Question: I’m 60 and am good about getting a physical every year. The nurse will take my blood pressure and will tell me two numbers. She’ll say it’s very good. I’m glad to hear that, but I don’t know what these numbers mean. Can Ask the Doctor explain? Do these numbers mean different things for different age groups? How about men and women? — Robert, of Waynesfield
Blood pressure is one of the five vital signs and is recorded as two numbers. The top number is called systolic blood pressure and it describes the pressure that blood exerts against the arterial wall when the heart contracts or squeezes. The bottom number is called the diastolic blood pressure, it is the pressure that blood exerts against the arterial wall when the heart is relaxing or filling up with blood in preparation for the next beat. Blood pressure is measured in millimeters of mercury (mm Hg).
A blood pressure number of less than 120/80 mm Hg is considered within the normal range. Both numbers are important in making the diagnosis of high blood pressure or hypertension. Typically, more attention is given to the top number (systolic) as a major risk factor for heart disease. A blood pressure of greater than 120 systolic and greater than 80mm Hg diastolic is considered elevated and healthy lifestyle habits must be adopted in order to prevent further elevation of high blood pressure.
As we age, the systolic blood pressure normally rises due to stiffening of the large arteries. Hypertension is associated with a significant increase in risk of adverse cardiac outcomes. It is the most important modifiable risk factor for early heart disease and this is why we check a patient’s blood pressure at every office visit. Other important modifiable risk factors include cigarette smoking, high cholesterol and diabetes.
Several studies indicate that the risk of heart disease and stroke doubles with every 20mm Hg systolic or 10 mm Hg diastolic increase in blood pressure.
Some of the common complications of untreated high blood pressure are: heart failure, ischemic stroke (caused by blockage), intracerebral hemorrhage (stroke caused by bleeding in the brain), myocardial infraction (heart attack), aneurysm (ballooning of the arteries) and kidney failure.
There are some gender differences in hypertension. A higher percentage of men have high blood pressure until the age of 45 years old. From 45-64 years old, the percentage appears similar in the sexes and after 64 years old a higher percentage of women tend to have high blood pressure compared to men.
Regularly monitoring the blood pressure is an important way to stay heart healthy.
Kishore Nallu MD, Interventional Cardiologist, St. Rita’s Heart Specialist