What's your Blood Pressure?

By Thomas E. Looze, MD

High blood pressure or hypertension is a common ailment affecting millions of people throughout the world. There are no symptoms. It can only be detected by measuring your blood pressure with a device called a sphygmomanometer. A physician will check your blood pressure by pumping up a cuff placed on your arm. The pressure in the cuff is slowly reduced until sounds of blood flow are heard with a stethoscope overlying the artery. The pressure at which a pulse is heard is called the systolic blood pressure. As the pressure in the cuff is slowly reduced further, the pulse sounds disappear. This is called the diastolic blood pressure. High blood pressure is defined as any blood pressure over 140/90 millimeters of mercury. Systolic blood pressure, the upper number, indicates the pressure that the heart must exceed to pump blood forward. The diastolic blood pressure, or the lower number, is the pressure that is maintained in between heartbeats. An elevation of either the systolic or the diastolic pressure is known to cause medical complications including hardening of the arteries, heart disease, kidney disease, and stroke.

Blood pressure should be treated if it is elevated. The first step is to determine whether there are any other illnesses that might be causing it. Sometimes there are congenital developmental defects or abnormal hormone regulation that can lead to hypertension. Most often we find that people have what is called “essential hypertension”. It is caused by a combination of a person’s genetics, dietary habits, age, race, obesity, lack of exercise, or due to an underlying illness such as kidney disease or diabetes.

When a person has high blood pressure in the physician’s office and has normal blood pressure at other times, it is helpful for the patients to check their own blood pressures at home. Today there are numerous low cost, easy-to-read electronic blood pressure devices available that can be used by the lay person to accurately record their blood pressure. These devices are reasonably accurate and can help you give your physician a better idea of what your blood pressure is like outside of the office setting. With these convenient at home blood pressure monitors, blood pressure can be recorded at different times of day and under stressful or quiet conditions and compared to the pressure recorded during an office visit to determine if treatment is necessary.

If you are under treatment for high blood pressure, regular recording of at-home readings can help your physician to know whether your blood pressure is being adequately controlled throughout the day.