Hypertension, commonly known as high blood pressure, occurs when the force of blood pushing against artery walls is consistently too high. This sustained pressure makes the heart work harder to pump blood throughout the body. Hypertension often presents without noticeable symptoms, earning it the nickname “the silent killer.” Regular screening is important for early detection and management, helping to prevent severe health complications such as heart attack, stroke, and kidney disease.
Measuring Blood Pressure
Blood pressure measurements involve two numbers: systolic and diastolic pressure, recorded in millimeters of mercury (mm Hg). Systolic pressure, the upper number, reflects the force of blood against artery walls when the heart beats and contracts. The lower number, diastolic pressure, indicates the pressure in the arteries when the heart rests and fills with blood between beats.
In a clinical setting, blood pressure is measured using an inflatable cuff, known as a sphygmomanometer, wrapped around the upper arm. For accurate readings, individuals should sit quietly with back supported and feet flat on the floor for at least five minutes before measurement, avoiding talking. The arm with the cuff should be bare, relaxed, and supported at heart level. Multiple readings are recommended during a single visit to account for fluctuations caused by factors like stress or temperature.
Screening Guidelines and Frequency
Adults aged 18 years or older should undergo regular blood pressure screening. For adults aged 18 to 39 years with no increased risk factors and a history of normal blood pressure, screening every three to five years is recommended.
Annual screening is recommended for adults 40 years or older. Individuals with increased risk factors, such as a family history of hypertension, being overweight or obese, or having other existing health conditions like diabetes, should have more frequent checks. Additionally, certain demographic groups, such as Black individuals, should have more frequent screening due to higher risk.
Interpreting Your Results
Blood pressure readings are categorized to understand their health implications. A normal blood pressure reading is less than 120 mm Hg systolic and less than 80 mm Hg diastolic (less than 120/80 mm Hg). Maintaining this range supports overall cardiovascular health.
Elevated blood pressure occurs when systolic readings range from 120 to 129 mm Hg and diastolic pressure is less than 80 mm Hg. Individuals in this category are likely to develop high blood pressure without preventive measures. Hypertension Stage 1 is diagnosed when systolic pressure is between 130 and 139 mm Hg or diastolic pressure is between 80 and 89 mm Hg.
Hypertension Stage 2 is diagnosed with systolic readings of 140 mm Hg or higher, or diastolic readings of 90 mm Hg or higher. A hypertensive crisis, a medical emergency, occurs when blood pressure exceeds 180 mm Hg systolic and/or 120 mm Hg diastolic. Immediate medical attention is necessary in such cases, especially if accompanied by symptoms like chest pain or shortness of breath.
Actions After Screening
Upon receiving blood pressure screening results, especially if elevated or indicating hypertension, consulting a healthcare provider is important. The provider can assess the individual’s overall health and discuss appropriate management strategies. For elevated or Stage 1 hypertension, initial recommendations focus on lifestyle modifications.
These modifications include adopting a balanced diet, incorporating regular physical activity, and managing stress. Limiting sodium intake and reducing alcohol consumption are also advised. Depending on the readings and individual risk factors, follow-up appointments are scheduled to monitor progress, and further tests may be recommended to rule out underlying conditions or assess organ damage.
Monitoring Blood Pressure at Home
Monitoring blood pressure at home complements in-office measurements and offers several benefits. It provides a more comprehensive picture of blood pressure trends, as readings fluctuate throughout the day due to stress, activity, or the medical environment itself, a phenomenon sometimes called “white coat hypertension.” Home monitoring can help identify “masked hypertension,” where in-office readings are normal but home readings are high, which is also associated with increased cardiovascular risk.
When choosing a home monitor, an automated upper arm cuff device is recommended for accuracy, as wrist and finger devices are less reliable. To ensure accurate home measurements, individuals should follow preparation guidelines similar to in-office readings. Taking at least two readings at the same time each day helps establish a consistent baseline. While home monitoring is a valuable tool for tracking and informing treatment decisions, it does not replace professional medical advice or regular check-ups.