Hypertension, or high blood pressure, is a quiet, pervasive condition that can have a devastating effect on our bodies. It contributes to heart and kidney diseases, stroke, vision deterioration and even sexual dysfunction. UR Medicine cardiologist Dr. John Bisognano explains what your blood pressure numbers mean and why they matter.
About half of all Americans have above normal blood pressure, whether they know it or not.
That’s why doctors make a habit of using the arm cuff to check your blood pressure levels as often as we can, looking closely at both the top and bottom numbers. This is important because when the force of blood pressing against the walls of your arteries is elevated, it raises the heart’s workload and can cause serious damage to the arteries as well as the heart.
The first (top) number of a blood pressure reading is the systolic pressure, when the heart is squeezing. The second is the diastolic pressure, when the heart is relaxed between beats and when the elastic recoil of the arteries continues to push blood forward. Both numbers are important.
Heart health experts recently released new guidelines for what your blood pressure should be and when you may need medications if we can’t maintain those levels.
- Normal: Less than 120/80 mmHg
- Elevated: Your top number is between 120 and 129, or your bottom number is greater than 80. You are on the way to having hypertension and your doctor will recommend lifestyle changes to prevent, or at least delay, your becoming hypertensive and needing medications to get the numbers down.
- Stage 1: Your top number is between 130 and 139 or your bottom number is 80 to 89. You have hypertension and will likely need medications. The good news is that those medications are inexpensive and easily accessible.
- Stage 2: Your top number is 140 or above or your bottom number is 90 or above. You’ll definitely need to take daily medications.
- Hypertensive crisis: Your top number is over 180 and/or your bottom number is over 120. That means an immediate change in medications or possibly hospitalization to determine if you have any organ damage, particularly if you’re not feeling well.
The new blood pressure guidelines were set by experts from the American Heart Association and American College of Cardiology who reviewed more than 900 studies of blood pressure control. It’s a great step forward in potentially saving lives by lowering blood pressure and your risk of heart attack, stroke or kidney failure.
John D. Bisognano, M.D., Ph.D., cares for patients with all types of acute cardiovascular disease, including advanced heart failure, as director of the UR Medicine Heart and Vascular Comprehensive Hypertension Center. He is involved in research aimed at finding new treatments for people with cardiovascular disease.