Normal Blood Pressure - How to Check, Lower, and Treat

Hypertension, High Blood Pressure

Hypertension (HTN) is a risk factor for several diseases, including stroke, heart disease, and end-stage renal disease. Since heart disease and stroke remain the first and third leading causes of death in the United States respectively, control of hypertension can help reduce morbidity and mortality. A formal public education program about hypertension started by the National Heart, Lung and Blood Institute in 1972 has shown dramatic results in the reduction of deaths from stroke and heart disease. But since 1993, the rate of reduction has slowed, suggesting a need for increased public and professional education. 

Hypertension Defined

Blood pressure (BP) is expressed as two numbers, written, for example, as 120/80 and spoken “one-twenty over eighty”. Systolic, or maximum blood pressure, is the top number. It reflects the pressure exerted by the left ventricle during contraction. Diastolic, or minimum blood pressure, is the bottom number. It reflects the pressure in the arteries when the heart is at rest.  Hypertension is defined as systolic blood pressure (SBP) of 140 mm Hg or greater, diastolic blood pressure (DBP) of 90 mm Hg or greater, or taking antihypertensive medication.  The relationship between the degree of hypertension and risk to the patient is linear - that is, the higher the numbers, the more the patient is at risk.   

Because of this linear relationship, categorizing a patient's blood pressure helps to guide treatment.  The following categories are used for adults over 18 who are not acutely ill and who are not currently taking BP medication:

Category Systolic   Diastolic
Optimal <120 and <80
Normal <130 and <85
High Normal 130-139 or 85-89
Stage I HTN 140-159 or 90-99
Stage II HTN 160-179 or 100-109
Stage III HTN >180 or >110


The systolic blood pressure and diastolic blood pressure numbers used should be based on the average of two or more readings taken at each of two or more visits after an initial screening.  When systolic and diastolic blood pressures fall into different categories, the higher category should be used to classify the patient's blood pressure status.  Unusually low readings should also be evaluated for significance.

Checking Your Blood Pressure

First of all I cannot stress enough how important it is to check your blood pressure in both arms. Research suggests that a difference of more than 10 points between arms increases your risk of stroke or heart attack by 38% in the next 13 years or so. To get an accurate reading make sure you have not eaten for at least two hours. Eating or drinking can cause your blood pressure to temporarily increase since your stomach requires more blood for digestion, your heart will pump harder therefore increasing your blood pressure. In any case even after eating your systolic pressures should not increase by more than 40 and in most cases no more than 15-20. Higher spikes should be evaluated by a physician.

Your systolic (upper number) blood pressure reading will be higher on your left arm because of its proximity to the pumping ventricle of the heart. For this reason it is also more representative of the pressure created by the heart as it pumps which is why the left side is preferred whenever you visit a doctor's office. However, next time ask them to check both arms and the difference should be minimal. If the difference is more than 10, but less than 15 don't be alarmed. Continue to check at home if possible with the use of a blood pressure monitor and get daily averages. If the blood pressure readings in one arm is consistently higher than 15, you should get evaluated by your physician.

The diastolic (lower number) blood pressure reading is the remaining/minimum pressure in the blood vessels between heartbeats. This number should be similar between the right and left arms because its not a direct result of the pumping of the heart.

When to Check

Check your blood pressure in both arms about 15 minutes after you wake up. Sit quietly in a chair with both feet flat on the floor. Make sure the cuff is placed correctly on your arm and at the same level as your heart.

If you indeed have a higher than 15 average reading between arms, then I suggest you get a carotid artery ultrasound to check for any plaque or blockages. See the link below for details.

http://www.lifelinescreening.com/What-We-Do/What-We-Screen-For/Carotid-Artery-Disease

I would also recommend checking your aorta

http://www.lifelinescreening.com/What-We-Do/What-We-Screen-For/Abdominal-Aortic-Aneurysms

and also check your legs for peripheral arterial disease

http://www.lifelinescreening.com/What-We-Do/What-We-Screen-For/Peripheral-Arterial-Disease

How to Lower Your Blood Pressure Naturally

There are many supplements on the market today, but the ones I personally use and recommend are listed below.

Beet Root Juice - helps to dilate blood vessels by increasing nitric oxide in the endothelium - Taking one tablespoon per day starting out and working your way up to a maximum of two ounces per day.

Pomegranate - helps like beet root juice, but also helps to reverse arterial plaque

There are many other things you can do, but those would be more individualized. Become a member today and learn what you can do to naturally lower your blood pressure.