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Heart Disease (Expert Forum)
Questions about blood pressure readings
Answered by
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Questions about blood pressure readings
by sophie, Jul 25, 2000 12:00AM
I have been in a battle fighting high blood pressure for awhile now. I understand that 120/80 is considered a normal reading and anything over 140/90 is considered above normal. My question is whether the systolic or diastolic reading is more important? What reading would be considered dangerously high? Also, how can the systolic be high and the diastolic be normal and vice-versa? I appreciate any understanding you can give me regarding what blood pressure readings mean. Thanks for your reply.
Doctor's Answer
by Cleveland Clinic, MD, Jul 25, 2000 12:00AM
, Jul 25, 2000 12:00AM
Dear Elise,
Agood way to think of the systolic (upper number) and diastolic (lower number) is as a pumping pressure and a relaxation pressure. Obviously they are related to each other but multiple factors regulate both and thus one can be high and the other low and visa-versa. In the past not much attention was paid to the diastolic pressure as a risk factor but newer evidence suggests that it is also important. There are no 'official' guideline as to what is very high. It will vary with each individual. Clinically however we are usually more concerned when the systolic is over 190 and the diastolic over 100. I have attached some additional information about blood pressure and other good sites to visit.
High blood pressure, or hypertension (HTN) , is defined in an adult as a blood pressure
greater than or equal to 140 mm Hg systolic pressure or greater than or equal to
90 mm Hg diastolic pressure. Blood pressure is measured in millimeters of
mercury (mm Hg). High blood pressure directly increases the risk of
coronary heart disease (which leads to heart attack) and stroke (or brain
attack), especially along with other risk factors.
High blood pressure can occur in children or adults, but is particularly prevalent in
blacks, middle-aged and elderly people, obese people, heavy drinkers and women who are taking oral
contraceptives. Individuals with diabetes mellitus gout or kidney disease have a higher frequency of
hypertension.
High blood pressure may be primary (essential) or secondary. If the hypertension is secondary there may be a treatable cause. Most of these causes are relatively rare (i.e. renal artery stenosis, pheochromocytoma). If no secondary cause is found then the high blood pressure is said to be primary. The vast majority of cases of HTN are primary. The main cause of primary HTN is genetic.
Q: I am hoping to get pregnant in the future and I am wondering if this will effect things?
A: Blood pressure may be elevate during pregnancy and if you have a predisposition to high blood pressure it should be closely monitored during pregnancy.
Q: I believe the higher blood pressure is directly related to anxiety which may be OK for the "normal"
person, however with me having this disorder I deal with anxiety A LOT and I often endure it without my medication.
A: It is important to take the medication you need for anxiety. In addition you may need blood pressure medication if your high blood pressure continues.
Q: How do salt and sodium affect high blood pressure?
A: Most Americans consume far more salt (sodium) than their bodies need. Heavy sodium consumption increases blood pressure in some people, leading to high blood pressure. People who are diagnosed with high blood pressure are often placed on restricted-sodium diets.
Reducing sodium (or salt) consumption may help lower blood pressure in some people. Your doctor may
recommend a sodium (salt) restricted diet. This will mean you'll have to avoid salty foods and cut down on the amount of salt you use in cooking and at the table.
Q: How does being overweight affect high blood pressure?
A: Studies have shown that body weight, changes in body weight over time, and skinfold thickness are related to changes in blood pressure levels. These factors have been linked to the subsequent rise and development of high blood pressure. People who are overweight are more likely to have high-normal to mild high blood
pressure.
Physical inactivity is a risk factor for heart disease. In addition, a sedentary or inactive lifestyle tends to
contribute to obesity, a risk factor for both high blood pressure and heart disease. Regular exercise helps
control weight and lower blood pressure. Don't be afraid to be active - exercise should definitely be part of your daily program. Besides helping to reduce your risk of heart attack, it can also help you lose weight or maintain a healthy weight.
Statistics show that many people who have high blood pressure are also overweight. If you are overweight or have gained weight over time, you'll be advised to cut down on calories and lose weight. Your doctor can prescribe a diet that's right for you.
If you're given a diet, follow it closely, including any recommendations about reducing your consumption of alcohol. Alcoholic drinks are high in non-nutritious calories, so if you're trying to lose weight, avoid alcoholic beverages. Often when people lose weight, their blood pressure drops as well.
Q: How does medicine help control high blood pressure?
A: For some people, weight loss, sodium reduction and other lifestyle changes won't lower high blood pressure as much as it needs to be lowered. If that's your situation, you will probably need to take medication. Many medications are available to reduce high blood pressure. Some get rid of excess fluid and sodium (salt). Others relax constricted blood vessels. Others prevent blood vessels from constricting and narrowing. Because there is usually no cure for high blood pressure, treatment generally must be carried out for life. If treatment is stopped, the pressure may rise again.
Q: Will I have to take medications for my hypertension the rest of my life?
A: Generally, someone with high blood pressure will be on lifelong medication.
Q: At what point do I need to see a heart specialist for this condition?
A: Usually hypertension can be managed by an Internal Medicine doctor.
Q: Will there ever be a right combination (of medication) to treat this condition?
A: It may take several trials to find the right combination of drugs. There are many different medications and new ones are coming out each year.
Q: My parents both had heart attacks and strokes and father had a bypass in Sept. 97 (age 74), mom had her stroke at age 49. They still take meds for hypertension. With this history is there a possibility I might have a heart attack in my later years?
A: Heart disease tends to run in families. Those who have a family history of heart problems shoud take extra care of themselves (i.e. weight loss, high blood pressure control, exercise, etc.).
http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/hbp.html
http://www.ihr.com/medreprt/articles/bloodpr.html
http://www.musc.edu/iash/
http://www.am-osteo-assn.org/ccoop/hibldprs.htm
http://www.mco.edu/whl/know.html
http://www.bloodpressure.com/
http://www.mediconsult.com/hypertension/
http://www-med.stanford.edu/school/DGIM/Teaching/Modules/HTN.html
http://www.merck.com/!!uYfKE0uiyuYfKE0uiy/pubs/mmanual/html/khgnjgcd.htm
http://www.aafp.org/afp/091596/special.html
http://pharminfo.com/disease/cardio_db.html
http://www.pslgroup.com/HYPERTENSION.HTM
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Agood way to think of the systolic (upper number) and diastolic (lower number) is as a pumping pressure and a relaxation pressure. Obviously they are related to each other but multiple factors regulate both and thus one can be high and the other low and visa-versa. In the past not much attention was paid to the diastolic pressure as a risk factor but newer evidence suggests that it is also important. There are no 'official' guideline as to what is very high. It will vary with each individual. Clinically however we are usually more concerned when the systolic is over 190 and the diastolic over 100. I have attached some additional information about blood pressure and other good sites to visit.
High blood pressure, or hypertension (HTN) , is defined in an adult as a blood pressure
greater than or equal to 140 mm Hg systolic pressure or greater than or equal to
90 mm Hg diastolic pressure. Blood pressure is measured in millimeters of
mercury (mm Hg). High blood pressure directly increases the risk of
coronary heart disease (which leads to heart attack) and stroke (or brain
attack), especially along with other risk factors.
High blood pressure can occur in children or adults, but is particularly prevalent in
blacks, middle-aged and elderly people, obese people, heavy drinkers and women who are taking oral
contraceptives. Individuals with diabetes mellitus gout or kidney disease have a higher frequency of
hypertension.
High blood pressure may be primary (essential) or secondary. If the hypertension is secondary there may be a treatable cause. Most of these causes are relatively rare (i.e. renal artery stenosis, pheochromocytoma). If no secondary cause is found then the high blood pressure is said to be primary. The vast majority of cases of HTN are primary. The main cause of primary HTN is genetic.
Q: I am hoping to get pregnant in the future and I am wondering if this will effect things?
A: Blood pressure may be elevate during pregnancy and if you have a predisposition to high blood pressure it should be closely monitored during pregnancy.
Q: I believe the higher blood pressure is directly related to anxiety which may be OK for the "normal"
person, however with me having this disorder I deal with anxiety A LOT and I often endure it without my medication.
A: It is important to take the medication you need for anxiety. In addition you may need blood pressure medication if your high blood pressure continues.
Q: How do salt and sodium affect high blood pressure?
A: Most Americans consume far more salt (sodium) than their bodies need. Heavy sodium consumption increases blood pressure in some people, leading to high blood pressure. People who are diagnosed with high blood pressure are often placed on restricted-sodium diets.
Reducing sodium (or salt) consumption may help lower blood pressure in some people. Your doctor may
recommend a sodium (salt) restricted diet. This will mean you'll have to avoid salty foods and cut down on the amount of salt you use in cooking and at the table.
Q: How does being overweight affect high blood pressure?
A: Studies have shown that body weight, changes in body weight over time, and skinfold thickness are related to changes in blood pressure levels. These factors have been linked to the subsequent rise and development of high blood pressure. People who are overweight are more likely to have high-normal to mild high blood
pressure.
Physical inactivity is a risk factor for heart disease. In addition, a sedentary or inactive lifestyle tends to
contribute to obesity, a risk factor for both high blood pressure and heart disease. Regular exercise helps
control weight and lower blood pressure. Don't be afraid to be active - exercise should definitely be part of your daily program. Besides helping to reduce your risk of heart attack, it can also help you lose weight or maintain a healthy weight.
Statistics show that many people who have high blood pressure are also overweight. If you are overweight or have gained weight over time, you'll be advised to cut down on calories and lose weight. Your doctor can prescribe a diet that's right for you.
If you're given a diet, follow it closely, including any recommendations about reducing your consumption of alcohol. Alcoholic drinks are high in non-nutritious calories, so if you're trying to lose weight, avoid alcoholic beverages. Often when people lose weight, their blood pressure drops as well.
Q: How does medicine help control high blood pressure?
A: For some people, weight loss, sodium reduction and other lifestyle changes won't lower high blood pressure as much as it needs to be lowered. If that's your situation, you will probably need to take medication. Many medications are available to reduce high blood pressure. Some get rid of excess fluid and sodium (salt). Others relax constricted blood vessels. Others prevent blood vessels from constricting and narrowing. Because there is usually no cure for high blood pressure, treatment generally must be carried out for life. If treatment is stopped, the pressure may rise again.
Q: Will I have to take medications for my hypertension the rest of my life?
A: Generally, someone with high blood pressure will be on lifelong medication.
Q: At what point do I need to see a heart specialist for this condition?
A: Usually hypertension can be managed by an Internal Medicine doctor.
Q: Will there ever be a right combination (of medication) to treat this condition?
A: It may take several trials to find the right combination of drugs. There are many different medications and new ones are coming out each year.
Q: My parents both had heart attacks and strokes and father had a bypass in Sept. 97 (age 74), mom had her stroke at age 49. They still take meds for hypertension. With this history is there a possibility I might have a heart attack in my later years?
A: Heart disease tends to run in families. Those who have a family history of heart problems shoud take extra care of themselves (i.e. weight loss, high blood pressure control, exercise, etc.).
http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/hbp.html
http://www.ihr.com/medreprt/articles/bloodpr.html
http://www.musc.edu/iash/
http://www.am-osteo-assn.org/ccoop/hibldprs.htm
http://www.mco.edu/whl/know.html
http://www.bloodpressure.com/
http://www.mediconsult.com/hypertension/
http://www-med.stanford.edu/school/DGIM/Teaching/Modules/HTN.html
http://www.merck.com/!!uYfKE0uiyuYfKE0uiy/pubs/mmanual/html/khgnjgcd.htm
http://www.aafp.org/afp/091596/special.html
http://pharminfo.com/disease/cardio_db.html
http://www.pslgroup.com/HYPERTENSION.HTM
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
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May 9, 2000
Blood pressure advisory:
The National Institutes of Health (NIH) says that many physicians are not adequately treating people with high blood pressure because they wrongly believe that the top number in a person's reading (systolic) is less important than the bottom number (diastolic). In an advisory to doctors, issued May 4, the NIH says that a high systolic reading is "a major underemphasized threat" — especially for older people — even if their diastolic reading is normal. "Unfortunately, many physicians have not yet . . . become aggressive in treating such patients," says Daniel Levy, M.D., director of the National Heart, Lung and Blood Institute's Framingham Heart Study and a co-author of the NIH advisory. Systolic blood pressure is the peak pressure inside the arteries when the heart contracts. Diastolic blood pressure is the pressure between contractions. Normal blood pressure is below 130 systolic and 85 diastolic. Ideal blood pressure is 120 over 80, or lower. For decades, physicians thought that diastolic pressure was more important than systolic and that it was normal for the top number to increase with age. Research now indicates that both of those beliefs are wrong. Only one-quarter of people with hypertension are adequately controlled, according to the NIH. In addition, millions don't know they have high blood pressure. For more on high blood pressure, see:
•High blood pressure alert - Americans need 'wake-up call' •Hypertension - Non-drug therapies •Track your blood pressure - Monitoring is important •National Heart, Lung and Blood Institute Home Page
Thanks.
I, too, have LVH and addditionally, septal hypokinesis (a restriction in mobility on the dividing muscle between the left and right sides of the heart).
Depending on the extent of your enlargement, if the muscle tissue has not stretched to tolerances beyond which it cannot recover, you may get a reduction in heart size. Your age, condition, arterial circumstances and height/weight ratios all enter into it as well.
It sounds like your stress reactions are pretty high too. That can be as damaging or more so than strenuous physical activity.
A measurement in 6 months and another in a year should provide you with the answers you seek.
I have a good Home BP machine and take it faily often, It is more normal at home than at the doctor's office. One of the doctor's nurses scolded me for having this as she said they are not accurate and could be detrimental to my health.
Can anyone comment on this?
Thank You.
Your nurse is talking rubbish! It is well known that going to the doctor is a typically anxious experience for most people... of course, you go there generally because you aren't well! So taking your bp at home, at work, and in other situations to get your personal bp profile is actually far more accurate than an isolated bp reading in your doctor's office. My husband has hbp and was given a mobile automatic bp machine, a box strapped around his waist with wires to electrodes attached to his chest and a cuff around his bicep that would inflate every 15 minnutes... caused him huge embarrassment because he had to wear it at work, and then (ironically) he found out his Dad was in hospital, so the readings taken from it were... surprise, surprise, really high. His doctor then insisted he was at risk of stroke (he's only 31) and has been insisting he go on medication. Taking your bp at home is not a risk to your health (unless you put the around your neck!!!). If you accurately record the time, date, and circumstances of each record, it will provide a valuable profile of your bp over the period of a day, week or month. You should be aware of how your bp changes naturally, i.e. rises after a meal, higher when standing than sitting or lying down, higher when excited, sexually stimulated, or anxious, lower when listening to quiet music or reading (depending on what you are reading of course!). So take your health into your own hands. Find out what your bp is really doing before you are forced onto meds without adequate justification.
Good luck.
Your nurse is talking rubbish! It is well known that going to the doctor is a typically anxious experience for most people... of course, you go there generally because you aren't well! So taking your bp at home, at work, and in other situations to get your personal bp profile is actually far more accurate than an isolated bp reading in your doctor's office. My husband has hbp and was given a mobile automatic bp machine, a box strapped around his waist with wires to electrodes attached to his chest and a cuff around his bicep that would inflate every 15 minnutes... caused him huge embarrassment because he had to wear it at work, and then (ironically) he found out his Dad was in hospital, so the readings taken from it were... surprise, surprise, really high. His doctor then insisted he was at risk of stroke (he's only 31) and has been insisting he go on medication. Taking your bp at home is not a risk to your health (unless you put the around your neck!!!). If you accurately record the time, date, and circumstances of each record, it will provide a valuable profile of your bp over the period of a day, week or month. You should be aware of how your bp changes naturally, i.e. rises after a meal, higher when standing than sitting or lying down, higher when excited, sexually stimulated, or anxious, lower when listening to quiet music or reading (depending on what you are reading of course!). So take your health into your own hands. Find out what your bp is really doing before you are forced onto meds without adequate justification.
Good luck.