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High Blood Pressure: Do I Have It?


High blood pressure, or hypertension, is a condition where the resistance to the heart pumping blood to the rest of the body is elevated.  Since having acute elevations of blood pressure as well as a long-term chronic condition can have serious effects on the body, knowing that you have high blood pressure and when to seek treatment for it is a key to good health. Consistent definitions of hypertension though are hard to pinpoint, and different health organizations have different "normal" values. Additionally, different individuals may have differing targets of where their blood pressure should optimally be.  

Blood pressure is typically denoted as a ratio, such as 130/80 mm Hg. The top number, called systolic pressure, measures the pressure in the arteries when the heart muscle contracts. The bottom number, known as diastolic pressure, measures pressure when the heart is between beats and is re-filling with blood. Systolic is the more variable of the numbers; diastolic is sometimes considered the more influential of the pair. However, both measurements are important. It is estimated that close to 30% of all adults in the U.S. have high blood pressure and need to take some action to keep it either controlled or to lower it.

Historically, most groups and health care providers have used values of 140/90 mm Hg or below as considered to be within the normal range. However, many studies have shown lower blood pressure than this is even more beneficial. The American Heart Association (AHA) recommends that blood pressure be 120/80 mm Hg or lower in most adults. The key to this is "most" adults, as somewhat higher values may be more acceptable at older ages when arteries lose their elasticity and even 120/80 may be too high for people whose hearts are compromised and need to pump under as little pressure as advisable to preserve their function. The AHA defines the range of 120-139 systolic and 80-89 diastolic as "prehypertension", and estimates as many as 90% of people with these readings on a consistent basis will go on to develop hypertension

We probably all know that high blood pressure is a major risk for stroke, heart attack, heart failure, and chronic kidney disease.  The harder it is to get blood around the body, the harder the heart works and higher the likelihood is that it will eventually fail. Higher blood pressures also hinder blood carrying oxygen from easily reaching the tissues of vital organs that depend on it. Many scientific studies have shown that even moderate elevations of blood pressure correlates with a shorter life span. So keeping your blood pressure at a level that is optimal for you is of vital importance.

Besides having your blood pressure checked at regular intervals during scheduled health maintenance visits or doctor physicals, most large chain pharmacies now have machines readily available for you to check your blood pressure at your convenience. When levels of over 120/80 mm Hg are consistently noted (and certainly levels of over 140/90), you should consult with your doctor to see how to best be treated. Some mild cases of hypertension can be treated with weight loss and restriction of salt intake.  Others need medication to get to acceptable levels. Remember the same level isn't optimal for everyone. Those with other diseases or heart compromise may have to maintain their blood pressure at lower levels, and some older individuals in good health may be able to maintain heart rates at slightly higher values. Everyone is an individual and is treated uniquely. 

One other important point: most cases of hypertension have no noticeable symptoms. The effect of hypertension on the end organs of the body may not be recognizable until they have significantly and sometimes permanently caused significant damage. So have your blood pressure checked regularly, and be sure to cooperate with your doctor in determining the best steps to be treated if your blood pressure is elevated.

Authored by Dr. Bob Goldstone, M.D.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.