Self Monitoring Your Blood Pressure, Know Your Numbers

January 30th, 2016

Most of us know our height and weight, but do you know your blood pressure numbers?  I believe we should all know these two important numbers.  You should be concerned about high blood pressure.  It runs in families and can cause early heart disease (heart attacks), strokes, kidney failure, and blindness.  As devastating as these conditions are, we often don’t feel when our blood pressure is high.  That is why high blood pressure has the nickname, the “Silent Killer”.

I recommend starting with an annual physical with your primary care provider.  He/she can take an accurate measurement of your blood pressure in both arms.  The top number is called the “systolic blood pressure” which measures the pressure in your blood vessels during contraction (pumping) of the heart, while the bottom number is called the “diastolic blood pressure” which is the pressure when the heart has relaxed.  I recommend that you write these numbers down or record them on your smartphone.  Then, purchase a blood pressure monitor.  I personally recommend the Omron blood pressure monitor with an upper arm (bicep) cuff as they are more accurate and generally not too expensive.  These are automatic cuffs and do not require any more skill than pushing a button.

Here’s how to get an accurate measurement:

  • Set up the blood pressure monitor on a kitchen table, with the cuff snugly around your upper arm.
  • Sit quietly for 2 full minutes with both feet flat on the floor.
  • Push the button with your other arm.  Sit still and try not to move until the reading is done.
  • The cuff should inflate and then deflate.
  • Do not be tempted to recheck the blood pressure until 10 minutes later.  Rechecking the blood pressure too soon can result in inaccurate measurements.
  • Try to take your blood pressure in the same arm each time.  Generally speaking, the blood pressure in the left arm will be slightly higher on average than the left since the heart sits closer to the left arm.

Here are some numbers and what they can mean.  Generally, we look at blood pressure trends and not individual numbers.

Top number <100 or bottom number <60:  Your blood pressure can be normal for you or too low.  check with your medical provider to see if this could have an impact on your health or needs further workup.  People with very low blood pressure can have fainting spells or light-headedness when they stand.

Top number 100-130 or bottom number 60-80:  This is the ideal range for blood pressure.  Make sure you maintain proper diet and exercise regularly to keep these numbers in range.

Top number 130-140 or bottom number 80-90:  This is called “pre-hypertension” and you are at risk for developing full blown hypertension in the coming years.  Medications are not usually indicated for this blood pressure range if you are otherwise healthy, but if you have a history of heart disease or diabetes your healthcare provider may start you on medications.  Diet and exercise are extremely important to reverse pre-hypertension.

Top number 140-160 or bottom number 90-100:  These are numbers consistent with true hypertension.  You should make an appointment to see your healthcare provider to find out what medication you need to be on.  Lifestyle changes such as daily exercise and low fat diet are also important.  In fact, if you are able to lose weight, and truly live a healthy lifestyle, you may be able to maintain a good blood pressure and can stop the medications.

Top number >160 or bottom number >100:  These are dangerously high blood pressures that need immediate attention.  If you have these numbers and have any symptoms of chest pain, blurry vision or loss of vision, decreased urination, leg swelling, or headaches, you need to go to your nearest emergency room.  Blood pressures that are in this range can result in serious life threatening problems.  If you forgot to take your blood pressure medication, take them immediately.  You will likely need to be given blood pressure medications through an IV at the hospital with close monitoring of your blood pressure and need some blood tests and an EKG to be done to make sure there is no damage to your heart.