Wednesday, August 1, 2012

Hypertension - the basics

What is blood pressure?

Blood pressure is a measurement of the force or pressure against the walls of your arteries as your heart pumps blood through your body. Blood pressure readings are usually given as two numbers, for example, 120 over 80, or written as 120/80 mmHg.
The top number is called the systolic blood pressure (SBP), and the bottom number is called the diastolic blood pressure (DBP).
Systolic blood pressure is the peak pressure in the arteries, which occurs when the ventricles of the heart contract and pumping most of the blood out to the body. Diastolic blood pressure is the minimum pressure in the arteries, which occurs when the ventricles are filled with blood, just enough for the heart to start  pumping them to the body.

How is blood pressure measured?

Blood pressure is most commonly measured via a sphygmomanometer, which historically used the height of a column of mercury to reflect the circulating pressure. BP values are generally reported in millimetres of mercury (mmHg), though nowadays variable modern electronic devices do not use mercury.

What are the numbers for low, normal or high blood pressure?

  • Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most of the time.
  • High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg or above most of the time. Hypertension can be divided to stage 1 or stage 2 hypertension, depending on your blood pressure. 
  • If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called prehypertension. People who has prehypertension, will most likely develop hypertension in the long run.

    CategorySystolic BP(mmHg)Diastolic BP (mmHg)
    Hypotension< 90< 60
    Prehypertension120–139or 80–89
    Stage 1 Hypertension140–159or 90–99
    Stage 2 Hypertension160–179or 100–119
    Hypertensive Crisis≥ 180or ≥ 120

What is hypertension and do I have it?

Hypertension is a medical term used for people with persistent high blood pressure. You have hypertension if:
- your blood pressure is always higher than 135/85 mmHg
- your average blood pressure during the day time (awake) is above 140/90 mmHg
- your average night time blood pressure (asleep) is above 125/75 mmHg 

Why is persistent hypertension bad?

Persistent hypertension is a major risk factor for strokemyocardial infarction (heart attack), heart failure and aneurysms of the arteries, and it can cause damage to your kidneys, liver, brain and other end organs
Even moderate elevation of arterial blood pressure is associated with a shortened life expectancy

When is the best time to measure blood pressure?

Blood pressure is best measure early in the morning after waking up, and before you go to bed. It is important to measure your blood pressure consistently at about the same time of the day for accurate comparisons. It is best not to drink coffee, smoke cigarettes, or engage in strenuous exercise for 30 minutes before taking the reading. Sit upright in a chair with your feet flat on the floor and with limbs uncrossed 5 minutes before measurement. The cuff should always be against bare skin, as readings taken over a shirt sleeve are less accurate. During the reading, the arm that is used should be relaxed and kept at heart level, for example by resting it on a table. 

The correct way of blood pressure measuring will be discussed further in the coming articles.

What are the risks for hypertension?

You might be have the risks of developing hypertension if:
- either or both of your parents have hypertension
- you have excess sodium intake in your diet
- have frequent excess alcohol intake
- have obesity or excessive weight gain
- physically inactive and does not exercise regularly
- have cholesterol problems
- have certain personality traits, e.g. hostile attitudes, time urgency/impatient, easily worried or stressed
- have less vitamin D in your diet

What can I do if I have hypertension?

Dietary and lifestyle changes can improve blood pressure control and decrease the risk of associated health complications, although drug treatment is often necessary in patients for whom lifestyle changes prove ineffective or insufficient.

  • weight reduction
    • maintain a normal body weight and body mass index (BMI) is important
    • BMI should be between 18 to 24 kg/m2
    • approximately 5 -20 mmHg of systolic BP reduction can be obtained with every 10kg weight loss
  • healthy diet
    • consuming diet rich in vegetables, less fat content can reduce the chances of developing hypertension, and reduce your blood pressure
    • diet high is vitamin D, calcium, potassium, magnesium is good for reducing your blood pressure
    • please refer to our Clique Hypertension Diet Guide for further information
    • reduction of SBP by 8 - 14 mmHg can be obtained by diet control
  • reduce salt intake
    • reduce dietary sodium/salt intake to 100 meq/day (2.4 g sodium or 6 g sodium chloride)  is important for people with high blood pressure
    • avoid salty food, adding salt to your food, or consume processed food regularly
    • some carbonated and sport drinks have high content of sodium
    • sodium reduction can reduce your SBP by 2 - 8 mmHg
  • physical activity
    • engage in regular aerobic exercises such as brisk walking, cycling, stair-climbing at least 30 minutes a day can help improve your blood pressure
    • taking a stroll after work/meals, walk in quick steps in the mall
    • reduce SBP by 4 -9 mmHg
  • moderate alcohol consumption
  • smoking cessation
  • reduce pain killer use

What should you tell you doctor if you have high blood pressure?

A doctor would like to know the following if you have high blood pressure
1. When was the last known normal blood pressure?
2. What time of the day is your blood pressure high? day or night?
3. Prior treatment for your blood pressure
4. Any family members with blood pressure issues, heart issues, or hormonal issues.
5. Do you smoke, drink alcohol, or having any other health issues, such as diabetes, high cholesterol?
6. Do you have headaches, transient weakness or blindness, difficult breathing, leg pains, racing heart, thining of skin, flank pain, daytime tiredness, loud snoring?
7. How is your diet, daily stress level and physical activity?

For more information about high blood pressure and its treatment, please contact +603-79601211 or write to us at

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