Relieving the Pressure of Hypertension: Knowing and Understanding Your Blood Pressure

There are many discussions in the medical community about whether hypertension (HTN), or high blood pressure, has signs and symptoms. Hypertension is often referred to as the “silent killer,” so the definitive conclusion is the only way to know if your blood pressure is high is to know your numbers. 

The American Heart Association reports that despite modern therapies, hypertension remains the major cause of ischemic heart disease, heart failure, stroke, chronic kidney disease, and vascular dementia. With aging populations, complex comorbidities like COVID-19, and the increasing challenges regarding hypertension control in the United States and elsewhere, it is imperative to be aware of your blood pressure, speak with your health care provider, and take the necessary measures to assist in controlling the disease and prevent further health conditions.  

If you have been diagnosed with hypertension, you are not alone! This article is the second in a series that will focus on explaining how our cardiovascular system works, understanding blood pressure readings, taking readings correctly, the causes and risk factors of hypertension, lifestyle changes, and the treatment and management of the condition.  

Understanding Your Blood Pressure 

It is important to understand blood pressure readings. The beats of our heart create pressure that pushes blood through our arteries, veins, and capillaries. This pressure is your blood pressure and is the result of two forces: Systolic and diastolic pressure. Systolic pressure (top number) occurs as blood pumps out of the heart and into the arteries of the circulatory system. Diastolic pressure (the bottom number) is created as the heart rests between heartbeats.   

Knowing Your Numbers 

Since hypertension can have no symptoms, it is critical to know your blood pressure, especially as you get older. The American Heart Association’s blood pressure guideline chart is a good source for identifying the ranges of blood pressure, systolic and diastolic.  

Elevations in blood pressure, on occasion, may be common if a person is experiencing stress but if your blood pressure remains at that elevated level or increases, it is important to have a discussion with your health care provider.  

Hypertension occurs when your blood pressure, the force of your blood pushing against the walls of your blood vessels, is consistently too high. Hypertension falls into three categories. 

Hypertension Stage 1 

Hypertension Stage 1 is when blood pressure consistently ranges from 130 to 139 systolic or 80 to 89 mm Hg diastolic. At this stage, your healthcare provider is likely to prescribe lifestyle changes, daily monitoring through remote services, and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular diseases (ASCVD)such as heart attack or stroke. 

Hypertension Stage 2 

Hypertension Stage 2 is when blood pressure consistently is 140/90 mm Hg or higher. At this stage of high blood pressure, your healthcare provider is likely to prescribe a combination of blood pressure medications and lifestyle changes.  

Hypertension occurs when your blood pressure, the force of your blood pushing against the walls of your blood vessels, is consistently too high. It is important to speak with your health care provider and address a treatment plan for any stage of hypertension, but it is imperative to seek medical attention for blood pressure that exceeds 180/120 mm Hg. With blood pressure this high, some could also experience chest pain, shortness of breath, back pain, numbness or weakness, changes in vision, or difficulty speaking. DO NOT WAIT – CALL 911 IMMEDIATELY. 

Tips on Taking Your Blood Pressure 

According to research from the American Heart Association, roughly half of U.S. adults should be taking their blood pressure routinely at home. This is especially important if you have been diagnosed with hypertension or are working with your physician to determine if you have hypertension.  

Taking your blood pressure at home can give your health care provider a more accurate representation of your blood pressure than the occasional office visit. Some individuals may also experience “white coat hypertension,” where their blood pressure spikes at the provider’s office. Many adults encounter the reverse, called “masked hypertension,” which means getting normal readings at a physician’s office but higher ones at home. This event also makes home monitoring important in the diagnosis of hypertension. 

Below are tips to help guide you in taking your blood pressure readings at home: 

  • Preparing to Take Your Blood Pressure – Doing the following, before you take your blood pressure, will assist in giving you a more accurate reading: 
  • Don’t smoke, consume caffeine, or exercise within 30 minutes of taking your blood pressure.  
  • If you have to urinate, do so before taking a reading. According to the American Heart Association, measuring blood pressure with a full bladder can add 10 to 15 points to your reading. 
  • Proper Posture – Slouching or sitting with your back or feet unsupported can raise your reading by six to 10 points, and cossed legs can increase your reading by anywhere from two to eight points. For the best results, sit in a chair with your back supported, feet flat, and legs uncrossed.  
  • Arm Position – The position and location of your arm is important. The arm should be supported on a flat surface, like a table, with the upper arm at heart level.  
  • Focus on Taking the Reading– Don’t multitask during the reading either. Talking to your partner or chatting on the phone while taking your blood pressure can add 10 to 15 points to your number. Stay silent and still.  
  • Cuff Placement – Always place the cuff on bare skin. Strapping it on top of clothing can add 10-40 mm Hg to a reading.  
  • Be consistent If you’re monitoring your blood pressure at home, make sure you take it at the same time daily. And typically, you only need to check it once a day. 
  • Take multiple readings at one time – While you typically only need to sit down and check your blood pressure once a day, the American Heart Association recommends taking two or three readings one minute apart.  
  • Log Your Readings – If you are not part of a remote monitoring program that automatically sends your data to a dashboard or electronic medical record, it is important to keep a log (for all readings) of the date, time and reading. You can do this through an app on your phone or in a small notebook.  

As part of living a healthier life, RPM Healthcare offers remote patient monitoring and care coaching services for those with high blood pressure and other health conditions. This weekly series on hypertension, the RPM365 platform, and care coaches are aimed at working with you to achieve a healthy lifestyle and prevent heart attack, stroke, and other health conditions that can affect your everyday life.

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