High blood pressure, or hypertension, is the leading cause of heart attack, stroke, heart failure and kidney disease. It’s called the “silent killer” because it often has no warning signs or symptoms, and many people don’t know they have it. So with one in three adults in the United States having high blood pressure, it’s natural for you to question if you should worry about it.
My answer is yes, but with some qualification. It’s not necessary, and sometimes unhelpful, for people to take their blood pressure multiple times a day. The benefits of blood pressure control occur after many years of treatment and it’s the rare circumstance where normalizing one’s pressure requires a sense of urgency.
Also, one or two elevated readings at home, at the drug store, or a doctor’s office does not mean you have high blood pressure—it is a diagnosis that generally requires weeks or months to establish. I personally don’t believe that patients should monitor their blood pressure at home unless specifically instructed to by their doctor.
But that doesn’t mean you’re off the hook. It’s important to know your blood pressure numbers and understand what they mean. This helps keep the lines of communication open between you and your doctor, so you can work in partnership toward the healthiest you.
Understanding the Numbers
Your blood pressure reading is made up of two numbers, but do you know what they are telling you?
The top number is called your systolic blood pressure. This represents the force of blood through your blood vessels during your heartbeat.
- Normal: 119 or below is normal systolic blood pressure
- Prehypertension: 120-139
- High blood pressure: 140 or greater
- High blood pressure in those over 60: 150 or greater
The bottom number is called your diastolic blood pressure, representing the force of blood through your blood vessels when your heart is resting.
- Normal: 79 or below is normal diastolic blood pressure
- Prehypertension: 80-89
- Hypertension: 90 and greater
The good news is that it is possible to prevent and control high blood pressure through some simple lifestyle changes:
- Maintain a healthy weight
- Get physically active
- Follow a healthy eating plan
- Limit salt and sodium
- Limit alcohol consumption
Lifestyle changes aren’t always enough depending on where you fall on the spectrum, in which case your doctor will work with you to incorporate blood pressure medication into your healthy lifestyle routine.
We live in the age of fitness trackers and electronic health self-monitoring devices, so I understand the desire may still be there to check your blood pressure regularly on your own. If you can’t resist the temptation, or simply find peace of mind in more regular monitoring, I recommend taking your blood pressure once a week, at the same time of day, such as in the morning or evening, unless your doctor has instructed you otherwise.
By Jonathan Altschuler, MD, interventional cardiologist and medical director of the Cardiac Catheterization Lab at Anne Arundel Medical Center.
