On a recent beautiful morning while I was taking my two-mile power walk, I was surprised when one of my companions asked, “What’s the story with those blood pressure numbers, what do they mean?” And, in fact, the other walker chimed in that it was a mystery to her as well.
Those are hugely important numbers, I explained, because when they’re consistently too high (hypertension), the result can be a stroke, a heart attack, kidney failure and even blindness. It’s also a “silent killer.” You can be walking around with very high blood pressures and feel perfectly fine.
What is the difference between the two numbers?
Let me first explain the two numbers: The higher recording, systole, occurs when the heart contracts. The lower number, diastole, occurs when the heart relaxes between beats.
What do the numbers mean?
If your blood pressure is 120/80 or less you’re in a good place. If, however, it runs between 120/80 to 140/90, this is called “pre-hypertension.” If they are even higher than 140/90, this is hypertension, a serious problem.
Most victims have no apparent cause for their hypertension. But often it is a familial issue or can be related to being overweight and physically inactive. African-Americans have a much higher incidence. Others risk factors include age (over 55) and heavy drinkers, or salt eaters, or users of anti-inflammatory drugs (such as Advil and Aleve), as well as smokers.
What is White Coat Syndrome?
Often my patients will become unnecessarily concerned about an isolated high blood pressure reading – “Doctor, my blood pressure was 148/92, much higher than usual and I’m worried.” Your blood pressure, I reassure them, is a dynamic process, always changing. When we are stressed, there are signals sent from the brain to the adrenal glands to produce more adrenaline which will make our hearts race and our blood pressure rise. This results in the so-called “white coat syndrome” many patients experience in a doctor’s office. My passionate and sensitive patients are much more likely to do this and I must separate them from the fixed hypertensives, those who have consistently elevated pressures.
What to do if you are concerned about your blood pressure numbers?
I recommend that concerned patients purchase an accurate blood pressure digital monitor and track their blood pressure three times a day: morning (usually the highest), midday and at bedtime. Be as relaxed and calm as possible, I tell them, and carefully follow the directions on how to use this machine.
If the result is consistently high, you will need to be treated for what is a life-long illness. But with appropriate direction from your doctor regarding medication and lifestyle changes, you will have a high likelihood of successful control of your blood pressure and prevention of its complications.
So my walking companions learned about the variability of blood pressure numbers and I learned not to assume so readily that this is common knowledge.