Ask the doctor
Show A. This question comes up often, perhaps because doctors and patients alike tend to pay more attention to the top (first) number, known as systolic pressure. It reflects the amount of pressure inside the arteries as the heart contracts. The bottom (second) number, diastolic pressure, is always lower since it reflects the pressure inside the arteries during the resting phase between heartbeats. As it turns out, both systolic and diastolic blood pressure are important. Per the most recent guidelines, you have what's called elevated blood pressure if your systolic blood pressure reading is 120 to 129 mm Hg (which stands for millimeters of mercury). Once your systolic reading reaches 130 or higher or your diastolic reading is 80 or higher, you're considered to have high blood pressure, or hypertension. Most people have what's known as essential or primary hypertension, which means it's not caused by a medical condition, medication, or substance. Primary hypertension can affect both systolic and diastolic pressure to a similar degree. But sometimes, especially in older people, it affects mainly the systolic pressure; this is called isolated systolic hypertension. Why does this happen? As you age, your arteries tend to become less elastic and less able to accommodate surges of blood. Blood flowing through your arteries at high pressure can damage the inner lining of these vessels, accelerating the buildup of cholesterol-laden plaque. This further stiffens and narrows the arteries, a condition known as atherosclerosis. Because the same volume of blood has to pass through a smaller area, the systolic pressure tends to rise, while the diastolic pressure remains the same or gradually falls over time. In some people with isolated systolic hypertension, the diastolic pressure reading may drop into the 50s or even the 40s. Most studies show a greater risk of cardiovascular disease (especially strokes) related to high systolic pressure as opposed to elevated diastolic pressure. But in 2019, an eight-year-long study involving more than 1.3 million adults found that while elevated systolic pressure had a greater effect on cardiac outcomes, high diastolic readings also affected a person's risk, regardless of the systolic reading. To ensure accurate readings when you're checking your blood pressure at home, be sure to sit comfortably with your back supported, your feet flat on the floor, and your arm resting on a table with your palm facing up. If needed, support your arm with a pillow so that your elbow is at the level of your heart. — Deepak L. Bhatt, M.D., M.P.H. Image: © Vadim Zhakupov/Getty Images You likely already know that your blood pressure is important, and that it can affect your health in many ways. But what exactly is a healthy blood pressure reading, and what do your blood pressure numbers mean? In this article, we’ll explain what’s considered normal, elevated, and high blood pressure, and what that means for you and your health. When a healthcare professional takes your blood pressure, it’s expressed as a measurement with two numbers, one number on top (systolic) and one on the bottom (diastolic), like a fraction. For example, 120/80 mm Hg. Blood pressure is measured in millimeters of mercury. That’s what the mm/Hg stands for. Here’s what the numbers mean:
Both numbers are important in determining the state of your heart health. Numbers greater than the ideal range may be a sign that your heart is working too hard to pump blood to the rest of your body. For a normal reading, your blood pressure needs to show:
The American Heart Association (AHA) considers blood pressure to be within the normal range when both your systolic and diastolic numbers are in these ranges. If you’re in the normal range, no medical intervention is needed. However, it’s important to maintain a healthy lifestyle and moderate weight to help prevent high blood pressure from developing. You may need to be even more mindful of your lifestyle if high blood pressure runs in your family. Normal blood pressure Blood pressure numbers that are higher than 120/80 mm Hg are a warning sign. It means you need to pay attention to your blood pressure and focus on heart-healthy habits. Although these numbers aren’t technically considered high blood pressure, you’ve moved out of the normal range. Elevated blood pressure may turn into high blood pressure, which puts you at an increased risk of heart disease and stroke. Elevated blood pressure No medications are necessary for elevated blood pressure. But your doctor may talk with you about the importance of a healthy lifestyle, such as getting regular exercise, eating a balanced diet, and managing your weight. You may receive a diagnosis of stage 1 hypertension (the medical term for high blood pressure) if:
However, the AHA notes that if you get only one reading this high, you may not truly have stage 1 hypertension. What determines the diagnosis of hypertension at any stage is the average of your blood pressure numbers over a period of time. Your doctor can help you measure and track your blood pressure to confirm whether it’s too high. Stage 1 hypertension If you’re at lower risk, your doctor may want to follow up in 3 to 6 months after you’ve adopted healthier habits. If you’re 65 years or older and otherwise healthy, your doctor will likely recommend treatment and lifestyle changes once your systolic blood pressure is greater than 130 mm Hg. The treatment for adults 65 and older who have significant health problems should be made on a case-by-case basis. Treating high blood pressure in older adults appears to decrease memory problems and dementia. Stage 2 hypertension indicates a more serious condition. You may receive a diagnosis of stage 2 hypertension if:
At this stage, your doctor will recommend one or more medications to manage your blood pressure. Medications aren’t the only treatment for this stage, though. Lifestyle habits are just as important in stage 2 hypertension as they are in the other stages. Stage 2 hypertension A blood pressure reading above 180/120 mm Hg indicates a serious health problem. The AHA refers to these high measurements as a “hypertensive crisis.” Blood pressure in this range requires urgent treatment, even if there are no accompanying symptoms. Seek emergency medical treatment if you have blood pressure in this range. You may also have symptoms such as:
However, sometimes a high reading can occur temporarily, and then your numbers will return to normal. If your blood pressure measures at this level, your doctor will likely take a second reading after a few minutes. If your second blood pressure reading is also above 180/120 mm Hg, you’ll need immediate treatment. Hypertensive crisisShare on Pinterest Treatment for hypertension depends on how high your blood pressure is, as well as your lifestyle and risk factors. For elevated blood pressure, the goal is to keep your blood pressure from developing into clinical hypertension. No medications are necessary at this stage. Your doctor may recommend:
For stage 1 hypertension, your doctor may recommend lifestyle changes as mentioned above, as well as:
For stage 2 hypertension, the typical treatment, in addition to a healthier lifestyle, is medication. Your doctor may prescribe one or more of the following medications to help lower your blood pressure:
A hypertensive crisis requires immediate treatment. Medications may be given orally or intravenously (through an IV). The most commonly used medications for a hypertensive crisis include:
If your blood pressure is in the hypertensive crisis range and you also have kidney failure, the following medications may be prescribed:
Even if you have healthy blood pressure numbers, it’s important to take preventive measures to keep your blood pressure within a normal range. This can help lower your risk of developing hypertension, heart disease, and other complications of high blood pressure. As you age, prevention becomes even more important. Systolic pressure tends to creep up once you’re older than 50, and it’s far more important in predicting the risk of coronary heart disease and other conditions. The following preventive measures may help lower or reduce your risk of developing high blood pressure:
Untreated or poorly managed high blood pressure can cause serious and even life threatening issues. It can damage your blood vessels as well as your organs. The longer your hypertension goes untreated, the more it can damage your body and affect your health. Potential complications of high blood pressure include:
Low blood pressure is known as hypotension. In adults, a blood pressure reading of 90/60 mm Hg or below is often considered hypotension. Hypotension can be dangerous because blood pressure that’s too low doesn’t supply your body and heart with enough oxygenated blood. Some potential causes of hypotension can include:
Hypotension is usually accompanied by lightheadedness or dizziness. Talk with your doctor to find out the cause of your low blood pressure and what you can do to raise it. Keeping your blood pressure within a normal range is key to preventing complications, such as heart disease and stroke. A combination of healthy lifestyle habits and medications can help lower your blood pressure. If you have overweight or obesity, weight loss is also important in keeping your blood pressure numbers down. Remember that a single blood pressure reading doesn’t necessarily classify your health. An average of blood pressure readings taken over time is the most accurate. That’s why it’s important to have your blood pressure taken by a healthcare professional at least once a year. You may need more frequent follow-ups if your readings are consistently elevated. When should you worry about the bottom number of blood pressure?Over time, isolated diastolic hypotension can cause heart failure. In fact, it may be one of the most common causes of heart failure. Pay attention to your diastolic number when you have your blood pressure checked. If your lower number is 60 or below, ask a healthcare professional about it.
What causes the diastolic to be high?Those factors include diabetes, kidney disease, obesity, smoking, hardening of the arteries (atherosclerosis), or a history of heart disease or a heart attack.
Which is worse in high blood pressure top or bottom number?Over the years, research has found that both numbers are equally important in monitoring heart health. However, most studies show a greater risk of stroke and heart disease related to higher systolic pressures compared with elevated diastolic pressures.
How can I lower the bottom number of my blood pressure?Diastolic blood pressure that's too low can lead to heart damage and may increase your risk for heart disease.. Focus on heart-healthy foods. ... . Limit saturated and trans fats. ... . Reduce sodium in your diet. ... . Eat more potassium. ... . Lay off the caffeine. ... . Cut back on alcohol.. |
What does high bottom number on blood pressure mean
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