What are the two blood pressure readings

Blood pressure is measured in millimetres of mercury, mmHg. It consists of two numbers, such as 130/80, which we say as “130 over 80”. The first is your systolic blood pressure, the maximum pressure your blood attains as your heart beats and pushes it around your body. The second is your diastolic pressure, the minimum level it reaches between beats.

And what’s the definition of high blood pressure?

High blood pressure, also known as hypertension, puts a strain on your heart and blood vessels and makes you more susceptible to heart attacks and strokes.

Normal blood pressure is regarded as being between 120-129 (systolic) and 80-84 (diastolic).

The definition of high blood pressure, according to 2018 ESC/ESH Guidelines, is anything above 140/90 mmHg. If you measure it in the comfort of your own home, where you’re likely to be more relaxed, the limit is slightly lower at 135/85.

If your blood pressure is between 120/80 and 140/90, you may be at risk of developing hypertension at some stage in the future unless you take action to bring it under control. This is called prehypertension.

A blood pressure reading of over 180/120 is dangerously high. Doctors call this a hypertensive crisis, and it requires immediate treatment.

Systolic blood pressure, the top number, is more important than diastolic blood pressure in people over 40. That’s because it’s a better predictor of stroke and heart attack. And only one of the two numbers has to be higher than it should be to count as high blood pressure.

All this can be summarised in a blood pressure chart, like this:

To check your blood pressure against the chart, start from your systolic pressure on the left-hand side, and move your finger to the right until you reach your diastolic pressure. The colour will tell you whether you have normal or abnormal blood pressure.

Tracking blood pressure over time

Bear in mind that a single reading doesn’t tell you very much – you need to take an average of multiple readings, for example morning and evening for a week. Here's how you can track your measurements over time using blood pressure diary (free download) and the 'OMRON connect' app.

Recommended blood pressure monitors

See all blood pressure monitors

References:

Williams B, Giuseppe M, Spiering W, et al. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension. Journal of Hypertension, 36(10). doi: 10.1097/HJH.0000000000001940

Bupa (2018). High blood pressure. Retrieved from www.bupa.co.uk/health-information/heart-blood-circulation/high-blood-pressure-hypertension

Blood Pressure Association (2018). Blood pressure chart. Retrieved from www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Bloodpressurechart

When you see your doctor, it seems like one of the first things they do is check your blood pressure readings. Even pharmacies and grocery stores have blood pressure machines for you to check your pressure on your own. So checking your blood pressure must be important, right? But what are those numbers actually telling you?

What Is Blood Pressure?

Blood pressure is the force that moves blood through your body. It is driven by the heart, and it changes as the heart muscle contracts and relaxes. There are two numbers involved in a blood pressure reading. The first is known as "systolic," and it measures the pressure when the heart muscle contracts. The second number is known as "diastolic," and it's the measurement of the pressure when the heart muscle is at rest. Blood pressure is read with the systolic number (the beat) over the diastolic (the rest), and it's measured in millimeters of mercury, or mm Hg. According to Continuing Education in Anaesthesia, Critical Care & Pain, Mercury is used because it is 13.6 times denser than water and therefore allows the instruments used in blood pressure readings to be smaller and more manageable for your doctor. A normal blood pressure reading, according to the American Heart Association, is a systolic number below 120 and a diastolic number under 80. This reading is typically read as 120/80, or 120 over 80 millimeters of mercury.

Hypertension

High blood pressure, or hypertension, is often a preventable disease, although some risk factors are out of the patient's control. African-Americans, older people, those who suffer from sleep apnea or kidney disease, and those with a family history of hypertension are more at risk for developing high blood pressure. Other risk factors can be controlled by the patient to some degree, such as not smoking, maintaining a health weight and active lifestyle, reducing stress, moderating alcohol consumption, and eating healthfully.

Both your lifestyle choices and genetics can contribute to the risk of high blood pressure. Hypertension is indicated with consistent readings exceeding 140 for systolic or 90 for diastolic.

Beginning with prehypertension, in which readings range 120–139/80–89, blood pressure tends to slowly increase over a period of years. Stage 1 hypertension exists when the systolic reading ranges 140–159 or the diastolic 90–99. Stage 2 occurs if the systolic reading is above 160 or the diastolic is above 100.

A systolic pressure exceeding 180 or a diastolic pressure above 110 is called a hypertensive crisis, and it's a life-threatening condition that requires emergency medical attention.

Hypotension

Blood pressure can also be hypotensive, or too low. Low pressure can occur when you stand up suddenly, when you spend too long standing, or after a meal. It may also occur for other reasons, such as anemia, infection, or certain chronic conditions. Symptoms include blurred vision, dizziness, fatigue, cold and clammy skin, or nausea. While low blood pressure is normal for some people, dehydration or improper dosage of blood pressure medications all cause blood pressure to drop.

For many people, the episode ends quickly with no ill effects. Resting for a moment or sitting with your feet higher than your heart can help people during mild episodes. However, hypotensive episodes can be dangerous because they are a leading cause of falls among older adults. Severe hypotensive episodes can lead to shock, which requires emergency care.

Measuring Blood Pressure

Blood pressure readings can be measured manually using a stethoscope and a device called a sphygmomanometer, or digitally. Unless you are trained on how to manually measure blood pressure, it's best to rely on a digital device. If you need to monitor your blood pressure at home, ask your doctor for a recommendation.

Pressures change from moment to moment, so any single measurement is not absolute. Instead, readings should be taken two or three times per sitting and at the same time each day. You should not exercise, smoke, or consume caffeine for a half hour before you begin any measurement. Be sure that you are sitting and that your arm is relaxed and supported by a chair arm or desk. Whatever numbers are consistent over a period of several days or weeks is called your "baseline" blood pressure.

Bear in mind, however, that many things can cause a sudden increase in blood pressure. Physical exertion, stress, and medications are just a few examples. For some people, simply going to get their blood pressure measured causes enough anxiety to spike the numbers.

High blood pressure is a serious, but treatable, health condition. Depending on your situation and your doctor's recommendation, you may need to make certain lifestyle changes, take medication, or both. Maintaining good blood pressure is important to healthy living, and you and your doctor can decide whether at-home readings are needed. Taking periodic blood pressure readings is the surest way to know how well you're keeping it under control.

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