Blood pressure: Everything you need to know

There is a reason why hypertension is called the ‘silent killer’ – most people are not aware they have high blood pressure, or they do not have symptoms.

Chronic high blood pressure dramatically increases the risk of heart disease, strokes and heart attacks, cognitive decline and dementia.

On average, men and women with hypertension die five years earlier than people with healthy blood pressure [1].

Managing your blood pressure is critical for good health and longevity.

Read on to learn what high blood pressure is, how to measure it, the risks of high blood pressure and what you can do now to help bring down your blood pressure to healthier levels.

What is high blood pressure?

Your blood pressure indicates how hard your heart is working to pump blood through the arteries. It is one of the body’s four vital signs.

The other vital signs are:

  • Body temperature
  • Heart rate
  • Breathing rate

 

Vital signs demonstrate how well your body is functioning. If a vital sign is too high or low, this is a strong sign that something is wrong with your health.

high blood pressure

Two factors influence how high or low your blood pressure is:

  1. Cardiac output – the amount of blood pumped out of the heart into circulation each minute (your heart rate times by how much blood comes from your heart per pump).
  2. Systemic vascular resistance – the amount of resistance that blood must overcome to circulate (influenced primarily by the diameter of your blood vessels).

 

Therefore, regular checks are important to monitor your blood pressure.

Hypertension is the clinical diagnosis of high blood pressure, otherwise known as a ‘hemodynamic’ disorder. Through a combination of factors, blood pressure becomes elevated over time and creates disease. Hypertension is associated with many chronic diseases and is considered the number one overall risk factor for cardiovascular disease, the primary cause of death in the U.S.

Hypertension can cause severe damage to the heart, and excessive pressure can result in changes that restrict blood and oxygen flow throughout the body. Other risks associated with hypertension include chest pains (angina), heart attack, heart failure, stroke and kidney failure.

The World Health Organization reports that one in four men and one in five women worldwide are hypertensive. If trends continue, 1.56 billion people will be hypertensive by 2025 [2]. The total economic cost due to CVD disease in low- and medium-income countries reached an estimated $3.7 trillion between 2011 and 2015, accounting for half of all non-communicable diseases [3].

Male before and after weight loss

Gavin’s 48kg weight loss was motivated by family history of diabetes and hypertension.

 

Understanding your blood pressure readings

High blood pressure dramatically increases the risk and incidence of coronary heart disease, stroke, congestive heart failure, and end-stage renal disease. It is, therefore, an important indicator of general health.

 

Measuring blood pressure has several other advantages:

  • Provides important warning signs for training. If you are highly stressed and have high blood pressure, you may need to adapt training accordingly. By doing so, you may improve your gym progress.
  • Provides feedback on your lifestyle. If you lead a stressful lifestyle and have neglected exercise and diet, this increases your risk for high blood pressure.
  • Provides a valuable metric to measure your health alongside weight loss and exercise.

 

How do I take a blood pressure reading?

  • Using a blood pressure cuff, apply the cuff to your left arm or whichever arm your doctor uses typically.
  • Always use the same arm for blood pressure readings, as each arm will give you a slightly different reading.
  • Sit quietly for five minutes before the reading, preferably at a desk or table, with your arm resting on a firm surface and feet flat on the floor. Avoid drinking coffee and rushing about as this may cause a temporary rise in blood pressure.
  • Always take your blood pressure reading before working out.
  • Ensure the arm and wrist are supported, and the cuff around the wrist is at the same level as your heart using an armrest or table. Your arm should be relaxed, not tensed.
  • When taking the reading, ensure you keep still and do not talk. Moving and talking can affect the reading. Ensure you uncross your arms.
  • Take two or three readings, each about two minutes apart, then work out the average. The first reading may be much higher than the subsequent readings. If so, keep taking readings until they level out and stop falling, then use this as the reading.
blood pressure reading

Now you’ve got your results, you can compare the data.

Remember that only a qualified medical professional can diagnose hypertension. So, if your readings consistently demonstrate high blood pressure, visit your doctor for confirmation and further advice.

Chronically high blood pressure is the primary measure used to diagnose hypertension.

 

What defines ‘normal’ and ‘high’ blood pressure?

Blood pressure readings fall under four main classifications.

Only one of the numbers needs to be above or below the thresholds to count as high or low blood pressure:

  • 90 over 60 (90/60) or less: Indicates low blood pressure.
  • More than 90 over 60 (90/60) and less than 120 over 80 (120/80): the ideal and healthy range.
  • More than 120 over 80 and less than 140 over 90 (120/80-140/90): Normal blood pressure reading, but it is a little higher than it should be.
  • 140 over 90 (140/90) or higher (over several weeks): High blood pressure (hypertension).

So:

  • If the top number is 140 or more – this indicates high blood pressure, regardless of the bottom number.
  • If the bottom number is 90 or more – this indicates high blood pressure, regardless of the top number.
  • If the top number is 90 or less – this indicates low blood pressure, regardless of the bottom number.
  • If the bottom number is 60 or less – this indicates low blood pressure, regardless of the top number.
  • Always consult your doctor if your blood pressure readings consistently show as high.
high blood pressure reading

What are the risks of high blood pressure?

High blood pressure is a problematic issue because most people often do not experience symptoms. As many as one in three individuals do not even know that they have high blood pressure [4]. Health consequences that can stem from hypertension include:

 

1. High blood pressure is a key risk factor in cardiovascular disease.

One meta-analysis showed a 92% increase in the frequency of cardiovascular events (like stroke and heart attack) for people with hypertension [5].

 

2. High blood pressure can increase risks of dementia

Blood pressure plays a crucial role in your cognitive function, and high blood pressure can increase your likelihood of cognitive decline and dementia. People with high blood pressure in mid-life are four to five times more likely to develop dementia in later life [6]. Equally, research shows that hypertension can increase your risk for cognitive impairment by 40% [7].

 

3. High blood pressure is a risk during menopause

Estrogen plays a crucial role in vascular remodelling. When a woman’s reproductive system shuts down during menopause and estrogen production ceases, her risk for atherosclerosis (the build-up of plaque in blood vessels) and high blood pressure also increases. If you have a family history of cardiovascular disease or other heart conditions, discuss your options with your doctor.

 

4. High blood pressure can shorten your life span

Due to the negative health outcomes associated with high blood pressure, those with hypertension tend to die earlier. On average, hypertensive men and women live five years less than those with normal blood pressure [8].

male weight loss before and after

Richard loses 19kg to beat high blood pressure after 3 years on medication.

 

What are the symptoms of high blood pressure?

The worrying thing about high blood pressure and hypertension is that you may not know or have any indication that you have it unless it is very severe. The best way to determine if you have high blood pressure is to take regular measurements either at home or with your doctor. This is especially important if high blood pressure or hypertension runs in your family.

 

How can you reduce high blood pressure without medication?

Evidence shows that lifestyle changes are the cornerstone of success when it comes to reducing your blood pressure, including:

 

1. Achieving a healthy weight and body composition can improve high blood pressure

Obesity is a major cause of hypertension and accounts for around 65-75% of the risk profile for high blood pressure [9]. Research shows that if you’re obese, losing 5-10% of your body weight can reduce your risk for hypertension by 65%  [10].

If you’re concerned about your blood pressure and have weight to lose, create a calorie deficit through diet and exercise, and use resistance training as a tool to maintain your muscle mass.

 

2. Refocusing your nutrition can improve high blood pressure

Research shows that some diet components are beneficial for managing blood pressure in addition to weight loss. Increasing potassium intake and lowering sodium may reduce your blood pressure by as much as 8-9 mmHg [11].

Focusing your diet on minimally processed foods (often high in sodium) with plenty of fruits, vegetables, and grains (all high in potassium) will help support healthy blood pressure.

 

3. Prioritising good quality sleep can improve high blood pressure

Evidence demonstrates clear links between sleep and blood pressure. A 2018 study showed that men sleeping for five hours were over 50% more likely to have high blood pressure (compared to men who slept seven hours or more) [12].

For most people, seven to nine hours per night is a good benchmark. If sleep is an issue for you, make sure to incorporate good sleep hygiene, like putting away light-emitting devices an hour before sleep, keeping your room cool and dark, and avoiding stimulants like coffee and nicotine in the hours before bed.

 

4. Exercising and staying active can improve high blood pressure

Your exercise and activity levels directly influence your risk of high blood pressure. Research shows that for those who are generally inactive (performing fewer than 1,000 steps each day), even 2,000 additional steps each day can lower your blood pressure by four mmHg [13]. Additionally, performing high-intensity exercise, such as resistance training, three days a week can reduce your blood pressure by 11 mmHg [14].

female hack squat

What about low blood pressure (hypotension)?

A blood pressure reading lower than 90 mm systolic or 60 mm Hg diastolic is generally considered low blood pressure. What is considered low blood pressure for you may be a normal blood pressure for someone else. This is why it is important to see your doctor if you have any symptoms to rule out any underlying health conditions [15].

Conditions and circumstances that can cause low blood pressure include:

  • Age
  • Medications
  • Certain diseases (Parkinson’s, diabetes)
  • Pregnancy
  • Heart problems
  • Dehydration
  • Blood loss
  • Severe infection (septicaemia)
  • Severe allergic reaction (anaphylaxis)
  • Lack of nutrients in your diet (anaemia)

 

How can you improve symptoms of low blood pressure?

There are some lifestyle changes you can make to help reduce symptoms of low blood pressure, but this of course depends on the underlying reasons.

Drinking more water to stay hydrated and increase blood flow will help to improve low blood pressure symptoms.

Avoid sitting in positions that constrict blood flow such as crossing your legs.

Consider eating smaller meals more frequently throughout the day to help prevent blood pressure dropping rapidly after meals.

Resistance training two to three days week to elevate your heart rate.

If you don’t already do so, make sure to include a balance of sodium (salt) and potassium (found in potatoes, bananas, pulses) in your diet as this will help regulate blood pressure. Alternatively, add a serving of Amplify which contains electrolytes.

 

Key takeaways on blood pressure

  • Blood pressure is one of the body’s four vital signs, which indicates how hard the heart is working.
  • Hypertension is the clinical term for high blood pressure, which can result in chronic disease long term.
  • Monitoring blood pressure provides vital feedback about health alongside dietary and lifestyle changes.
  • A healthy blood pressure reading is around 120 (systolic) over 80 (diastolic), and if you register as having high blood pressure, you should refer to your doctor.
  • High blood pressure increases the risk of cardiovascular disease, cognitive decline, and decreased lifespan.
  • Lifestyle and behaviour changes are the two main ways you can lower your blood pressure, in conjunction with weight loss.
  • The vast majority of people know very little about blood pressure or the potentially grave impacts on long-term health.

 

We have answered the 15 most common questions people have about blood pressure so you can take back control of your health.

 

References

[1] Franco, O., et al. (2005). Blood Pressure in Adulthood and Life Expectancy With Cardiovascular Disease in Men and Women. Hypertension, 46(2).

[2] The World Health Organization (2020). Hypertension fact sheet. https://www.who.int/news-room/fact-sheets/detail/hypertension [Last accessed 1 September 2020].

[3] The World Health Organization (2020). The top 10 causes of death. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death [Last accessed 8 September 2020].

[4] Wall, H., Hannan, J. and Wright, J. (2014). Patients with undiagnosed hypertension. JAMA, 312(19).

[5] Luo, D., et al. (2020). Association between high blood pressure and long-term cardiovascular events in young adults: systematic review and meta-analysis. BMJ, 370.

[6] Launer, L., et al. (2000). Midlife blood pressure and dementia: the Honolulu–Asia ageing study. Neurobiology of Aging, 21(1).

[7] Reitz, C., et al. (2007). Hypertension and the Risk of Mild Cognitive Impairment. Archives of Neurology, 64(12).

[8] Franco, O., et al. (2005). Blood Pressure in Adulthood and Life Expectancy With Cardiovascular Disease in Men and Women. Hypertension, 46(2).

[9] Hall, J., et al. (2015). Obesity-Induced Hypertension. Circulation Research, 116(6)

[10] Stevens, V.J. et al. (2001). Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Journal of Cardiopulmonary Rehabilitation, 21(3).

[11] Iqbal, S., Klammer, N. and Ekmekcioglu, C. (2019). The Effect of Electrolytes on Blood Pressure: A Brief Summary of Meta-Analyses. Nutrients, 11(6).

[12] Grandner, M., et al. (2018). Sleep Duration and Hypertension: Analysis of > 700,000 Adults by Age and Sex. Journal of Clinical Sleep Medicine, 14(6).

[13] Gangwisch, J. (2014). A Review of Evidence for the Link Between Sleep Duration and Hypertension. American Journal of Hypertension, 27(10).

[14] Börjesson, M., et al. (2016). Physical activity and exercise lower blood pressure in individuals with hypertension: a narrative review of 27 RCTs. British Journal of Sports Medicine, 50(6).

[15] Low blood pressure. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/low-blood-pressure. Accessed Feb. 27, 2020.

[16] Chockalingam, A., et al. (2006). Worldwide epidemic of hypertension. The Canadian Journal of Cardiology, 22 (7), pp. 553–555.

[17] Gheorghe, A., et al. (2018). The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review. BMC Public Health,.18, 975.

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