What do the top and bottom numbers mean?
The upper, systolic, pressure is created by the ejection of blood from the heart, the lower, diastolic, by the resistance of small arteries during the pause between beats. The lower one is often called cardiac, but this is inaccurate: it speaks more about the condition of the blood vessels and the functioning of the kidneys, which regulate the volume of fluid and the tone of the arteries. The difference between the numbers is called pulse pressure. In young people, the vessels are elastic, so the increase often affects the lower number, and after 60 years, the arteries become stiffer and the upper one grows.
- The normal diastolic pressure is below 90 mmHg. Art.
- Target numbers for most adults are below 130/80
- Isolated increase in the lower most often occurs before 50 years of age
- After 60 years of age, upper blood pressure increases more often
- Diagnosis is made by repeated measurements, not by a single episode
Why does low blood pressure increase?
The main mechanism is increased tone and narrowing of small arteries, as well as sodium and fluid retention. In most cases, we are talking about primary hypertension, which does not have one cause: heredity, excess weight, excess salt, lack of exercise, alcohol, chronic stress and lack of sleep. In some patients, a secondary cause is found - kidney disease, narrowing of the renal artery, excess adrenal hormones, thyrotoxicosis, sleep apnea syndrome. Medicines can also raise blood pressure: painkillers, hormonal contraceptives, vasoconstrictor nasal drops.
- Excess weight and inactivity
- Lots of salt in diet
- Alcohol and smoking
- Chronic stress and lack of sleep
- Diseases of the kidneys and renal arteries
- Sleep apnea
- Some medications and nasal drops
Symptoms and why it is dangerous
Most often, increased lower pressure does not manifest itself in any way and is discovered by chance. Sometimes there is a headache in the back of the head in the morning, heaviness in the head, tinnitus, fatigue, and flickering of spots before the eyes. The absence of complaints does not mean safety: long-term elevated diastolic pressure damages small vessels in the kidneys, eyes and brain, thickens the wall of the left ventricle and increases the risk of stroke, heart attack and chronic kidney disease. Therefore, treatment decisions are made based on numbers and overall cardiovascular risk, and not on how you feel.
- Headache in the back of the head, often in the morning
- Noise in the ears and spots before the eyes
- Fatigue and poor sleep
- Nosebleeds
- Often - complete absence of complaints
How to measure blood pressure correctly
Measurement errors are the most common cause of falsely high numbers. You need to measure after a five-minute rest, sitting, with your back supported and your hand at heart level, your legs are not crossed, you cannot talk. The cuff should correspond to the circumference of the shoulder: a narrow cuff will increase the result. Take two measurements one to two minutes apart and record the average. Half an hour before the measurement, do not drink coffee, smoke or play sports. To confirm the diagnosis, the doctor usually asks to keep a blood pressure diary or prescribes 24-hour monitoring.
- Rest 5 minutes before measurement
- Hand on support at heart level
- Cuff according to shoulder size
- Two measurements in a row, record the average
- No smoking or drinking coffee for 30 minutes
- Keep a diary in the morning and evening for at least a week
What to do and how to treat it
They start with lifestyle: losing weight even by a few kilograms significantly reduces blood pressure, limiting salt to a teaspoon per day, regular walking or other aerobic activity for at least 150 minutes a week, giving up alcohol and smoking, and normal sleep. The examination includes an ECG, echocardiography, blood and urine tests, and ultrasound of the kidneys if indicated. If the numbers remain high, the doctor selects drugs - ACE inhibitors or sartans, calcium antagonists, thiazide diuretics. Treatment is usually long-term; it cannot be interrupted when the pressure normalizes.
- Reduce weight and waist circumference
- Limit salt and processed foods
- At least 150 minutes of aerobic activity per week
- Quit alcohol and smoking
- Treat sleep apnea with snoring and breathing pauses
- Take prescribed medications continuously, not in courses
