What’s a High Reading for Blood Pressure?

Blood pressure is a measurement of the force of your blood against the walls of your blood vessels. Low blood pressure can make it difficult for all your tissues to get blood. High blood pressure ( hypertension) can move blood with too much force.

Your arteries carry oxygen-rich blood to all the tissues and organs in your body. While the volume of blood delivered throughout your body is essential, the efficiency with which your blood travels is an integral part of the process.

This article will explore standard blood pressure measurements and what is considered too high, how blood pressure increases, and what you can do to keep your blood pressure measurements healthy.

What Is High Blood Pressure in Physiology?

High blood pressure is an increased force on your blood vessel walls. This can happen for many reasons. If your cholesterol is high, your blood vessels can narrow or become blocked. This can reduce vessel wall compliance (the ability of a blood vessel wall to expand or contract with changes in pressure) and lead to increased blood pressure.

As a result, your heart increases the force it uses to pump blood through these smaller vessels. Approximately 95% of high blood pressure is called “essential” or “primary,” which can develop as part of the normal aging process, though sometimes it occurs in younger people.

Certain medications, your diet, weight, and how much exercise you get can also affect your blood pressure.

What Is a High Blood Pressure Reading?

There are two parts to your blood pressure measurement: systolic and diastolic.

• Systolic: The top or first number in a blood pressure reading is the systolic pressure. It measures the force of the blood against your vessel walls when your heart is contracting or actively pumping blood.
• Diastolic: The bottom or second number, your diastolic pressure, is the force your blood puts on vessel walls when your heart is being refilled and is at rest.

Typical “normal” blood pressure readings vary based on your age, gender, race, size, and health status. General guidelines suggest that keeping your systolic blood pressure below 120 millimeters of mercury (mmHg) and your diastolic pressure below 80 mmHg is best. Below is a list of blood pressure readings and how they are categorized by risk.

• Normal: 120/80 and under
• Elevated: 120–129/80 or less
• Stage 1 Hypertension: 130–139/80–89
• Stage 2 hypertension: 140 and higher/90 and higher
• Hypertensive crisis: 180 and higher/120 and higher

While these are considered normal blood pressure levels and limits, these blood pressure ranges change with age. Children and teens have blood pressure readings that usually run lower but may depend on their height, weight, and stage of development.

In older adults, the normal range of blood pressure is usually 130/80 instead of 120/80. This type of blood pressure measurement may be called isolated systolic hypertension, and its the result of a gradual stiffening of your arteries that happens naturally with age.

HBP Meaning in Terms of Health Risks 

High blood pressure can lead to various health problems, including:

• Heart attack
• Heart failure
• Kidney disease
• Stroke
• Vascular dementia

High blood pressure makes your heart work harder, weakening it over time. It also puts too much pressure on the tissues at the receiving end of the blood. For example, high-pressure blood flow into the kidneys damages the delicate renal (kidney) cells over time, leading to kidney disease or failure.

High blood pressure can also loosen calcifications or fat deposits within your blood vessels, causing a heart attack or stroke if those clots travel to the heart or brain.

Managing High Blood Pressure

In the early stages of high blood pressure, dietary changes and lifestyle changes may be enough to lower your blood pressure to a healthy range. However, as you approach stage 1 hypertension, your healthcare provider will likely prescribe medication to help reduce your blood pressure and recommend diet, exercise, and other lifestyle changes.

Most people with stage 2 hypertension require medication to control their blood pressure. Some people have blood pressure that’s so high it becomes a hypertensive crisis, a medical emergency requiring immediate treatment.

There are certain situations, though, when your blood pressure might have to be managed differently due to other things happening inside your body.

In Pregnancy

Blood pressure increases during pregnancy are often the result of high blood volumes but can also be a sign of severe complications like preeclampsia.

Treatment for high blood pressure during pregnancy is tricky because of the risk of treatment complications both for the gestational carrier and the growing fetus. Many international organizations recommend treating hypertension when blood pressure rises above 130/80 in pregnancy, however, certain circumstances require individualized care.

A primary healthcare provider will work alongside an obstetrician-gynecologist (ob-gyn) to help manage high blood pressure during pregnancy to ensure a healthy pregnancy for you and your baby and lower the risks of serious cardiovascular complications.

With Chronic Disease

People with an existing chronic disease who also develop high blood pressure may have to tread lightly regarding blood pressure management. Certain medications used to lower blood pressure may not be appropriate to use alongside some conditions.

A healthcare provider will discuss the risks vs. benefits of treatment, weighing the severity of your hypertension alongside how treatment might impact your other health conditions. Not addressing high blood pressure could worsen or complicate other health problems, such as heart failure and high cholesterol.

Some research has raised concern that using blood pressure-lowering treatments in older adults, frail individuals, or those with multiple serious medical issues can increase their risk of serious complications. However, numerous studies suggest treating hypertension in these populations is still necessary and appropriate.

At Night 

Blood pressure, heart rate, and other body functions often decrease at night when your body is at rest, but when your blood pressure increases during sleep, this is known as nocturnal hypertension. People who experience nocturnal hypertension are usually at an increased risk for serious cardiovascular events like heart attack and stroke.

Nocturnal hypertension may be related to other conditions, such as sleep apnea, requiring specific medications at bedtime.

During Serious Illness

There are also times during acute or serious illnesses when desired ranges for your blood pressure are different from what is standard. One example is after a stroke. If your stroke is treated with intense blood thinners called tissue plasminogen activator (t-PA), your blood pressure will be maintained at a range with a systolic pressure of 180 or less and a diastolic pressure of 105 or less.

However, if you are not treated with t-PA, a healthcare provider may recommend permissive hypertension. This means your systolic blood pressure could increase to 220 without treatment. Permissive hypertension aims to keep your blood flow strong to areas around the stroke so these areas do not enlarge in size.

Integrated Treatment Approach to Reducing Blood Pressure 

Managing blood pressure isn’t something you can usually accomplish with a single pill or treatment. You should also address any underlying issues that are contributing to your high blood pressure, such as sleep apnea, obesity, or high cholesterol

A healthcare provider will recommend lifestyle changes, including stress management, diet changes, and more exercise.

Healthcare providers prescribe medications to lower blood pressure that does not improve with lifestyle changes alone or when your blood pressure is very high and needs to be lowered quickly. Examples of blood pressure medications include:

• Diuretics
• Beta-blockers
• Angiotensin converting enzyme (ACE) inhibitors
• Angiotensin II receptor blockers (ARBs)
• Calcium channel blockers
• Alpha blockers, alpha-2 receptor agonists
• Combined alpha and beta-blockers
• Vasodilators

Summary

For most people, blood pressure higher than 120/80 is a sign to start changing their lifestyle. However, lifestyle changes aren’t enough in certain circumstances, such as severe illness or genetic predisposition to hypertension. If your blood pressure climbs high enough, a healthcare provider will prescribe medications to keep it within a healthy range and reduce your risk of developing other health problems.