I’ve decided to write my first blog article about an important health concept that confuses many people: Blood Pressure. What do those numbers mean? What’s systolic? What’s diastolic? What’s a normal blood pressure reading? Why should I care? Hopefully you’ll be able to answer these questions after reading this article.
Blood pressure is the force that moves blood through your circulatory system. Normal blood pressure is necessary for life. The pressure created by our heart muscles contracting forces our blood to flow out from our heart through arteries to deliver oxygen, nutrients, hormones, immune cells, and many other chemicals to the tissues and organs within our body. The same blood pressure returns blood back to the heart through our veins and allows our blood to pick up the toxic waste products of cell metabolism, including the carbon dioxide we exhale with every breath, and the toxins we clear through our liver and kidneys. (I’ll cover more on toxins and waste at another time.)
Let’s start with terminology… Your blood pressure reading will have two numbers such as 118/72. You read this as “118 over 72”. The top number, the higher number, is called your systolic blood pressure. The bottom number, the lower number, is your diastolic blood pressure. Blood pressure usually has units tagged onto the end: 118/72 mmHg. mmHg stands for millimeters of mercury. Mercury was originally used for measuring pressure. I won’t go into the physics of this here but mmHg remains the standard unit of measurement for pressure in medicine. Hypertension means high blood pressure while hypotension means low blood pressure. Your pulse (measured at the wrist) is the number of contractions (beats) your heart makes per minute. You cannot get blood pressure information from taking a pulse.
Diastolic Pressure (the bottom lower number)- this is the pressure in your arteries when your heart is relaxed and filling. If this number is high that means that your blood vessels are constantly under significant pressure.
Systolic Pressure (the top higher number)- this is the pressure in your arteries when your heart contracts and squeezes out blood into your body. As blood is being quickly forced out of the heart into the blood vessels the pressure inside the vessels raises.
How Is Blood Pressure Measured?
I’m assuming everyone has had their blood pressure measured at least once in their life, hopefully a lot more than once. If it’s been a while, here’s a quick reminder of the procedure and a few tips to help make it more accurate.
Your doctor or nurse will use a stethoscope to listen to the blood moving through your artery. She’ll place a cuff onto your arm and inflate it to a pressure higher than your systolic blood pressure, making it tighten around your arm. Then she’ll slowly release it. As the cuff deflates, the first sound she hears through the stethoscope is the systolic blood pressure. It sounds like a whooshing/bumping noise. The point where this noise goes away marks the diastolic blood pressure.
Typically blood pressure is measured in the left upper arm. Some cuffs go around the forearm or wrist, but often they’re not as accurate. The American Heart Association guidelines for blood pressure measurement state: “Patient should be seated comfortably, with back supported, legs uncrossed, and upper arm bared. Patient’s arm should be supported at heart level. Neither the patient nor the person taking the measurement should talk during the procedure.” Failing to follow any of these guidelines can falsely raise or lower the blood pressure reading. To get an accurate blood pressure measurement, your doctor should evaluate your readings based on the average of two or more blood pressure readings at three or more office visits.
What’s a Healthy Blood Pressure?
Blood pressure is categorized into 4 types: Normal, Prehypertension, Type 1 Hypertension, and Type 2 Hypertension.
(American Heart Association Chart)
I’ve tried not to be super technical and boring but now I’ve got to give you a few facts and statistics. Usually both systolic and diastolic pressures will rise, but an elevated systolic or diastolic blood pressure alone may be used to make a diagnosis of high blood pressure. Typically, more attention is given to the systolic blood pressure (the top number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term build-up of plaque and an increased incidence of cardiac and vascular disease. And, according to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.
Most people should aim for a blood pressure within the Normal range. This may be accomplished with or without pharmaceutical help. A few medical populations, such as patients with chronic kidney disease, diabetes or coronary artery disease, have higher target blood pressures.
So why is all this important? Why should you care what your blood pressure is?
Most people with high blood pressure don’t have symptoms. That’s why high blood pressure is often called the “silent killer.” The first symptom of untreated high blood pressure may be a heart attack, stroke, kidney damage or eye problems. The higher your blood pressure is, the higher your risk of health problems in the future. If your blood pressure is high, it is putting extra strain on your arteries and on your heart. Over time, this strain can cause the arteries to become thicker and less flexible, or to become weaker. If your arteries become thicker and less flexible, they will become narrower inside, making your heart work harder to push blood through them and making them more likely to become clogged up.
What Do I Do Now?
If your blood pressure is normal (Hurray!!), get it checked at least yearly and go about your normal healthy lifestyle. Those of you who are young and healthy with a normal blood pressure despite doing your best to live as unhealthy a lifestyle as possible (we’ve all been there), now would be a good time to make a some changes so you don’t find yourself in the hypertension categories in a few years. It’s usually easier to keep your blood pressure in the normal range than to try to reduce it if it’s already raised.
If you fall into the pre-hypertension range now is absolutely the time to do something. Adopting a healthy lifestyle can help bring it under control and reduce your risk of life-threatening complications. Be sure to get your blood pressure checked regularly to be sure you are making progress. If you have type 1 or type 2 hypertension, please talk to your doctor about making a plan to bring it under control.
As a naturopathic physician I prefer to work with my patients to develop a blood pressure lowering plan without initially using prescription medications. If you are willing to make some changes in diet and lifestyle, you can generally bring your numbers down. This is not necessarily a quick or easy thing to do, but it’s a lasting solution that will encourage your body to heal itself and bring itself back to a healthy state. Even with healthy changes, pharmaceutical intervention may be necessary for some patients to control their blood pressure. However, the inclusion of lifestyle changes in the treatment plan can reduce the amount of medication necessary (you get to take a lower dose) and help slow or stop further destruction within your body.
Here are a few ways to naturally lower your blood pressure and decrease your risk of cardiovascular disease.
- Reach and/or maintain a healthy body weight. Extra fat in the body requires additional blood vessels to be able to circulate more blood to the fat tissue in order to keep the fat cells alive. This increases the workload of the heart because it must pump more blood through extra blood vessels. More circulating blood means more pressure on the artery walls which means increased blood pressure. In addition, atherosclerosis (hardening of the arteries) is present 10 times more often in obese people compared to those who are not obese.
- Eat a diet rich in fruits, vegetables, and high-fiber foods.
- Cut down on processed foods. If you make it, you know what’s in it. J
- Cut down on sodium intake (salt in the diet). Processed foods contain a surprisingly high amount of sodium and added sugars. Excess sodium can cause your kidneys to retain water in the blood which increases blood pressure.
- Avoid all trans fats and hydrogenated oils. Trans fats have been found to increase the risk of cardiovascular disease more than any other micronutrient. Trans fats are found in margarine, frying oils, partially hydrogenated vegetable oils (shortening and some non-dairy creamers), deep fried foods (corn chips, potato chips, fried chicken), refrigerator dough (biscuits, croissants, frozen pizza crust, etc), store bought baked goods, and ready-made frosting.
- Eat 4 stalks (1 cup chopped) of celery daily. Studies have found that a phytochemical called phtalides (NBP) found in celery relaxes the tissues of the artery walls to increase blood flow and reduce blood pressure.
- Get regular aerobic exercise (e.g., brisk walking) at least 30 minutes a day, 5 days per week.
- Moderate your alcohol drinking. The American Heart Association urges people to drink in moderation or, better, not at all. This means an average of one to two drinks per day for men and one drink per day for women. (A drink is one 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits.) I personally believe that this is still too much alcohol and would encourage my patients to cut this maximum amount in half.
- STOP SMOKING! This is one of the best things you can do for every aspect of your health.
- Get enough sleep. Sleeping at least 7-8 hours per night can help with the treatment and prevention of high blood pressure. People who sleep six hours or less a night may be at higher risk of developing high blood pressure or worsening already high blood pressure. It’s thought that sleep helps your blood regulate stress hormones and helps your nervous system remain healthy. Over time, a lack of sleep could hurt your body’s ability to regulate stress hormones, leading to high blood pressure. Sleep apnea can also increase your risk of high blood pressure, as well as heart problems and other health issues.
- Use stress reduction techniques such as deep breathing, yoga and meditation.
- Get your blood pressure checked regularly, especially if it’s high. You can purchase a home blood pressure cuff and take regular readings. Be sure to find a reliable one because many are cheaply made and inaccurate. You can also stop at your local fire station and ask them to take your pressure. Most will happily do this for free. You can take your chances and try the machine at your pharmacy or grocery store. If you’ve ever watched the kids waiting in line hang from it and bang on it you’ll understand my reluctance to believe that the numbers will be accurate unless you get lucky and they’ve re-calibrated it within the last week or so.
- Get regular check-ups with your doctor to discuss your health and make a plan to make or keep yourself healthy.
Our bodies want to be healthy. If we remove obstacles and provide our body with the building blocks needed, it will begin to repair and strengthen itself. That being said, if you wait too long to address a health issue, permanent damage can be created. Get started on your personal journey to a healthy life now. And, remember- Do more than Exist … EXCEL!!