What pressure is considered normal?
Diagnosis is not made by one measurement. Repeated measurements are needed on different days, or better yet, 24-hour blood pressure monitoring (ABPM), which also detects nocturnal hypertension, which is invisible with regular measurements.
- Optimal: below 120/80 mmHg. Art.
- Normal: 120–129 / 80–84
- High normal: 130–139 / 85–89 – already requires attention and lifestyle changes
- Stage 1 hypertension: 140–159 / 90–99
- Hypertension 2 degrees: 160–179 / 100–109
- Hypertension 3 degrees: 180/110 and above
How to measure blood pressure correctly
- Не курить и не пить кофе за 30 минут, посидеть спокойно 5 минут перед измерением.
- Сидеть, опираясь на спинку, ноги не скрещены, стопы на полу.
- Рука на столе на уровне сердца, манжета по размеру, на 2–3 см выше локтевого сгиба.
- Не разговаривать во время измерения.
- Сделать 2 измерения с интервалом 1–2 минуты и записать среднее.
- Измерять утром до приёма таблеток и вечером; вести дневник и приносить его врачу.
At the first visit, the pressure is measured on both arms: if the difference is persistent and more than 15 mm Hg. Art., this is a reason for additional examination of blood vessels. Subsequently, they are measured on the hand with higher numbers.
Symptoms and target organs
In most cases there are no symptoms. When they appear, it is often a sign of either very high numbers or already developed complications.
- Headache, usually in the back of the head, in the morning
- Dizziness, tinnitus, spots before the eyes
- Nosebleeds, facial redness
- Shortness of breath on exertion, palpitations
- Fatigue, decreased performance
Target organs that suffer silently: heart (left ventricular hypertrophy, then heart failure), brain (stroke, vascular dementia), kidneys (chronic kidney disease), eyes (retinal damage), blood vessels (aneurysms, atherosclerosis).
Survey
- Суточное мониторирование артериального давления — точнее разовых измерений и выявляет ночную гипертензию.
- ЭКГ и эхокардиография — оценка гипертрофии и работы сердца.
- Анализы: креатинин с расчётом СКФ, калий, глюкоза, липидный спектр, общий анализ мочи с белком.
- УЗИ почек и почечных артерий — исключение почечных причин.
- Осмотр глазного дна.
- При подозрении на вторичную гипертензию — гормональные исследования.
Treatment
The goal is not to “bring down the pressure today,” but to keep it in the target range constantly. For most patients this is below 140/90, and if well tolerated it is around 130/80. Target numbers for the elderly and for concomitant diseases are determined by the doctor.
- The drugs are taken DAILY and constantly, and not “when it rises.” This is the main rule and the main reason for treatment failures
- Often a combination of two or three drugs in small doses is required - this is more effective and safer than one in maximum
- Limiting salt to 5 g per day reduces blood pressure by 5–10 mmHg. Art.
- Weight loss: every 10 kg gives minus 5–20 mm Hg. Art.
- Aerobic activity 30 minutes most days of the week
- Quitting smoking and limiting alcohol
- Getting adequate sleep and treating sleep apnea
In case of a hypertensive crisis (pressure above 180/120), you cannot sharply reduce the pressure: too rapid a drop is dangerous for the brain and heart. The goal is a gradual decline over the course of hours, and if there is chest pain, shortness of breath or neurological symptoms, you should call an ambulance.
