MEASURING BLOOD PRESSURE

The only way to find out if you have high blood pressure is to have your blood pressure checked. It is measured by a quick, painless test using a medical instrument called a sphygmomanometer.

The test measures systolic pressure (when the heart beats) and diastolic pressure (when the heart rests between beats). Blood pressure is measured in millimeters of mercury (mm Hg). A doctor or another qualified health professional should check a patient's blood pressure at least once every two years.

A rubber cuff is wrapped around a person's upper arm and inflated. When the cuff is inflated, it compresses a large artery in the arm, momentarily stopping the flow of blood.

Next, air in the cuff is released, and the person measuring the blood pressure listens with a stethoscope. When the blood starts to pulse through the artery, it makes a sound; sounds continue to be heard until pressure in the artery exceeds the pressure in the cuff. While the person listens and watches the sphygmomanometer gauge, he or she records two measurements. The systolic pressure is the pressure of the blood flow when the heart beats (the pressure when the first sound is heard). The diastolic pressure is the pressure between heartbeats (the pressure when the last sound is heard). Blood pressure is measured in millimeters of mercury, which is abbreviated mm Hg.

DISTINGUISHING BLOOD PRESSURE LEVELS

Blood pressure is measured in millimeters of mercury (mm Hg). The classifications in the following table are for persons who are not taking antihypertensive drugs and are not acutely ill. When systolic and diastolic pressures fall into different categories, the physician will select the higher category to classify the person’s blood pressure status. Diagnosis of high blood pressure is based on the average of two or more readings taken at each of two or more visits after an initial screening.

Classification of blood pressure for adults age 18 years and older, with recommended follow-up

Category	Systolic (mm Hg)		Diastolic (mm Hg)	Follow-up recommended
Optimal*	<120	and	<80	Recheck in 2 years
Normal	<>	and	<>	Recheck in 2 years
High normal	130 - 139	or	85-89	Recheck in 1 year
Hypertension STAGE 1(Mild)	140 - 159	or	90 - 99	Confirm within 2 months
STAGE 2 (Moderate)	160 - 179	or	100 - 109	Evaluate within 1 month
STAGE 3 (Severe)	>179	or	>109	Evaluate immediately or within 1 week depending on clinical situation

*Optimal blood pressure with respect to cardiovascular risk is <120/80>

(From the Sixth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, NIH publication, 1997)

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FACTORS THAT CONTRIBUTE TO HIGH BLOOD PRESSURE

What factors increase the chance that a person will develop high blood pressure?

Heredity

Male sex

Age

Sodium (salt) sensitivity

Obesity

What other related factors contribute to high blood pressure?

Heavy alcohol consumption

Use of oral contraceptives and some other medications

Sedentary or inactive lifestyle

Because medical science doesn't understand the causes of most cases of high blood pressure, it's hard to say how to prevent it. Still, several factors may contribute to it. Being overweight or using excessive salt are two avoidable factors.

Age is one risk factor that can't be changed. Generally speaking, the older people get, the more likely they are to develop high blood pressure.

Heredity is another factor. People whose parents have high blood pressure are more likely to develop it than those whose parents don't.

The incidence of high blood pressure isn't directly related to a person's sex. However, doctors usually keep a close watch on a woman's blood pressure during pregnancy or if she's taking oral contraceptives. Some women who have never had high blood pressure develop it during pregnancy. Similarly, a woman taking oral contraceptives is more likely to develop high blood pressure if she's overweight, has had high blood pressure during pregnancy, has a family history of high blood pressure or has mild kidney disease.

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