High blood pressure (hypertension) is often called the “silent killer” due to the lack of symptoms associated with the condition. The only way to know if you have high blood pressure is to have it checked, either by a healthcare provider or using a home blood pressure monitor. Typically, a few blood pressure readings will be taken to gauge your level. Often, the stress of having the test may cause a temporary rise in blood pressure, and your blood pressure rises and falls depending on the time of day. Only with the average of a few readings can you know where you are in terms of a healthy or unhealthy level.
Understanding a blood pressure reading: Systolic and Diastolic Pressure
Blood pressure is measured with two measurements. The first and higher level is your systolic blood pressure, which measures the force of your blood pushing through your blood vessels during each heartbeat. The lower level is diastolic blood pressure, which measures the pressure between beats. Both blood pressures are measured in millimeters of mercury (mm Hg), the standard unit of pressure measurement.
Typically, doctors or cardiologists will give more attention to your systolic pressure. Your systolic pressure is more likely to rise as you get older and your arteries and blood vessels begin to thicken, making it harder for blood to be pushed through.
Blood Pressure Categories and Ranges
The American Heart Association (AHA) divides blood pressure ranges into five categories.
Normal Range: The first blood pressure category is what is considered healthy blood pressure or normal blood pressure. Typically, a normal level will mean systolic readings of less than 120 mm Hg and diastolic readings of less than 80.
Elevated Range: If your systolic blood pressure rises above 120 but not beyond 129, it is classified as elevated blood pressure. People who have elevated blood pressure levels are usually not given blood pressure medications to control their condition. Still, they are in an at-risk category for it developing into high blood pressure and encouraged to take steps to lower the risk factors for hypertension.
Hypertension Stage 1: Hypertension was previously defined as any reading above 130/80. In 2017, the AHA amended their guidelines and characterized Stage 1 hypertension as beginning once your systolic blood pressure consistently ranges between 130-139 or your diastolic pressure is between 80-89. Typically, people who have this first stage of hypertension are encouraged to make healthy lifestyle changes to lower their blood pressure. Doctors often prescribe blood pressure management drugs based on the risk for heart disease or stroke.
Hypertension Stage 2: If your hypertension forces your blood pressure range to be over 140/90 regularly, your doctor will likely prescribe blood pressure medicine to help manage your condition. They will also recommend you make immediate lifestyle changes to help bring your levels under control and lower your risk of a heart attack.
Hypertensive Crisis: If you take a blood pressure reading and it is more than 180/120 in two or more readings at least five minutes apart, you are likely in hypertensive crisis. In that case, you should seek immediate emergency medical attention. You may be experiencing organ damage signs such as chest or back pain, shortness of breath, and difficulty speaking. Do not wait for your blood pressure to come down. Call emergency services immediately.
Factors that may affect your blood pressure measurement
There are a few special circumstances that can affect your blood pressure readings:
- White Coat Hypertension: Many people will find that the stress of a blood pressure measurement at the medical center will temporarily increase their reading. This is known as “white coat hypertension.” The medical staff will usually take at least two measurements, typically at least 5-10 minutes apart, to get as accurate a reading as possible. If it is suspected that a patient has white coat hypertension, the medical staff may advise that they use a personal blood pressure machine to take some readings at home and at a range of times during the day.
- Pregnancy and High Blood Pressure: Between 1 in 12 and 1 in 17 pregnant women between the ages of 20-44 experience high blood pressure during pregnancy. This is often referred to as preeclampsia. Women who develop hypertension either before or during the first 20 weeks of pregnancy are considered to have chronic hypertension. If hypertension only develops after 20 weeks of pregnancy and then reverts to a healthy level after a woman has given birth, it is described as gestational hypertension instead.
Regular blood pressure monitoring is the best way to know if you have high blood pressure. When it comes to interpreting and managing your blood pressure levels, you should always consult your doctor or a healthcare professional. They will assess your blood pressure against specific factors that may be affecting it and advise the best type of blood pressure management and treatment plan.
Written by John Bankston
- High Blood Pressure Symptoms and Causes
- High Blood Pressure
- Overview – High blood pressure (hypertension)
- Understanding Blood Pressure Readings
- High blood pressure redefined for first time in 14 years: 130 is the new high
- High Blood Pressure – NHLBI
- White-Coat Hypertension
- Hypertension in Women of Reproductive Age in the United States
- Preeclampsia Foundation
- High Blood Pressure During Pregnancy