Your Blood Pressure: What’s It Telling You?

By Dr. Priya Sammani ( MBBS, DFM )

I see it often in my clinic. Someone comes in, feeling perfectly fine, maybe for a routine check-up. We wrap the cuff around their arm, take a reading, and then… the numbers are a bit higher than we’d like. “But I feel okay, Doctor!” is a common, and totally understandable, reaction. That’s the tricky thing about blood pressure; it doesn’t always send out warning signals. Let’s talk about what those numbers really mean for you.

What Exactly Is Blood Pressure?

Think of your arteries as a network of highways delivering vital supplies – oxygen and nutrients – all over your body. Your heart is the powerful pump, sending blood through these highways with every beat. Blood pressure is simply the measure of the force of that blood pushing against the walls of your arteries. This happens constantly, about 60 to 100 times a minute, day in and day out.

Now, you might hear “heart rate” and “blood pressure” used together, but they’re different. Your heart rate is just how fast your heart is beating. Your blood pressure is about the power behind each push of blood. Just because your heart is beating faster doesn’t automatically mean your blood pressure is up too. The only way to truly know your blood pressure is to measure it.

Why Those Numbers Go Up and Down

Your blood pressure isn’t a static thing; it’s a bit of a chameleon. It changes based on what you’re doing, thinking, and feeling.

  • Exercising or feeling a surge of excitement? Your blood pressure will likely go up.
  • Resting quietly, maybe reading a book? It’ll be lower.

Other things can make it shift too, like:

  • Your age.
  • Medications you might be taking.
  • Even just changing your position, like standing up quickly.

Why Keeping an Eye on Your Blood Pressure Is So Important

High blood pressure often gets called the “silent killer,” and for good reason. It usually doesn’t have obvious symptoms in the early stages. This means it can be quietly causing damage to your heart, kidneys, and even your brain before you realize anything is amiss.

Consistently high blood pressure is a big risk factor for heart and blood vessel problems. If it’s not managed, it can lead to some serious issues down the line, such as:

  • A transient ischemic attack (TIA), sometimes called a “mini-stroke.”
  • A full stroke.
  • Heart attack.
  • An enlarged heart or heart failure.
  • Peripheral artery disease, which can cause pain and poor circulation, especially in your legs.
  • Aneurysms (bulges in artery walls).
  • Kidney disease.
  • Damage to the tiny blood vessels in your eyes.

Who’s More Likely to Deal with High Blood Pressure?

Some folks have a higher chance of developing high blood pressure. Your risk might be increased if you:

  • Have a family history of high blood pressure, heart disease, or diabetes.
  • Are of Black ethnicity.
  • Are age 60 or older.
  • Have high cholesterol.
  • Use oral contraceptives (birth control pills).
  • Are carrying extra weight (obesity).
  • Have diabetes.
  • Use tobacco products (smoking or vaping).
  • Don’t get much physical activity.
  • Eat a diet that’s heavy on salt.

Getting Your Blood Pressure Checked

We should check your blood pressure at least once a year during your regular check-up if your numbers are usually normal. If we see that your readings are creeping up, or if they’re already high, I’ll likely ask you to monitor it more closely. This might mean checking it at home, sometimes a few times a day, other times maybe once a week.

The key with home monitoring is consistency. Try to take your readings around the same time each day. It’s a good idea to take two or three readings, about a minute apart, and then average them out. Sometimes, if we need a really detailed picture, I might suggest a 24-hour ambulatory blood pressure monitor. You’d wear a small device that automatically takes readings every 15 to 30 minutes while you go about your normal day.

Getting Ready for a Reading

To get the most accurate reading, there are a few simple things you can do:

  • Hold off on smoking, exercising, or having caffeine for at least 30 minutes before the measurement.
  • Pop to the loo first – a full bladder can actually nudge your numbers up a bit.
  • Roll up your sleeve so the cuff is on your bare arm.
  • Sit quietly for about five minutes beforehand. No chatting!
  • Sit up straight, with your feet flat on the floor (no crossed legs, please!).
  • Rest your arm on a table so it’s about level with your heart.

How We Measure It

You’ll feel a cuff wrap around your upper arm. We then inflate it, which feels like a tight squeeze for a moment. This briefly stops the blood flow in the main artery of your arm (the brachial artery). As we slowly release the air from the cuff, I’ll be listening with a stethoscope.

The first sound I hear as the blood starts flowing again gives us the systolic pressure (that’s the top number). The point where the sound disappears as the cuff deflates further gives us the diastolic pressure (the bottom number). These days, many automatic machines do this very effectively too.

Sometimes, people get a bit anxious at the doctor’s office – we call it “white coat syndrome” – and their blood pressure might be higher than it normally is. If I suspect this, home monitoring is a great way to see what your numbers look like in your usual environment.

The actual measurement is quick and generally painless. That tight squeeze from the cuff only lasts a few seconds.

Understanding Your Blood Pressure Results

So, you get two numbers. For example, 120/80 mm Hg.

  • Systolic Blood Pressure (the top number): This is the pressure when your heart is actively beating and pushing blood out.
  • Diastolic Blood Pressure (the bottom number): This is the pressure when your heart is resting between beats.

We measure these in “millimeters of mercury” (mm Hg), a historical term from when older devices used mercury.

What Do the Numbers Mean?

Here’s a general guide:

  • Normal Blood Pressure: Less than 120 (systolic) AND less than 80 (diastolic). So, <120/<80 mm Hg.
  • Elevated Blood Pressure: Systolic between 120-129 AND diastolic less than 80. If you’re in this range, it’s a good nudge to start making some healthy changes.
  • Stage 1 Hypertension (High Blood Pressure): Systolic between 130-139 OR diastolic between 80-89.
  • Stage 2 Hypertension (High Blood Pressure): Systolic 140 or higher OR diastolic 90 or higher.

If your numbers fall into Stage 1 or 2, we’ll definitely talk about lifestyle adjustments and possibly medication.

When Blood Pressure Is Dangerously High: Hypertensive Crisis

This is serious. If your top number ever hits 180 or higher AND/OR your bottom number hits 120 or higher, you need to get emergency medical help right away. Call for an ambulance or have someone take you to the hospital immediately.

During a hypertensive crisis, you might experience:

  • Shortness of breath
  • Chest pain
  • Trouble seeing or speaking
  • Pain in your back
  • Weakness or numbness

What About Low Blood Pressure?

A reading below 90/60 mm Hg is generally considered low blood pressure (hypotension). For some people, this is just their normal, and it doesn’t cause any problems. For others, it can mean not enough blood is getting to their vital organs, and they might feel dizzy, lightheaded, or faint.

Which Number Matters More?

Honestly, both numbers are important. We can diagnose high blood pressure based on either the top or bottom number being too high. However, for folks over 50, we often pay a bit more attention to the systolic (top) number as a risk factor for heart disease. This is because arteries tend to get stiffer and can accumulate plaque (fatty deposits) as we age, which can push that top number up.

You’ll know your reading right after the test. But, to diagnose high blood pressure, we usually need to see a pattern of high readings over a few different days. So, don’t be surprised if I ask you to come back for another check.

Managing High Blood Pressure: What We Can Do

If your blood pressure is high, please don’t panic. There’s so much we can do! Treatment usually starts with lifestyle changes, and sometimes, medication is also needed.

Lifestyle Adjustments – You Have Power Here!

  • Reach and maintain a healthy weight: Even losing a small amount of weight can make a big difference.
  • Get moving: Aim for regular physical activity. A brisk walk most days is a great start.
  • Eat a heart-healthy diet: Think lots of fresh fruits, vegetables, and whole grains. Cut back on salt, unhealthy fats, and cholesterol. The DASH (Dietary Approaches to Stop Hypertension) diet is excellent for this. I can refer you to a dietitian if you’d like personalized advice.
  • Limit alcohol: If you drink, do so in moderation. That generally means no more than one drink a day for women and lighter-weight men, and up to two for most men. (One drink = 12 oz beer, 5 oz wine, or 1.5 oz 80-proof spirits).
  • Manage stress and anger: Find healthy ways to cope with stress.
  • Avoid tobacco: If you smoke or use other nicotine products, quitting is one of the best things you can do for your blood pressure and overall health.
  • Keep other conditions in check: Managing things like high cholesterol, triglycerides, and diabetes is also key.

Medications and Follow-Up

  • Take medications as prescribed: If we decide medication is right for you, please take it exactly as we discussed. Don’t stop or change your dose without talking to me first. Blood pressure medicine doesn’t “cure” high blood pressure; it manages it while you’re taking it.
  • Be aware of OTC interactions: Some over-the-counter medicines, like certain decongestants, can interfere with blood pressure medications. Always check with me or your pharmacist.
  • Keep your follow-up appointments: These are really important so we can monitor how you’re doing, adjust medications if needed, and continue to support your heart health.

If I’ve asked you to track your blood pressure at home, please bring your log of readings to your appointments. It’s super helpful!

Key Takeaways on Blood Pressure

This is a lot of information, I know. So, let’s boil it down to the most important things to remember about your blood pressure:

  • Know Your Numbers: Regular checks are crucial, even if you feel fine.
  • Understand What’s Normal: Aim for less than 120/80 mm Hg.
  • High Blood Pressure is Serious but Manageable: It’s a major risk factor for heart disease and stroke, but lifestyle changes and medications can help.
  • Lifestyle Matters Immensely: Diet, exercise, weight management, and avoiding tobacco are powerful tools.
  • Seek Help for Very High Readings: A reading of 180/120 mm Hg or higher is a medical emergency.
  • Talk to Us: If your home readings are consistently off, or if you have any concerns, please reach out.

You’re not alone in figuring this out. We’re here to help you understand your blood pressure and take the best steps for your health.

Dr. Priya Sammani
Medically Reviewed by
MBBS, Postgraduate Diploma in Family Medicine
Dr. Priya Sammani is the founder of Priya.Health and Nirogi Lanka. She is dedicated to preventive medicine, chronic disease management, and making reliable health information accessible for everyone.
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