Know What Your Blood Pressure Numbers Mean

It’s called the silent killer for a reason. High blood pressure can go unnoticed for years, all the while damaging the heart, blood vessels and organs like the kidneys.

The damage done builds up; it can cause an organ to fail – and much worse.

“Typically, there are no clear symptoms like a headache; a lot of time, there’s nothing obvious,” said Avera Medical Group internal medicine specialist Comfort Agaba, MD, MPH. “Unfortunately, by the time a person starts to feel like something’s wrong, they could be closer to end-stage organ failure.”

Agaba said organ failure caused by hypertension – the clinical name for high blood pressure – can include:

• Enlargement of the heart and subsequent heart failure
• Damage to the kidneys resulting in dialysis or kidney transplant
• Stroke or heart attack
• Damage to the eyes and vision, due to retinopathy or hypertensive eye disease

Understanding What Normal Blood Pressure Means

Preventing high blood pressure starts with a definition of normal, healthy blood pressure.

• Agaba said that definition was 120 over 80, or 120/80, for many years. Clinicians call it systolic over diastolic.
• Now, healthy blood pressure is seen as 120 for the first number and less than 80 for the second number.
• Any reading above that – for either number – can be an issue.

“When the first number is more than 120 and the second is 80 or more, you have elevated blood pressure,” Agaba said. “But a single reading that’s high does not always mean you have hypertension. One measurement is just a snapshot.”

Agaba said that regular appointments with your provider are a good way keep an eye on your blood pressure.

“Getting several measurements over a period of time and averaging them is important,” she said. “We often encourage patients to buy a device to use at home.”

Clinicians look at blood pressure with this American Heart Association guide:

• Normal: 120 (or less) and less than 80
• Elevated: 120-129 and less than 80
• Stage 1 hypertension: 130-139 and 80-89
• Stage 2 hypertension: 140 or higher and 90 or higher

You should see a doctor right away if your first and second numbers go above 180 and 120.

How to Lower Your Blood Pressure

Preventing high blood pressure in the first place is always easier than wrestling with numbers that are already too high. Factors that lead to high blood pressure include:

• Being overweight
• Using tobacco
• Binging alcohol or overusing it
• Eating a diet high in processed foods, sodium and some meats
• Limiting your amount of daily exercise or activity

“Family history can increase high blood pressure risk by 30%,” Agaba said. “Age plays a role, too, since it’s a cumulative condition.” People ages 50-75 are more likely to have the cumulative effects.

But it can affect anyone including younger women. “The big difference in occurs when a woman is pregnant,” Agaba said. “It can happen whether or not they knew about possible hypertension before."

Pregnant women who have hypertension sometimes have seizures. “Many times that risk goes up as the delivery date gets closer," she added. “Women should talk to their OB provider about blood pressure. Follow any directions they provide.”

Hypertension is elusive; only regular checks at home or with your provider can show a true blood pressure problem.

Try to Control What You Can to Lower Blood Pressure

Doctors often find many adults already are in a more advanced stage of hypertension.

“When we find it at an early stage, we can start with lifestyle changes,” Agaba said. Modifications in diet and exercise can help change blood pressure, especially early in the diagnosis, Agaba said.

“If it’s more advanced, patients need medication,” she added. “Doctors will assess other risk factors for treatment intensity, but lifestyle changes are always a part of the effort.” Agaba said once a patient begins use of medication, it can be a lifelong approach.

So remember: if you don’t have symptoms, you could still have high blood pressure. An appointment with your primary care provider is a great first step in the right direction.

“Treatments we use differ for every individual patient, but the long-term effects are serious,” Agaba said. “If you’re not sure where your numbers stand – act. Knowledge is powerful.”

Learn more about recommended screenings as you age. Or, find a provider near you to schedule your yearly checkup.