Normal blood pressure in an adult is 120/80. Hypertension is defined as blood pressure greater than 140/90. Blood pressure readings are made up of two numbers the top number is called the systolic blood pressure, the bottom number is called diastolic blood pressure. Both are important. Blood pressure goes up and down as the heart pumps blood. The systolic blood pressure, the higher number, is the peak blood pressure. Systolic blood pressure is the pressure generated in the arteries when the heart is actively pumping blood. The diastolic blood pressure, the low number, is the lowest blood pressure during the pumping cycle of the heart. It is the pressure in the arteries when the heart is filling and not actively pumping blood into the vessels. If either the systolic blood pressure is more than 140 or the diastolic blood pressure is more than 90, hypertension can be diagnosed.
Some patients have what is called white coat hypertension. This is when the patients blood pressure is high in the doctors office but normal at other times. For some people the doctors office can be stressful and intimidating. There may be worry about a health problem, stress getting to the appointment on time, stress from waiting for the doctor to see the patient, or worry that an exam or procedure may be embarrassing or uncomfortable. All these emotions can cause the blood pressure to go up. For these reasons it is often helpful to have blood pressure readings taken outside of the office setting. Most pharmacies have blood pressure machines that can be used for free. It is also possible to purchase a blood pressure machine for use at home. These can be purchased from a drug store and tend to be reasonably priced. It can be helpful to have these readings taken and written down to bring to the doctors appointment. In some cases it is wise to obtain these readings outside of the office before a diagnosis of high blood pressure is given,
Patients that have blood pressure readings higher than 120/80 but lower than 140/90 do not have high blood pressure but they are at risk of developing hypertension. People in this category may need more frequent monitoring either in the office or outside of the office. Lifestyle changes such as weight loss, exercise, smoking cessation, decreased salt and fatty foods, and decreased alcohol consumption can help prevent hypertension from developing.
Hypertension can be present in varying degrees. For example a person with blood pressures of 145/95 should be easily managed to bring the blood pressure down to normal. For many patients in this category lifestyle changes alone or single drug therapy is likely to bring the blood pressure to normal range. People with systolic blood pressure over 160 have a more sever form of the disease. People in this category will require more aggressive management and more frequent follow up. If the systolic blood pressure is over 200, therapy needs to be aggressive. Patients with blood pressure this high have a much greater risk of suffering complications from the high blood pressure such as heart attack, heart failure, stroke, or kidney problems.