NEED TO KNOW
SPECIAL ISSUE: HIGH BLOOD PRESSURE
WORDS - Terri Fleming
ILLUSTRATION - Jordan Cannon, David Zhou, Sarah Etherton

Knowing your blood pressure numbers and what they mean is empowering. The only way to diagnose and manage high blood pressure is to frequently take readings and keep track of these numbers regularly over time. Because many people do not experience symptoms, keeping track of your blood pressure numbers is a key preventative measure. 

A blood pressure monitor is a tool you can use to measure your blood pressure. If you have experienced healthy blood pressure numbers consistently as a child at annual check-ups, you should continue to have your blood pressure read at least every two years through adulthood. If you are at risk for high blood pressure, your doctor may advise you to take your blood pressure reading more frequently, as often as twice a day. Your blood pressure is typically read at annual check-ups, but you can regularly check your own blood pressure using a blood pressure monitor cuff at home. Cuffs can be prescribed by your health care provider, or bought online or at your local pharmacy. Ask your health care provider to recommend an easy-to-use monitor, and make sure the cuff fits your arm to produce accurate readings. If you are uninsured or your insurance does not cover an at-home monitor, many pharmacies have blood pressure reading machines that are free for public use. 

Once you start regularly checking your blood pressure, try to take readings at the same time every day and keep track of both numbers in a chart, journal, or note on your phone. Save these recordings in a place you can easily access them, and be sure to bring these records to every health care appointment. 

The Numbers:

Your blood pressure reading measures the force of your blood moving through your arteries when your heart beats and when it rests. Blood pressure is recorded with two numbers: a systolic number over a diastolic number. 

Systolic = Pumping: The systolic number is the top number on your reading and measures the pressure on artery walls when the heart is beating and pumping blood.

Diastolic = Filling: The diastolic number is the bottom number on your reading and measures the pressure on artery walls when the heart is resting between beats and filling with blood.

Which number is more important? 

It's common for providers to focus on systolic blood pressure. Higher systolic numbers are a major risk factor for cardiovascular disease for people over 50. Over time, systolic blood pressure may rise for many reasons, including increased stiffness of large arteries and buildup of plaque in arteries as we age.

What about heart rate?  

Heart rate and blood pressure are the two numbers that measure the functioning of your cardiovascular system. Your blood pressure is the force of your blood moving through your blood vessels, while your heart rate is the number of times your heart beats per minute. When your heart is beating more times a minute, healthy blood vessels will dilate (get wider) and allow the blood to flow easily. An elevated heart rate is normal during exercise or stressful situations, but can be concerning if heart rate is elevated at rest, as it can suggest a variety of other conditions such as cardiac arrhythmias, anxiety, hyperthyroidism, and many more.

Diagnosis:

The following stages can help you understand your numbers in the context of different stages of hypertension. However, healthy numbers can depend on other factors and should always be discussed with your health care provider to get an accurate diagnosis for you. Moreover, having one high reading does not automatically mean you have hypertension. Talking with your health care provider will provide a more reliable diagnosis and possible treatment plan. 

• Healthy: systolic and diastolic less than 120/80

• Elevated: systolic between 120-129 and diastolic less than 80

• Stage I of Hypertension: systolic number of 130-139, and diastolic of 80-89

• Stage II of Hypertension: systolic number of 140 or greater, and diastolic of 90 or greater 

• Hypertensive Crisis: systolic number greater than 180 and/or a diastolic number greater than 120. 

  • It’s important to note that some people in hypertensive crises may not have any symptoms, but it is still important to contact your health care provider immediately if you have a blood pressure reading that is this high. 

  • If your blood pressure is this high and you experience symptoms such as chest pain, shortness of breath, numbness in any extremity, weakness, or changes in vision or speech, call 911.