Medihub - Medical Information - Cardiology

Reviewed by Dr Lim Chin Hock

Blood Pressure

What is Blood Pressure?

Blood Pressure (BP) is the measurement of the force within the arteries in which each heartbeat pumps out and carries the blood from the heart into all the other blood vessels throughout the body.

Measurement of BP

With technological advances, there are now many equipments and devices available to measure BP. A visit to your doctor’s clinic will invariably result in a BP reading being taken on top of your regular checks.

A stethoscope and arm cuff is commonly used to determine your BP reading which is recorded as two numbers:

Systolic Blood Pressure- Always reflected as the first number, this is the amount of pressure against the artery walls for each time the heart contracts to squeeze blood out of the heart.

Diastolic Blood Pressure- The second number that is the amount of pressure inside the arteries when the heart is at rest between heart beats.

You may notice that your BP reading is not always the same. This is due to the normal physiological changes that take place in response to activities or emotions. Age, drugs and positional factors can also affect the BP readings.

Normal BP reading should be less than 120/80.

High Blood Pressure

Also known as Hypertension, High Blood Pressure is a ‘silent killer’ as most people often do not know they have it until they suffer from a stroke or myocardial infarction (heart attack).

According to the 2004 National Health Survey conducted in Singapore, 20% of adults aged 18-69 have some form of hypertension.

Hypertension puts people at higher risk for cardiovascular and other blood vessel diseases and it is important to have it treated. If left untreated, it can potentially lead to:

Transient Ischemic Attack (TIA) or stroke
Myocardial Infarction (heart attack
Heart Failure
Heart Enlargement
Peripheral Vascular Disease in the legs
Kidney Disease
Haemorrhages in the blood vessels of the eye

Diagnosis of High Blood Pressure should be obtained in at least 3 visits to the doctor’s clinic, spread over a few weeks.

Some people are more at risk for high blood pressure than others. This includes:

A genetic predisposition for hypertension or cardiovascular diseases or diabetes in the family
Elderly people above 60 years of age
Women on oral contraceptives
Overweight or obese individuals
In asia, certain ethnic groups. Indians are found to be at higher risk for developing hypertension.

Treating hypertension

Current guidelines recommend BP to be reduced to lower than 120/80 in normal, healthy adults. A diabetic patient or patient with chronic kidney disease should place their goal on obtaining a BP of 130/80.

Besides the wide variety of anti-hypertensive drugs available to treat hypertension, it is also advised that a kidney patient embark on some forms of lifestyle modifications such as:

Consuming a low sodium (salt) diet and reducing fat intake
Maintain a healthy weight and BMI
Cessation of smoking
Embark on an exercise regime
Reduce and limit alcohol intake to one drink per day or less

Guidelines to managing hypertension

Blood Pressure Classifications	BP range (mm/hg)	Therapeutic recommendations
Normal	<120/80	Maintain healthy lifestyle
Pre-hypertension	120-139/80-89	Modify lifestyle
Hypertension
Stage 1	140-159/90-99	Modify lifestyle + Medications
Stage 2	>/= 160/100	Modify lifestyle + Medications

Reference:

1. JNC VII, National Heart, Lung and Blood Institute

2. National Health Survey 2004- Hypertension, Health Promotion Board of Singapore