Understanding What Your Blood Pressure Readings Actually Mean — And How to Manage Your BP for Better HealthHealthChampion | 06.16.2021
Understanding What Your Blood Pressure Readings Actually Mean — And How to Manage Your BP for Better HealthChecking your blood pressure is a required part of every check-up with your primary physician, as well as visits to the ER or urgent care. And if you have to stay in the hospital, you can expect your attending nursing staff to routinely check your blood pressure, as well as other vitals. The nurse or physician checking your blood pressure will often mention your blood pressure as two numbers, such as “110 over 80.” Sometimes, they may even throw in a head shake or disapproving look, letting you know that your readings are high. When that happens, you can probably expect at least a discussion about your hypertension. But your healthcare provider will rarely explain what those numbers mean.
What is a blood pressure measurement and what does it mean?The quick answer is that blood pressure measures the force in your arteries as the heart beats. Specifically, it measures the pressure that your blood applies to your arteries’ walls during two major stages of the cardiac cycle. Remember that the heart is a pump that sends oxygenated blood to our tissues and organs. When the heart relaxes, it gathers blood to send to the rest of your body. When the heart contracts, that oxygen-carrying blood is then pushed out to your tissues and organs, putting additional pressure on the arteries carrying that blood. And for additional context, the average human heart beats about 60 to 100 times per minute. Your circulatory system maintains pressure on your arteries even during the split second the heart is at rest. This is why two numbers are provided whenever you have your blood pressure measured. These two readings measure your blood pressure in two different stages – when your heart is pumping and when it’s at rest.
Systolic vs. DiastolicTwo types of blood pressure reading are systolic and diastolic:
- Systolic. The top number in your blood pressure measurement is the systolic.
- It comes from the Greek word systole, which means to contract (as in your heart contracting to push out blood through your arteries). The systolic measures the pressure inside your arteries when the heart beats.
- For most adults, a normal systolic reading is under 120.
- Diastolic. The bottom number in your blood pressure measurement is the diastolic.
- It comes from the Greek word diastole, which means to draw asunder or dilation. The diastolic measures the pressure inside your arteries when the heart is at rest between beats.
- For most adults, a normal systolic reading is under 80.
|Category||Systolic (Top Number, pumping)||Connection||Diastolic (Bottom Number, not-pumping)|
How is blood pressure measured?There are several types of blood pressure measuring devices in popular use today:
- Sphygmomanometer: A Sphygmomanometer is the traditional rubber cuff found in most Doctors offices. This cuff is placed on your upper arm and secured in place. A hand inflation bulb is used to inflate to cuff, causing the circulation in your arm to be blocked. A stethoscope is used to hear the arterial blood flow as the cuff is slowly deflated.
- Electronic Digital Arm Cuff: The electronic digital arm cuff works in the same way as the traditional sphygmomanometer but uses an electronic monitor to capture the arterial pressure changes translating them into the systolic and diastolic readings.
- Electronic Wrist Cuff: The electronic wrist cuff works the same way as the electronic digital arm cuff except is wrapped around the wrist. This device is the easiest to use but also requires following the wrist positioning guidelines from the manufacturer or it will give a false reading.
- That initial pressure measurement on the sphygmomanometer, expressed as millimeters (mm) of mercury (Hg), is your systolic pressure reading.
- Once the sound of your release blood pressure fades, your caregiver or blood pressure device then uses the second (lower) sphygmomanometer reading as your diastolic pressure reading.
What does high blood pressure mean?Let’s start by defining what it means to be hypertensive or be diagnosed with high blood pressure. Hypertension is typically diagnosed by two straight high blood pressure readings on two separate days. To be diagnosed with high blood pressure these two readings must both range from a systolic reading of 130 or greater and/or a diastolic reading of 80 or greater. Unfortunately, high blood pressure doesn’t often cause clear symptoms for most people considered hypertensive. High blood pressure may sometimes cause headaches, shortness of breath, dizziness or other symptoms.
How should you manage high blood pressure?The most prevalent strategies for lowering your blood pressure prior to medications are diet, weight loss, lifestyle modifications (alcohol use and smoking), stress management and increasing your activity. When blood pressure is elevated the first step in managing it will be diet. Eating a diet low in fat and low in salt will help reduce your blood pressure. Weight also contributes to high blood pressure. If you are overweight, losing weight (even just 5 or 10 pounds) with a healthy diet will help to reduce blood pressure. If you regularly drink alcohol or smoke cigarettes, reducing these habits or quitting will help to reduce your blood pressure. Stress has also been found to impact many people’s blood pressure. Reducing stress or learning how to manage stress will help to lower blood pressure. Another proactive step for controlling hypertension is exercise and activity. Increasing your activity level can have significant impact on lowering or managing your blood pressure. Medication is the last line of treatment for high blood pressure. There are many different types of medications used for lowering blood pressure. These medications are broken into classes by how they work to reduce your blood pressure. If medication is needed your doctor will identify the appropriate medication for you. But it’s important to note that hypertension medication doesn’t eliminate the need to change your lifestyle.
What does low blood pressure mean?Low blood pressure is a systolic lower than 90 and/ or diastolic lower than 60. While lower blood pressure is often desired, symptoms will develop if your blood pressure becomes too low. In some occasions, low blood pressure can even be life threatening. Symptoms of low blood pressure can be dizziness, lightheadedness (especially when standing up), fainting, blurred vision, nausea, fatigue and lack of concentration. Causes of low blood pressure could be a new medical condition (such as an infection) or medication related.
How do you manage low blood pressure?Low blood pressure without symptoms may not need to be managed. Often your physician or therapist will review your lifestyle, weight and diet to ensure your body is healthy and that low blood pressure will not cause any issues. Low blood pressure with symptoms should always be managed by a physician.
- Chobanian AV, Bakris GL, Black, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA2003;289(19):2560–72.
- Chopra, H.K., Venkata, C., Ram, S. Recent Guidelines for Hypertension. https://doi.org/10.1161/CIRCRESAHA.119.314789
- Collins, Francis. High Blood Pressure: A Global Threat. National Institutes of Health; April 4, 2013. https://directorsblog.nih.gov/2013/04/04/high-blood-pressure-a-global-health-threat/
- Illiades, Chris, MD. How Is Blood Pressure Measured and What Do the Numbers Mean? Everyday Health; November 24, 2009. https://www.everydayhealth.com/hypertension/understanding/what-does-blood-pressure-measure.aspx
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- Lawrence, Leah. The mercury sphygmomanometer: End of an era? Healio; March 1, 2011 https://www.healio.com/news/endocrinology/20120325/the-mercury-sphygmomanometer-end-of-an-era
- Vermont Department of Health. HPDP-AHA Blood Pressure Chart. https://www.healthvermont.gov/file/hpdpaha-blood-pressure-chartjpg-0