Health
Navigating the Levels and Varieties of High Blood Pressure
Knowing how to interpret your blood pressure readings, especially if you’re over 50, can be pivotal to your health. Distinguishing between the different stages and types of hypertension might seem daunting, but demystifying the numbers can empower you to take the necessary precautions and actions.
The American College of Cardiology/American Heart Association (AHA) marked a turning point in 2017 when it updated its guidelines to classify hypertension as a blood pressure reading of 130/80 mm Hg or higher. This update signalled a new health risk for a significant proportion of the population, particularly older adults.
With age, the major arteries in our bodies can stiffen. This hardening of arteries can result in high blood pressure, a condition that can cause severe complications if left unchecked or unmanaged. Heart disease, stroke, kidney disease, eye problems, and even cognitive decline are potential outcomes. Therefore, a shocking 46% of adults in the U.S., according to AHA estimates, are categorized as having high blood pressure.
Being aware of your blood pressure levels is the first step. If your systolic pressure stands between 120-129 mm Hg and your diastolic pressure is under 80 mm Hg, you fall into the elevated range. Risk factors at this stage typically include inactive lifestyle, poor diet, and family history. Proactive lifestyle changes at this stage can prevent further progression.
Jordana Cohen, M.D., an associate professor of medicine at the Hospital of the University of Pennsylvania, advises that patients over the age of 75, smokers, or those with risk factors for diabetes, kidney disease, high cholesterol, or heart disease should consider a reading of 130/80 mm Hg as a signal to speak with a doctor.
“On the other hand, under the age of 75 and [with] no other risk factors, 140/90 is when we really start treatment,” she counsels.
Moving up the scale, a systolic pressure of 130-139 mm Hg or a diastolic pressure of 80-89 mm Hg indicates stage 1 hypertension. Those over 50 in this stage face higher risk of cardiovascular diseases. It’s vital at this point to monitor regularly and make lifestyle changes like reducing sodium intake and increasing physical activity.
Benjamin Galper, M.D., a cardiologist at Kaiser Permanente, underscores the importance of managing blood pressure effectively, particularly for those above 50.
“For my patients, I recommend starting medication if their blood pressure reaches stage 1 … and lifestyle changes, including exercise and nutrition adjustments, are not allowing them to reach their goal.”
The highest level, stage 2 hypertension, is marked by a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or above. This stage puts individuals at a high risk for heart attacks, strokes, and kidney damage, necessitating immediate medical intervention and lifestyle adjustments.
To ensure that your blood pressure readings are accurate, Dr. Cohen suggests taking readings about 30 seconds to a minute apart, twice daily – once in the morning and once before bed, ideally an hour after dinner. This should be done at least three days per month.
Hypertensive urgency, or uncontrolled hypertension as Dr. Cohen terms it, arises when blood pressure exceeds the 180/120 mark without causing symptoms of damage to vital organs like the heart, brain, kidneys or eyes. In case of seeing these numbers, it’s critical to double-check the reading and seek immediate medical assistance to adjust the treatment plan and avert potential damage.
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