High Blood Pressure

Adult HouseCalls Online

DEFINITION

• Systolic blood pressure greater than 140 or
• Diastolic blood pressure greater than 90 or
• Taking medications for high blood pressure

General Information

• Systolic vs Diastolic - The blood pressure (BP) reading is written as two numbers, the systolic pressure and the diastolic pressure. For example, if a person had a BP of 130/65, then 130 would be the systolic blood pressure and 65 would be the diastolic blood pressure..
• Definition of High Blood Pressure - An adult has hypertension (high blood pressure) if the blood pressure (BP) readings consistently show a BP greater than 140/90, that is, a systolic BP over 140 OR a diastolic BP over 90.
• Untreated hypertension may cause damage to the heart, brain, kidneys, and eyes.
• Automatic home BP measurement devices can sometimes be unreliable. You should check your BP in both arms. If there is another adult in the home, consider checking his/her BP to see if the device is functioning correctly. If there is any doubt, go in to your doctor's office to get your blood pressure checked.

Blood Pressure Classification in Adults

• Normal: less than 120/80
• Prehypertension: between 120-139/80-89
• Hypertension - Stage 1: between 140-159/90-99
• Hypertension - Stage 2: greater than 159/99

Internet Resource - National High Blood Pressure Education Program

• My Blood Pressure Wallet Card. Available at http://www.nhlbi.nih.gov/health/public/heart/hbp/hbpwallet.htm
• Your Guide to Lowering Blood Pressure. Available at http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_low/index.htm

See More Appropriate Topic (instead of this one) If

• CHEST PAIN
• HEADACHE

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WHEN TO CALL YOUR DOCTOR

Call 911 Now (you may need an ambulance) If

• You think you are having a stroke or a heart attack
• Difficult to awaken or acting confused

Call Your Doctor Now (night or day) If

• You feel weak or very sick
• Your BP is over 200 / 120
• Your BP is over 140/90 and you are more than 20 weeks pregnant
• Pregnant with hand or face swelling

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think you need to be seen
• Your BP is over 180 / 110 (and you are feeling fine)
• Your BP is over 140 / 90 and you are less than 20 weeks pregnant
• You ran out of BP medications
• Taking BP medications and you think you are having side effects (e.g., impotence, cough, dizziness)

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Your BP is over 160 / 100 (and you are feeling fine)
• Your BP is over 140 / 90 and you are taking blood pressure medications
• Your BP is over 130 / 80 and you have any heart problems, kidney disease or diabetes
• Your BP is over 120 / 80 and no improvement one month after lifestyle modifications (see Home Care Advice)

Self Care at Home If

• Your BP is between 120-139 / 80-89 (prehypertension), you are feeling fine, and you don't think you need to be seen.
• Your BP is less than 120 / 80 (normal blood pressure), and you don't think you need to be seen

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HOME CARE ADVICE FOR HIGH BLOOD PRESSURE

1. General:
   • Untreated high blood pressure may cause damage to the heart, brain, kidneys, and eyes.
   • Treatment of high blood pressure can reduce the risk of stroke, heart attack, and heart failure.
   • The goal of blood pressure treatment for most patients with hypertension is to keep the blood pressure under 140/90.
2. BP 120-139 / 80-89
   • This is considered borderline high blood pressure, or “prehypertension”.
   • Sometimes, changes in your lifestyle can reduce your blood pressure without medications
   • If your blood pressure stays elevated during the next 1 month, you should go in to see the doctor and get your blood pressure checked.
3. BP less than 120 / 80
   • This is considered normal blood pressure
4. Lifestyle Changes - The following lifestyle changes can help you reduce your blood pressure:
   • Maintain a healthy weight. Lose weight if you are overweight.
   • Do 30 minutes of aerobic physical activity (e.g., brisk walking) most days of the week.
   • Eat a diet high in fresh fruits and low fat dairy products. Limit your intake of saturated and total fat. Choose foods that are lower in salt.
   • If you smoke, you should stop.
   • If you drink alcohol, you should limit your daily alcohol drinking. Women should have no more than one drink per day. Men should have no more than 2 drinks per day. A drink is defined as 1.5 oz hard liquor (one shot or jigger), 5 oz wine (small glass), 12 oz beer (one can) than 24 oz beer, or less than 10 oz wine.
5. Call Your Doctor If:
   • Headache, blurred vision, difficulty talking or difficulty walking occurs.
   • Chest pain or difficulty breathing occurs.
   • You want to go in to the office for a blood pressure check
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.