Everything You Need to Know About Blood Pressure

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

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.

But chronic high blood pressure dramatically increases the risk of heart disease, strokes and heart attacks, as well as cognitive decline and dementia.

Men and women with hypertension die five years earlier than people with healthy blood pressure, on average.

This article looks at what blood pressure is, how to measure it and what healthy and unhealthy ranges are.

It then looks at the health risks associated with high blood pressure and the four steps you can take immediately to bring down your blood pressure to healthier levels.

 

What Is Blood Pressure?

Blood pressure is an indication of how hard the heart is working to pump blood through the arteries. It is one of the body’s four vital signs.

The other vital signs are:

  1. Body temperature
  2. Heart rate
  3. Breathing rate

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

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).

Regular checks are important to monitor your blood pressure.

 

What Defines ‘Normal’ or ‘High’ 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 the flow of blood and oxygen 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 [14]. 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. [15]

 

Why Track Blood Pressure?

High blood pressure greatly 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.

If you are worried about high blood pressure readings, always consult a medical professional.

 

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. Blood pressure readings fall under four main classifications.

As you can see from the blood pressure chart below, 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:

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

 

What Are The Risks Of High Blood Pressure?

High blood pressure is such a problematic issue because most people often do not experience obvious symptoms. As many as one in three individuals do not even know that they have high blood pressure[3]. Health consequences that can stem from hypertension include:

1. Cardiovascular Disease

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[4].

2. Cognitive decline and 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[5]. Equally, research shows that hypertension can increase your risk for cognitive impairment by 40%[6].

3. Menopause (in women)

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. A shorter lifespan

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[7].

Poor diet and lifestyle contribute to high blood pressure.

 

How Can You Reduce Your Blood Pressure?

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

1. Achieve a healthy weight and body composition.

Obesity is a major cause of hypertension and accounts for around 65-75% of the risk profile for high blood pressure[8]. Research shows that if you’re obese, losing 5-10% of your body weight can reduce your risk for hypertension by 65%[9].

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. Refocus your nutrition.

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[10].

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. Prioritise good quality sleep.

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)[11].

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. Get moving.

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 4 mmHg[12]. Additionally, performing high-intensity exercise, such as resistance training, three days a week can reduce your blood pressure by 11 mmHg[13].

Cardiologist Tanvir’s weight loss helped him bring his blood pressure and blood sugar down to healthy levels again.

 

Key Takeaways

  • 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.

 

With hypertension reaching epidemic proportions across the globe, nearly half of all adults in the US alone have high blood pressure. Here are 5 science-backed solutions to help reduce high blood pressure.

 

References

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

[2] 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].

[3] Wall, H., Hannan, J. and Wright, J. (2014). Patients With Undiagnosed Hypertension. JAMA, 312(19).

[4] 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.

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

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

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

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

[9] 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).

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

[11] 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).

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

[13] 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).

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

[15] 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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