Anatomy-Lexicon

Blood pressure readings

introduction

The blood pressure is always given with two blood pressure values. The first blood pressure value is the highest pressure in the system and is called the systolic value. This blood pressure value comes from the moment blood is ejected from the heart. The second blood pressure value is the diastolic value and represents the constant pressure in the vascular system during the filling phase of the heart. Under normal conditions and without taking individual deviations into account, the blood pressure should ideally be 120/80 mmHg. At rest, the systolic blood pressure should be between 100-130mmHg, the diastolic value between 60-85mmHg. During exercise or exertion, both blood pressure values rise, but the systolic value is much more pronounced than the diastolic value.

Classification according to WHO

The World Health Organization (WHO) has set various limit values to classify high blood pressure.

Values of <130 / <90 mmHg are normal blood pressure.
Values of 130-139 / 85-89 mmHg would be highly normal.
Any blood pressure value beyond that is known as high blood pressure, has negative effects on the cardiovascular system and life expectancy and must be treated.

However, there are also differences here, so that high blood pressure (hypertension) is divided into different degrees of severity.

Blood pressure values between 140-159 / 90-99 mmHg are referred to as grade 1 hypertension.
Grade 2 hypertension is from 160-179 / 100-109 mmHg.
The most severe grade of hypertension, grade 3, are values> = 180 /> = 110 mmHg.

All of these blood pressure values apply in peace and with one Adult. The classification of normal blood pressure values in children is very controversial.
Attempts have been made to apply a similar classification to that of adults, however, according to this, around 30% of children worldwide would need treatment for high blood pressure. Since this would not be ethically justifiable and the values in children can fluctuate greatly, such a classification has been refrained from.

The German Hypertension League has limit values for Children from 12 years set. The limit to high pressure for 12-year-olds is included 125/80 mmHg, for 16-year-olds 135/85 mmHg and for 18-year-olds 140/90 mmHg. These blood pressure values are above the recommended limit values of American doctors, who have set a limit of 120/78 mmHg for 16 year olds and a limit of 120/80 mmHg for 18 year olds.

Normal values

The normal blood pressure readings for a healthy adult at rest are included <120 mmHg systolic and <80 mmHg diastolic. The values are based on the age and body weight of the person. Here is the blood pressure natural fluctuations subject: with excitement, exertion, stress or sport, blood pressure rises. Caffeinated drinks such as coffee and cola, as well as table salt, also increase blood pressure. With fluid loss (desiccosis), relaxation and sleep, the blood pressure drops.

Fluctuations in blood pressure are basically normal, but if they are very severe, they can cause symptoms. So some patients report about Attacks of dizziness, a headache or Racing heart.

In order to represent the course of the blood pressure values, one should always be at the same time, e.g .: 3 times a day the Measure blood pressure and make a note. You should also make sure that you create the same situation. This includes that you should be physically and mentally relaxed beforehand, for example sit relaxed for 15 minutes beforehand and then measure your blood pressure. No clothing should cover the arm and it should not be rolled up either. Ideally, you should regularly compare the blood pressure in your left and right arms. You should also not take coffee or other substances that increase blood pressure beforehand.

If the blood pressure is increased at the doctor's, but is always measured normally at home, it may be related to the excitement at the doctor. This so-called "Kittel Syndrome“Is a common occurrence and can be verified by self-measurements at home.

Also one Long-term measurement of blood pressure is possible to write down the exact course of the day.

Blood pressure readings in children

Children have lower blood pressure than adults. The German Hypertension League specifies the following upper limit values for children: 12 year olds 125/80 mmHg, 8 year olds 115/80 mmHg and 4 year olds 110/70 mmHg. When these values are reached and repeatedly confirmed in measurements, one speaks of the onset of hypertension.

These values should definitely be collected by a doctor, as children need a special blood pressure cuff. If you measure your child's blood pressure with your blood pressure cuff at home, the values are incorrect. It is important that the width of the cuff covers 2/3 of the upper arm.

The limit values should be compared with body weight, as this is more informative than age alone. Today, children with high blood pressure are increasingly being observed, which is related to the increasing overweight even among children and adolescents. However, the meaningfulness of the values remains controversial. In an international comparison, different limit values are given; according to the American limit values, many more children in Germany already have high blood pressure that requires treatment.

How do I best measure my blood pressure values?

Various methods are used to measure blood pressure. First of all, one should pay attention to the pulse quality (e.g. pulsus durus as a hard, difficult to print pulse in arterial hypertension). The manual blood pressure measurement according to Riva-Rocci is gradually being replaced by an oscillometric measurement method in everyday clinical practice. Here, pressure sensors in a blood pressure cuff register and measure the pressure fluctuations caused by the blood flow.
With the Riva-Rocci method, important details should be paid attention to: Applying the cuff approximately at heart level with the upper body posture as upright as possible. The width of the cuff should be about half the circumference of the upper arm. Cuffs that are too wide or too narrow significantly falsify blood pressure values. Extensive extension of the arm also lowers the measurement accuracy. It is recommended to carry out the measurement in a slightly bent arm position.
Regular pressure measurements are an important support for the doctor and the patient in order to be able to display a progress profile. Individual blood pressure peaks in the practice / clinic can occur as so-called nervousness hypertension. A 24-hour blood pressure measurement with continuous pressure measurement is suitable for unmasking this. The best method for therapy monitoring combined with an increase in compliance is, however, self-measurement of blood pressure by the patient.

Read more on this topic at: Blood pressure - how do I measure correctly?

What is long-term blood pressure measurement?

In order to be able to guarantee a continuous recording of the blood pressure values under everyday conditions, one can fall back on the risk-free 24-hour long-term blood pressure measurement. The main indication is the suspicion of an imbalance in the day-night rhythm of blood pressure. This means, for example, the lack of sinking during sleep.The white coat syndrome with occasional blood pressure peaks during the measurement in the clinic can also be avoided.
With this method, the patient wears a cuff on the upper arm for 24 hours, which inflates every 15 minutes during the day or every 30 minutes at night and saves the measured values on a recording device. The long-term blood pressure measurement enables a meaningful display of a pressure profile. Any conspicuous peaks or drops can be indicators of a temporary dysfunction of the cardiovascular system during the evaluation. This can be achieved by the patient recording their activities within these 24 hours while wearing the measuring device. Normal values are a 24-hour mean value of 130 mmHg (systolic) and 80 mmHg (diastolic) or a daily mean value of 135 mmHg (systolic) and 85 mmHg (diastolic).

Read more on this topic at: Long-term blood pressure measurement

Which of the two blood pressure values is more important?

Based on the scientific fact that the systolic blood pressure value represents the time of the sputum, one might suspect that this is the more important value. After all, it supplies the entire body with the oxygen-carrying blood. However, if the heart does not adequately fill the chambers with blood during diastole, there is again insufficient blood ejection. Therefore, both systole and diastole are to be regarded as vital cardiac actions. The own supply of the heart muscle cells via the perfusion of the coronary arteries ("coronary arteries") also takes place primarily during diastole. If this heart muscle supply is reduced due to insufficient diastolic filling of the chambers, the overall performance of the heart is reduced. Even with an increased heart rate, e.g. the time of the diastole decreases relatively more than that of the systole and the self-sufficiency of the heart disappears.

Blood pressure readings in men

The same limit values apply to women and men. Men develop high blood pressure more often before the age of 50.

On average, men have an unhealthy lifestyle than women. Therefore, they are more often and sooner affected by high blood pressure. Risk factors include smoking, alcohol consumption, diabetes mellitus, obesity and sleep apnea syndrome. The obstructive sleep apnea syndrome mainly affects overweight men who have breathing pauses of at least 10 seconds 5 times per hour while sleeping. They also frequently snore, although this is not a bad thing. The pauses in breathing are dangerous, as they cause the body to wake up with a rise in blood pressure in order to ensure the supply of oxygen. As a result, this disease leads to high blood pressure in the long term.

Since high blood pressure in itself causes hardly any noticeable symptoms, it is only discovered late in a routine examination in many people. One symptom that may indicate high blood pressure in men is erectile dysfunction of the penis.

2. Blood pressure value too high - what could be the causes?

The increase in the 2nd blood pressure value is the diastolic blood pressure value. This value corresponds exactly to the pressure at which the blood begins to pulsate again through the arterial blood vessels when the pressure is released from the blood pressure cuff. There are various pathological causes that can lead to an increase in diastolic blood pressure in particular.

In the case of general heart failure ("Heart failure") there is usually insufficient pressure when the blood is ejected into the aorta (" main artery "). This ultimately causes both blood pressure values to drop.

However, a diastolic heart failure is described, which is associated with diseases such as high blood pressure, diabetes mellitus, atrial fibrillation or obesity ("overweight").

Obesity in particular leads to pathological deposits of fatty plaques in the arterial walls. This causes the vessels to constrict and the resistance in the vascular system increases due to the constriction. As a result, the blood pressure takes on higher values. An increase in blood pressure can in principle also be caused by an unhealthy, non-Mediterranean diet. This also includes increased alcohol consumption, because this is associated with an increased increase in calories.

A high-fat (cholesterol-containing) and salty diet is said to have a blood pressure-increasing effect. The exact cellular mechanisms involved in the salty diet are the subject of current research. Smoking is also considered a risk factor, as it primarily contributes to narrowing of the arterial blood vessels. Certain medications and caffeine can also lead to an increase in blood pressure.

Organ-specific diseases can also be the cause. These include renal artery stenosis (renal hypertension), diseases or tumors of the adrenal glands with increased cortisol release, Cushing's syndrome as a hormonal axial dysfunction or the use of birth control pills. Around 50% of all cardiac weaknesses are due to a disruption of the filling phase of the heart (diastole). This leads to insufficient filling of the heart chambers, which in turn results, as described above, in a reduced ejection capacity of the heart. The heart begins the attempt to compensate for the reduced ejection capacity by increasing the heart rate by increasing the sympathetic tone.

In the long run, however, the cardiomyocytes ("heart muscle cells") tire, which in turn leads to the heart failure described above ("heart muscle weakness"). Elevated diastolic blood pressure values are generally normal in the evening. The arterial blood pressure is subject to a daily rhythm (low values in the morning with an increase in the evening).

Read more on this topic at: Diastole too high - is that dangerous?

Blood pressure levels too low

Low blood pressure is known in technical terms as arterial hypotension. The blood pressure values are below 100 mmHg systolic and below 60 mmHg diastolic.

Many people have low blood pressure, especially young, slim women are affected. In addition, many of those affected are inactive in terms of sport. This is not a disease per se, but only a value that deviates from the mean value of the population.

In most cases, hypotension is not dangerous as the blood supply to the organs is guaranteed. Occasionally, however, those affected describe the following symptoms: dizziness, tiredness, headache, ringing in the ears or rapid heartbeat. Low blood pressure can rarely be dangerous, e.g. if it leads to fainting or if there is an illness behind it.

There are 3 different causes of low blood pressure:

Primary hypotension is the form in which one does not know the exact cause of the low blood pressure values (idiopathic).
In secondary hypotension, the low blood pressure is the result of another disease. Diseases that can lead to this include Addison's disease (a disease of the adrenal cortex), an underactive thyroid (Hypothyroidism), Infections, cardiovascular diseases and various other diseases. Severe fluid losses, such as those that can occur with diarrhea, vomiting or heavy bleeding, also lead to low blood pressure.
The third form is orthostatic hypotension. This is due to the change in body position from lying or sitting to standing. Some of the blood sinks into the leg veins and the return flow to the heart is reduced. Thus the blood pressure drops. Affected people can pass out (syncope). In order to clarify this, a so-called Schellong test carried out. The blood pressure and pulse are measured repeatedly while lying down and then when you stand up abruptly. If a patient is diagnosed with orthostatic hypotension, the patient should move their feet in circles each time before changing to the upright position to activate the muscle pump. In addition, he should get up slowly, hold on and ensure that he is drinking enough fluids throughout the day.

One should not forget that various medications can also cause blood pressure lowering as a side effect. This also applies to drugs that are taken because of high blood pressure; the dosages may have to be adjusted.

More information can be found here:

low blood pressure
Low Blood Pressure And Nausea - You Can Do That!

What do strongly fluctuating blood pressure values speak for?

In the daily profile, blood pressure is subject to typical physiological fluctuations. In the morning (around 8 a.m. to 9 a.m.) a first peak with higher values can be determined, while the blood pressure normalizes and reaches its low point around noon (2 p.m. to 3 p.m.) In the early evening (4pm to 5pm) the values usually rise again and reach a second peak. Strongly fluctuating blood pressure values can be an indication of several underlying organic diseases. For example, this can be caused by a dysregulation of the vascular tone (including medication) or a cardiac dysfunction. Sports activity causes the blood pressure to rise due to the increased need of the body cells for oxygen. In well-trained people, blood pressure drops back to normal more quickly after exercise.

How can I lower my blood pressure?

Elevated blood pressure values reflect the vascular situation in the body. High blood pressure is often based on calcified vessels, as this reduces the lumen of the vessel, but the same amount of blood is pumped through it. Vascular calcifications are known as arteriosclerosis and are associated with an increased risk of stroke and heart attack. The narrowed vessels, in turn, increase the resistance to the volume of blood that is pressed through, so that these increase blood pressure even further.

There are many different methods that can be used to lower blood pressure. The most important measure is usually weight normalization, as blood pressure is heavily dependent on body weight. Overweight people therefore often show high blood pressure values. Adequate exercise and a balanced diet are therefore beneficial in normalizing blood pressure.

Excessive salt consumption should also be avoided. Caffeinated drinks such as coffee or cola also increase blood pressure and should only be consumed in moderation. Smoking and alcohol consumption also increase blood pressure.

Various substances have shown positive effects as home remedies. These include beetroot, ginger and garlic, among others.

In the last step, drugs against high blood pressure can be used to lower blood pressure in the long term and prevent secondary diseases.

You can also read our topic on this: What is the best way to lower my blood pressure?

Changes in blood pressure levels

Changes in blood pressure during pregnancy

Blood pressure must be particularly monitored during pregnancy, as high values and low values can be bad for the child's development. Therefore, the gynecologist routinely measures the pregnant woman's blood pressure. Values above 140/90 mmHg are too high.

Women who had high blood pressure before pregnancy are particularly at risk, as it can rise even further during pregnancy. If you have previously taken medication for this, you will mostly be on the medication alpha-methyldopa rearranged.

Read more about the topic here: Lowering blood pressure during pregnancy

But women who only develop high blood pressure values during pregnancy must be closely monitored.

Diseases such as diabetes mellitus and being overweight in the mother, or high blood pressure in the family or personal anamnesis can also contribute to high blood pressure.

High blood pressure values during pregnancy can lead to preeclampsia, which occurs rarely but can be very dangerous for mother and child.
Here occurs after the 20th week of pregnancy in addition, increased protein excretion in the urine. If this precursor of the disease develops into eclampsia with neurological symptoms in the mother such as seizures, the child must be delivered immediately.

A special form of preeclampsia, the so-called HELLP syndrome, in which liver dysfunction with blood clotting disorder also develops, is also very dangerous.
Fortunately, these dangerous diseases are very rare and can be identified and treated at an early stage by taking control examinations.

Most increases in blood pressure during pregnancy resolve after the birth. In the event of a second pregnancy, however, these women are predisposed to develop high blood pressure values again and should check their values regularly.

Read more on the topic: Pregnancy Hypertension - Dangerous?

Low blood pressure is also more common in pregnant women. Especially towards the end of pregnancy, the child can rely on the Vena cava (Vena cava) of the mother and obstruct the return of blood to the heart (vena cava compression syndrome). This can cause dizziness, a drop in blood pressure, and fainting. Therefore, pregnant women are recommended to lie on their back or left side.

Read more about this at:

Low blood pressure during pregnancy

Changes in blood pressure during exercise

During exercise, the systolic blood pressure rises to values of up to 220 mmHg. This is normal for healthy people and is not harmful. The heart rate also increases during exercise. These values are also used for a stress ECG on the bicycle ergometer or the treadmill. With this one can observe the heart rate and the blood pressure under stress and see indications of cardiac damage in the EKG. This is canceled when the maximum pulse rate is reached (220 minus age / minute), pain or exhaustion.

In the long term, exercise lowers blood pressure and is one of the most important therapeutic and preventive measures for high blood pressure. It also reduces body weight. People with hypertension should rather do endurance training, but avoid peak loads with high blood pressure peaks.

Exercise can also be counterproductive in hypotension, as blood pressure drops even more sharply after exercise. Therefore, people with low blood pressure should only do light endurance sports and not reach their limits.

Changes in old age

Nevertheless, the importance of the two blood pressure values for the blood supply to the body changes depending on age. The diastolic value plays a rather subordinate role from the age of around 50 years. The reason for this is that the systolic value reacts more sensitively to vascular changes such as arteriosclerosis. It is precisely this process that is typical of the aging of our arterial blood vessels. In young adulthood, the two values are more likely to be equivalent. An isolated rise in the diastolic blood pressure value is usually the first sign of the development of arterial hypertension. This isolated occurrence is also known as secondary hypertension. Ultimately, the interaction of both phases (systole and diastole) is essential for healthy cardiac muscle activity. In particular, too high a blood pressure amplitude (difference between systolic and diastolic blood pressure) is a risk factor for chronic cardiac insufficiency.

Changes in blood pressure in old age: Due to certain processes in the blood vessels, an increase in arterial blood pressure in old age is relatively normal. Around every second 60-year-old suffers from arterial hypertension. Again, a healthy diet and a healthy lifestyle play a central role as a protective factor. Vascular changes include the deposition of fatty plaques on the arterial walls and the loss of elastic fibers in the large body arteries (such as the aorta). This "stiffening" and the narrowing by plaques favor this development. Due to the partial loss of elasticity, the aorta's function of the aorta is reduced. It is precisely this function that ensures a continuous flow of blood to the periphery, in which the aorta initially holds back 50% of the ejected blood after each systole. The partial loss of this air vessel function leads to an inconsistent blood flow. While the systolic blood pressure value usually rises continuously during the aging process, the diastolic blood pressure value initially increases and then decreases again towards the age of 70. As a result, the blood pressure amplitude increases steadily. An isolated systolic hypertension is the result (most common form of geriatric hypertension). Especially the systolic blood pressure with a higher value represents a danger for the blood vessels. As these become inelastic and more susceptible with age, the risk of a stroke or a heart attack increases significantly.

Changes in a Heart Attack?

During a heart attack (occlusion of one or more coronary arteries / branches) the blood pressure value can change or in some cases remain normal. Depending on how a heart attack manifests itself, blood pressure can also react differently. A silent heart attack (especially in diabetes mellitus patients with consecutive polyneuropathy) can occur without symptoms; an increase in blood pressure appears unlikely. On the other hand, if the sympathetic nervous system is activated, palpitations, fear and sweating can occur. Referred pain to the sternum, shoulder, neck and epigastrium is also typical. This makes the blood pressure very likely to rise.

Read more on this topic at: Consequences of a heart attack

Changes after eating

Normally, a meal should not cause large fluctuations in blood pressure values. Various diseases, on the other hand, can lead to it. Pathological conditions in the pancreas, among other things, can lead to a rapid rise in blood pressure values. Gastrointestinal ulcerations can also cause blood pressure to rise due to their painful expression in the epigastrium.