
| Category | Systolic (mmHg) | Diastolic (mmHg) | Management |
|---|---|---|---|
| Normal | 120 or less | 80 or less | N/A |
| Elevated | 120-129 | 80 or less | People with elevated blood pressure are at risk of high blood pressure unless steps are taken to control it. |
| Hypertension stage I | 130-139 | 80-89 | Doctors may prescribe blood pressure medications and some lifestyle changes to reduce the risk of heart diseases and stroke. |
| Hypertension stage II | 140-159 | 90-99 | Doctors may prescribe a combination of both medications and lifestyle changes. |
| Hypertensive crisis | 180 or higher | 120 or higher | This is the most critical condition and requires emergency medical attention. |
What are the signs and symptoms of high blood pressure?
High blood pressure may not have any symptoms and so hypertension has been labeled “the silent killer.” Longstanding high blood pressure can lead to multiple complications including heart attack, kidney disease, or stroke.
Some people experience symptoms with their high blood pressure. These symptoms include:
- Headache
- Dizziness
- Shortness of breath
- Blurred vision
- The feeling of pulsations in the neck or head
- Nausea
What causes high blood pressure?
The causes of hypertension are multifactorial, meaning there are several factors whose combined effects produce hypertension.
- High salt intake or salt sensitivity: This occurs in certain populations such as the elderly, African Americans, people who are obese, or people with kidney (renal) problems.
- Genetic predisposition to high blood pressure: People who have one or two parents with hypertension have high blood pressure incidence about twice as high as the general population.
- A particular abnormality of the arteries, which results in an increased resistance (stiffness or lack of elasticity) in the tiny arteries (arterioles): This increased peripheral arteriolar stiffness develops in individuals who are also obese, do not exercise, have a high salt intake, and are older.
How is blood pressure measured?
Blood pressure is measured by a blood pressure cuff (sphygmomanometer). The blood pressure cuff consists of an air pump, a pressure gauge, and a rubber cuff. The instrument measures the blood pressure in units called millimeters of mercury (mm Hg).
The cuff is placed around the upper arm and inflated with an air pump to a pressure that blocks the flow of blood in the main artery that travels through the arm. The arm is held at the side of the body at the level of the heart, and the pressure of the cuff is gradually released. As the pressure decreases, a health practitioner listens with a stethoscope over the artery at the front of the elbow or an electronic machine senses the pulsation. The pressure at which the practitioner (or machine) first hears a pulsation from the artery is the systolic pressure (the top number). As the cuff pressure decreases further, the pressure at which the pulsation finally stops is the diastolic pressure (the bottom number).
How is high blood pressure diagnosed?
To make an official diagnosis of high blood pressure you will need to see your doctor. Often your blood pressure will be checked on at least two different visits, at different times of the day. Your doctor may ask you to keep a blood pressure log for a short time in order to see your overall blood pressure trends. If your blood pressure is consistently over 134/80, your doctor will work with you to determine the best regimen for treating your high blood pressure.
What is the treatment for high blood pressure?
Blood pressure is caused by many different factors, so there are many different treatments. The goal of treating high blood pressure is to keep the blood pressure below 134/80.
Treatments for high blood pressure include:
- Lifestyle modifications:
- Quit smoking
- Lose weight if you are overweight
- Exercise
- Avoid alcohol
- Eat a low-sodium, low-fat diet like the DASH diet.
- Medications: There are many different categories of blood pressure medications. Your doctor will work with you to find the right one. The main types include:
- Beta-blockers
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II Receptor (ARB) blockers
- Calcium channel blockers
- Diuretics (water pills)
- Treatment of underlying conditions that cause high blood pressure, such as:
- Renal artery stenosis
- Pheochromocytoma
- Congestive heart failure
- Diabetes
- Obesity
What changes in diet help lower blood pressure naturally?
Dietary changes are often the first line of treatment recommended by your doctor. You may be advised to:
- Limit caffeine intake
- Reduce salt intake
- Limit fatty foods
- Avoid alcohol
- Manage cholesterol
- Add potassium-rich foods to your diet (unless you are being treated for kidney failure, as potassium rich foods may be harmful to you)
Doctors often recommend the Dietary Approaches to Stop Hypertension (DASH) Diet created by the National Heart, Lung and Blood Institute (NHLBI), which focuses on whole grains, fruits and vegetables, low-fat dairy, and lean meats.
In addition to dietary modification, quitting smoking is extremely beneficial in managing high blood pressure.
Can exercise help lower high blood pressure?
Exercise and physical activity help lower blood pressure by helping you lose weight and keeping your heart and blood vessels in good condition.
Weight loss achieved through diet and exercise helps control factors such as blood sugar, and other complications of obesity. Avoiding these complications helps lower blood pressure and prevent high blood pressure.
Consult your doctor before starting any new exercise program. Cardiovascular activities including walking, jogging, biking, or swimming for 30 to 45 minutes per day can help lower blood pressure.
What alternative therapies help lower and mangage high blood pressure?
Some complementary and alternative medicine strategies can help you manage your high blood pressure and prevent it from becoming elevated further.
- Reduce stress.
- Use relaxation methods such as deep breathing, imagery relaxation, yoga, meditation, and biofeedback.
- Keep a daily blood pressure chart.
- Get adequate sleep.
- Some home remedies, such as garlic, coenzyme Q-10 (CoQ10), calcium, magnesium, fish oil, and flaxseed have been shown in studies to lower blood pressure. Consult your physician before taking any supplements.
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