Blood pressure is the force your blood exerts against artery walls as your heart pumps it. It is measured with two numbers: systolic pressure (the top number), which indicates pressure when your heart beats, and diastolic pressure (the bottom number), which reflects pressure when your heart rests between beats. Monitoring these numbers offers insights into your circulatory health and the workload on your cardiovascular system.
What 178/93 Blood Pressure Means
A blood pressure reading of 178/93 mmHg falls into “Stage 2 Hypertension” according to current guidelines. Stage 2 hypertension is defined by systolic readings of 140 mmHg or higher, or diastolic readings of 90 mmHg or higher.
A “hypertensive crisis” occurs when blood pressure reaches 180 mmHg systolic or 120 mmHg diastolic. This crisis has two types: hypertensive urgency, which involves severely elevated blood pressure without immediate organ damage, and hypertensive emergency, where severe high blood pressure is accompanied by acute damage to organs like the brain, heart, kidneys, or eyes.
Immediate Steps to Take
If you measure your blood pressure at 178/93 mmHg, remain calm, as panic can temporarily increase it further. Rest quietly for a few minutes, then re-measure to confirm the reading. Ensure you are sitting upright, feet flat, and arm supported at heart level for accuracy.
If the reading remains 178/93 mmHg or higher, seek medical attention promptly. If you experience symptoms like chest pain, sudden severe headache, shortness of breath, vision changes, numbness or weakness, or difficulty speaking, these indicate a potential hypertensive emergency; seek emergency medical care immediately.
If no severe symptoms are present, contact your primary care physician to discuss the reading and determine next steps. Your physician may advise an urgent care visit or provide home management instructions.
Common Causes and Contributing Factors
Elevated blood pressure, such as 178/93 mmHg, stems from various factors. Primary (essential) hypertension, accounting for most cases, often develops gradually over years without a single cause. Genetic predisposition and age, as arteries stiffen, increase risk.
Lifestyle choices also significantly influence blood pressure. Being overweight or obese strains the heart and blood vessels. A high-sodium diet, lack of physical activity, and excessive alcohol consumption contribute to elevated pressure. Chronic stress can also play a role in sustained high readings.
In some cases, high blood pressure is secondary hypertension, caused by an underlying medical condition or medication. Common secondary causes include kidney disease, thyroid problems, and certain medications like decongestants, NSAIDs, or oral contraceptives. Illicit drugs, such as cocaine or amphetamines, can also cause dangerous spikes.
Potential Health Consequences
Sustained high blood pressure poses serious risks to various organs. The excessive force on artery walls damages and hardens blood vessels, increasing the risk of cardiovascular events.
The heart is vulnerable; prolonged high blood pressure can lead to heart attack, heart failure, or an enlarged heart. The brain is also at risk of stroke, caused by a blood clot or burst vessel. Kidneys can suffer damage, leading to kidney failure, as their delicate blood vessels are compromised. High blood pressure can also affect the eyes, leading to retinopathy and vision loss. These consequences highlight why high blood pressure is often called a “silent killer,” as it frequently presents with no symptoms until severe damage occurs.
Managing High Blood Pressure
Managing high blood pressure involves a combination of lifestyle adjustments and medical interventions. Dietary changes, emphasizing the DASH (Dietary Approaches to Stop Hypertension) eating plan, promote fruits, vegetables, whole grains, and lean proteins while limiting saturated fats and cholesterol. Reducing sodium intake to under 2,300 mg/day (ideally 1,500 mg) significantly lowers blood pressure.
Regular physical activity (at least 150 minutes of moderate-intensity aerobic exercise per week) strengthens the heart and improves blood vessel flexibility. Maintaining a healthy weight or weight loss if overweight also has a positive impact. Stress reduction techniques (e.g., meditation, yoga) and limiting alcohol (one drink/day for women, two for men) contribute to control.
Beyond lifestyle, medication is often necessary. Various classes of antihypertensive drugs work through different mechanisms to lower blood pressure, including:
Diuretics
ACE inhibitors
ARBs
Beta-blockers
Calcium channel blockers
Adherence to prescribed medication and regular home monitoring are important for effective long-term management. This comprehensive approach, guided by a healthcare professional, is a lifelong commitment to maintaining blood pressure within a healthy range and reducing complications.