How high is your blood pressure?

Hypertension is a global issue that affects around 1.13 billion people. It is a chronic modern disease characterised by two sets of values. The first value, i.e. systolic blood pressure, tells you how high the pressure is in your veins when the heart muscle contracts, while the second value, i.e. diastolic blood pressure, tells you how high the pressure is when your heart muscle relaxes.

How high is too high?

Optimal values are when both systolic and diastolic values are below 120/80 mm Hg. If one or both values are above 140/90 mm Hg, we are talking about hypertension.

DEFINITION AND CLASSIFICATION OF BLOOD PRESSURE VALUES

Classification	Systolic blood pressure, mm Hg		Diastolic blood pressure, mm Hg
Optimal	< 120	and	< 80
Normal	120–129	and/or	80–84
Normal in the upper range	130–139	and/or	85–89
Stage 1 hypertension	140– 159	and/or	90–99
Stage 2 hypertension	160–179	and/or	100–109
Stage 3 hypertension	≥ 180	and/or	≥ 110
Isolated systolic hypertension	≥ 140	and	< 90

The risk of cardiovascular disease doubles with each increase by 20/10 mm, starting with 115/75 mm Hg.

What causes elevated blood pressure?

Hypertension does not affect just the elderly, though it is true that veins become weaker with age, which increases the likelihood of its occurrence. Hypertension is also affecting more and more young people due to the modern lifestyle.

In addition to physical inactivity, stress, obesity and high salt intake, the main risk factors include a family history of hypertension and concomitant kidney disease or diabetes. However, the real cause of hypertension is most often hidden.

Even mildly elevated values should not be ignored

Most patients have ‘only’ mildly elevated blood pressure, or stage 1 hypertension, which puts as many as 74% of hypertensive patients at risk. If left untreated, hypertension can lead to serious consequences. In fact, damage to target organs (blood vessels, heart, brain, kidneys, eyes), which makes hypertension a major risk factor for cardiovascular morbidity and mortality, already takes place in stage 1 hypertension.

Timely treatment of small increases in blood pressure can prevent organ damage and the subsequent development of more severe forms of the disease.

Do your values differ if you measure them at home or at the doctor’s office?

Elevated blood pressure due to fear of the doctor, or so-called white coat hypertension, is not just a myth – it is an important obstacle as well. It is estimated that 15-25% of people have a falsely high blood pressure measured at the doctor’s office, whereas their blood pressure measured at home, i.e. in everyday circumstances, is normal.

Monitoring blood pressure at home can also help with the reverse phenomenon, i.e. when it turns out that the values measured at home are elevated, though when the doctor measured them they seemed just fine. This phenomenon is called masked hypertension and affects around 10-20% of people. Since patients with masked hypertension are difficult to detect, many go untreated, increasing their risk of cardiovascular complications.

False readings can also be obtained if a person talks, stands, holds their arm in an incorrect position, is drunk, cold or wears a cuff that is too tight while their blood pressure is taken.

To avoid false readings it is essential to conduct proper measurements and repeat them several times. To confirm the diagnosis, it is advisable to combine the measurements at the doctor’s office with the measurements at home or with 24-hour continuous measurements.

What should I do in case of elevated values?

Hypertension can be prevented or alleviated with a healthy lifestyle. Regular physical exercise, normal body weight, reduced intake of salt, fat and alcohol, no smoking, reduced exposure to stress, and eating plenty of fruit and vegetables may help to lower blood pressure, and in many cases even return it to normal levels. Often (depending on how high blood pressure is and other risk factors), in addition to a healthy lifestyle, it is also necessary to take medications to lower blood pressure.

References

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