Blood Pressure: Knowing Your Numbers and Goals

Alan Tanabe/ August 12, 2021/ High blood pressure, Medication Management/ 4 comments

Greetings, everybody! I am glad to be back after a lengthy absence, and I hope this article finds you well.

The topic for this article is blood pressure. Now, I’m confident that most of us have heard about blood pressure. However, how many people know their goal blood pressure, and why it is important to have your blood pressure controlled? I hope to provide answers to clarify some of these frequently asked questions.

What is blood pressure and why is it so important to have it controlled?

A simple definition of blood pressure is the force of the blood against the walls of the blood vessels as it travels throughout the body. Now two different numbers make up a blood pressure reading. The first, or top number, is the systolic pressure. This measures the pressure when the heart contracts and forces the blood through the blood vessels. The second, or bottom number, is the diastolic pressure. This measures the pressure when the heart relaxes in between beats. So an example reading would be a blood pressure of 120/80.

Controlling blood pressure is important because the longer that it remains uncontrolled, it causes damage to the blood vessels. Your heart works harder when your vessels are damaged to keep the blood flowing throughout the body. Also, the tissues and organs in your body may not receive adequate amounts of oxygen as blood flow may be compromised. These factors contribute to increasing the risk for complications including heart attack, stroke, vision problems, sexual dysfunction, and other problems.

What is my goal blood pressure?

There are more than one set of suggested guidelines for blood pressure control. The Eighth Joint National Committee (JNC8) suggests that a person over 60 years of age without the presence of diabetes or chronic kidney disease (CKD) has a goal blood pressure of less than 150/90. JNC8 also suggests that a person under the age of 60, or a patient over the age of sixty with the presence of diabetes or CKD has a goal blood pressure of less than 140/90.

A more-recently released guideline from the American College of Cardiology and the American Heart Association (ACC/AHA) lends less importance to patient age. The ACC/AHA guideline is as follows:

-Desired blood pressure: Less than 120/80

-Elevated blood pressure: Systolic 120-129 AND Diastolic less than 80

-Stage 1 hypertension: Systolic between 130-139 OR Diastolic between 80-89

-Stage 2 hypertension: Systolic 140 or above OR Diastolic 90 or above

Blood pressure can be considered too low, as well. Generally, a systolic should not be much lower than 100 and a diastolic should not be much lower than 60. When blood pressure is too low, the risk for dizziness and falls may increase.

Now a physician or pharmacist may adjust your personal blood pressure goal based on your medical history. For example, if a patient has a history of a heart attack, congestive heart failure, or a stroke, your goal blood pressure may be more stringent (example less than 130/80), to reduce the risk of further complications. Additionally, we take other factors into consideration regarding realistic approaches to achieve blood pressure control. These factors may include a patient’s physical ability to exercise, financial limitations, or allergies. If you have a history of falls or occasional low blood pressure, your doctor might suggest a higher goal, for example 140/90. This is an excellent topic of discussion to have with your primary provider and pharmacist.

Monitoring your blood pressure

Now how do you know what your blood pressure is? You can have your blood pressure measured in a number of ways.

  1. Your primary provider can check your blood pressure. The advantage of this method is that a trained professional is using reliable equipment to attain an accurate measurement. However, a potential disadvantage is that you likely need an appointment. Additionally, when going to a clinic setting, one may experience “white coat syndrome.” When a health professional measures blood pressure, some people may feel nervous, thus resulting in an elevated reading.

2. You can check your own blood pressure with the use of a home blood pressure monitor. Home blood pressure monitors are available to wear around the cuff of the arm or the wrist. My experience favors the arm cuff style, as the wrist monitors tend to have greater variations in readings. However, if properly placing the arm cuff is difficult due to dexterity limitations, a wrist monitor is an acceptable alternative. I do recommend that whichever style you use, ask your provider or pharmacist how to use the proper technique to increase accuracy. I also recommend taking your home monitor to your appointments. This allows comparison of your monitor with the clinic’s equipment to determine accuracy.

3. Some pharmacies have a blood pressure machine for the general public to use. While these offer convenience, they may be less accurate as the cuff may not be an ideal fit for your arm. In addition, with the current COVID-19 concerns, many businesses have prohibited use of these public monitors.

4. Some people have mentioned an app available on their phone that claims it can measure your blood pressure by placing your finger on your phone. Short answer: No.

To learn more about how to monitor and control your blood pressure, please contact Betty Chaffee, PharmD at BetterMyMeds.com. Betty specializes in educating and personalizing medication regimens for patients. As always, we welcome and encourage any questions and comments that you may have regarding our posts.

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About Alan Tanabe

Alan Tanabe, PharmD. has been a registered pharmacist in the state of Michigan since 1991. In addition to working as a pharmacist in a community setting, he has specialized in patient services including Medication Therapy Management to help patients achieve better health-related outcomes.

4 Comments

  1. Hi Betty, I’m checking my BP daily right now to get it regulated due to an Afib event I had recently. Your information was very helpful. I was also put on Toprol for my heart.
    My meds are a lot different from when we met years ago.

    1. Good to hear from you Marie. Yes, things do change with time, don’t they. And those blood pressure goals can change too, sometimes they get tighter (lower), sometimes looser (higher) depending on what’s going on. Give me a call or shoot me an email if you want to talk!

  2. Thanks for explaining. I can never remember what a “good” blood pressure is. I have one question. How does this relate to physical exercise when the heart rate goes up? Is there a length of time of elevated levels we have to worry about and how does it relate to age?

    1. Excellent question, Tony, As we get older, our target heart rates when we exercise decreases. I am including a link to an article by the American Heart Association that includes a chart of target heart rates during exercise for different age groups. It is important to remember that other individual factors regarding health and history also need to be taken into consideration, so while I find this chart helpful, it does not apply to everyone across the board. For example, a patient with known heart damage from a previous heart attack may have a different target heart rate than a patient of the same age with a “healthy” heart.
      https://www.heart.org/en/healthy-living/fitness/fitness-basics/target-heart-rates

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