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High blood pressure (Hypertension)

ABCMD definition of Hypertension: When the pressures inside your blood vessels are higher than they should be.

What is blood pressure (what do those numbers mean anyway?)

Beginning at the age of 3, blood pressure should be measured on a routine basis whenever you head into your doctor’s office. Doctors will measure your blood pressure with a device called a sphygomometer. This is just a big, fancy word for a blood pressure cuff, or better yet the thing they inflate around your arm when they are listening to the blood vessels at your elbow. After doctors and nurses perform this exam they will tell you a set of two numbers, “120 over 80.” The first number is what we call a systolic pressure and the second number is a diastolic pressure. A systolic pressure (the bigger of the two) tells you and your doctor what the pressure is inside all of your blood vessels when your heart is actually in the act of pumping blood to the body. The diastolic pressure, on the other hand, tells you what the pressure is when your heart is in-between beats and is at rest.

What is a normal blood pressure?
Less than 120/80 mm Hg is considered normal

What defines Hypertension (High blood pressure)?

In order to be diagnosed with high blood pressure, you must have three separate measurements, on three separate occasions, that are greater than 140/90 (except in pregnancy, when you do not need the three different visits and measurements.)

On a side note, you may also have “isolated systolic hypertension”, or in other words only have too high of blood pressures in your blood vessels when your heart is beating. For example 150 over 70. Here your systolic pressures are high and your diastolic pressures are just fine. In these cases patients are often treated the same as if both numbers were too high.

Doctors are not worried about just those people with blood pressures greater than 140/90. In fact most doctors begin recommending treatments once blood pressures are elevated above the ideal/normal of 120/80. These patients with blood pressures above normal, but still below the cut-off for “high blood pressure” are labeled as pre-hypertensive, meaning they should be watched closely for developing high blood pressure in the near future and should begin to make lifestyle changes including weight loss, decreased alcohol consumption, stopping smoking, decreased salt intake, increased exercise, etc. These changes alone, if done with consistency can often prevent development of true high blood pressure and can avoid the patient having to start taking medication to lower blood pressures.
Classification of high blood pressure

Doctors like to classify how severe everything is, as I am sure you know. High blood pressure is no different. Often time your treatment will be affected by how severe your blood pressure is.

Less than 120/80 is normal
120-139/80-89 is called pre-hypertensive
140-159/90/99 is called stage 1 hypertension
Greater than 160/greater than 100 is stage 2 hypertension
Greater than 200/greater than 120 is an emergency

High blood pressure can also be “essential” or “secondary.” 95% of patients with high blood pressure have what we call essential. The word essential is really a terrible name for this common form as it is not essential for anything. For your case, all you need to know is that essential is the most common form, while secondary means the high blood pressure is being caused by another problem in your body such as kidney disease, medication use (birth control pills are a big culprit in young women), Cushing’s syndrome, etc.

Why is high blood pressure bad for you

High blood pressure is the most important risk factor for strokes! Along with lowering your chance of having a stroke by treating high blood pressure you also can help prevent heart disease, heart attacks, kidney failure, and plaque formation in your arteries (the blood vessels that carry blood rich in oxygen all over your body).

Treatment for high blood pressure

High blood pressure is first treated by lifestyle changes, especially those already mentioned including: weight loss, decreased alcohol consumption, stopping smoking, decreased salt intake, increased exercise, etc. Doctors often give this a try, but if the changes do not work or you have a hard time making these changes medications are the next line of treatment.

To read about your specific blood pressure medication, see our medications link.

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