Everybody’s blood pressure goes up and down throughout the day. Walking to work, meditating, stressing about your Facebook feed, taking that sweet afternoon nap, and pounding a triple shot espresso all influence your blood pressure. There’s even a thing called “White Coat Hypertension” where people report higher than normal blood pressure readings due to the stress of just being in a doctor’s office with a cuff strapped to your arm. Blood pressure is a moving target. It’s not the end of the world if it spikes every now and then.

Isolated systolic hypertension occurs when the top number of a blood pressure reading (systolic blood pressure) is high and the bottom number (diastolic blood pressure) is normal. Isolated systolic hypertension is most common along older adults, but is also found in young and middle-aged adults. It’s important for patients with isolated systolic hypertension to work with their doctors to determine the best possible treatment to achieve a healthy blood pressure and reduce risk of complications.
What is a normal blood pressure? Blood pressure is essential to life because it forces the blood around the body, delivering all the nutrients it needs. Here, we explain how to take your blood pressure, what the readings mean, and what counts as low, high, and normal. The article also offers some tips on how to maintain healthy blood pressure. Read now
Most doctors do not make a final diagnosis of high blood pressure until they measure your blood pressure several times (at least 2 blood pressure readings on 3 different days). Some doctors ask their patients to wear a portable machine that measures their blood pressure over the course of several days. This machine may help the doctor find out whether a patient has true high blood pressure or what is known as “white-coat hypertension.” White-coat hypertension is a condition in which a patient’s blood pressure rises during a visit to a doctor when anxiety and stress probably play a role.
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High blood pressure (hypertension) is very common and the share of both men and women with high blood pressure increases steadily with age.High blood pressure sneaks up on you. Except at extreme levels, high blood pressure is usually a silent condition causing no symptoms, so it is important to have regular blood pressure checks.Many things are thought to help bring about high blood pressure, including several changes in the heart and blood vessels.Why is high blood pressure important?Having high blood pressure increases your risk of a variety of health problems. Some of the complications of having high blood pressure include:an increased risk of heart and blood vessel disease – the higher the blood pressure, the higher the risk of angina, heart attack and stroke;heart failure; andkidney damage.How is blood pressure measured?When the heart pumps, it produces pressure inside the arteries and moves the blood forward. This is called systolic pressure. Then the heart relaxes as it fills again and the pressure in your arteries falls. This is called diastolic pressure.Blood pressure readings are given as 2 numbers – systolic pressure over diastolic pressure. The pressure is measured in millimetres of mercury (mmHg).As a general guide,optimal blood pressure is considered to be less than 120 mmHg (systolic pressure) over 80 mmHg (diastolic pressure) — written as 120/80;normal blood pressure is between 120/80 and 129/84; andhigh-normal blood pressure is between 130/85 and 139/89.What is high blood pressure?High blood pressure, or hypertension, means that the systolic or diastolic pressure or both are above the normal range. A reading above 140/90 mmHg is usually considered to be ‘hypertension’, although hypertension is further divided up by doctors into mild, moderate or severe depending on the blood pressure reading.The grades of hypertension are as follows.Mild (grade 1) hypertension: from 140/90 mmHg up to 159/99 mmHg.Moderate (grade 2) hypertension: from 160/100 mmHg up to 179/109 mmHg.Severe (grade 3) hypertension: 180/110 mmHg or more.When deciding whether your blood pressure reading is of concern or not, your doctor will take various factors into account, including your age, cholesterol level, smoking status and presence of other conditions such as diabetes, previous stroke, heart problems or kidney disease.Your doctor will also want to check your blood pressure on more than one occasion before deciding whether you have high blood pressure or not. They may ask you to check your blood pressure at home or wear a 24-hour blood pressure monitoring device. Home blood pressure machines can be purchased or hired from some pharmacies.It is important to remember that our blood pressure rises at certain times, and that is not necessarily a bad thing. During exercise, for example, the pulse rate and blood pressure increase in order to carry extra blood and oxygen to the muscles. When you finish exercising, the blood pressure returns to normal.Blood pressure also rises with excitement, anger or fear but this usually does not last long.How do I know if I have high blood pressure?Unless it is very high, high blood pressure usually has no symptoms. The only way to know if your blood pressure is raised is to get it measured.Every adult should have their blood pressure checked regularly. Your doctor will advise you how often. This depends on your age, your general health and whether you are taking any herbal products, supplements or medicines, including the contraceptive pill.Some people may experience symptoms related to conditions causing or caused by high blood pressure. If you have high blood pressure, your doctor will check for these symptoms.Your doctor will also ask about the health of your family members and whether any member in your family has been diagnosed with high blood pressure. They will perform a physical examination looking for any problems related to high blood pressure.What causes high blood pressure?In most people, high blood pressure results from the interaction of numerous genetic (inherited) and lifestyle factors. This is sometimes called primary or essential hypertension.A small proportion of people have secondary high blood pressure, which is high blood pressure that is caused by a specific underlying condition, such as kidney disease or hormonal problems.Other risk factors include:being overweight;smoking;not getting enough physical activity;having a high alcohol intake; andeating a diet high in salt (sodium chloride).High blood pressure treatmentsHigh blood pressure can be treated with lifestyle measures and medicines. Your doctor will recommend treatment for you based on:your blood pressure readings;whether you have other conditions related to high blood pressure; andyour overall risk of cardiovascular disease.Lifestyle measuresMaking some adjustments to your lifestyle can help lower blood pressure and improve your overall health. Lifestyle measures are the only treatment needed to control blood pressure in some people.Achieve and maintain a healthy weight. Being overweight often means a higher blood pressure.Eat a wide variety of nutritious foods, with lots of vegetables, fruit and grains. Eat moderate amounts of fish, skinless chicken, lean meat cuts, eggs, nuts, legumes and reduced fat dairy foods. Avoid foods high in saturated fat (e.g. fried foods, biscuits, chips) and replace with foods containing mainly polyunsaturated and monounsaturated fats (e.g. oils, spreads, avocado, nuts and seeds).Eat less salt: use herbs, spices, fruit and vinegar for flavouring and dressings; choose low salt pre-prepared foods; avoid pickled and takeaway foods which have a high salt content.Get regular physical activity. Strive to put a little bit more activity in your day at every opportunity. Aim to accumulate at least 30 minutes of moderate physical activity most days of the week. Walking, cycling and swimming are ideal. Find activities you enjoy so you can keep them up.Cut down on alcohol. Healthy men and women should have no more than 2 standard alcoholic drinks a day. Also, aim for at least 2 alcohol-free days per week.Stop smoking: quitting reduces blood pressure as well as your risk of heart attack and stroke.Medicines for high blood pressureMedicines can help control high blood pressure but do not cure it. Usually blood pressure medicines need to be taken long-term.The main types of medicines that are used to treat uncomplicated high blood pressure include:angiotensin converting enzyme inhibitors (ACE inhibitors);angiotensin receptor blockers (ARBs);calcium channel blockers; andthiazide diuretics.The type of medicine that your doctor prescribes will depend on:your age;whether you have conditions associated with high blood pressure;whether you have other health problems or take other medicines;the side effects of different medicines; andthe cost of different medicines.To control blood pressure successfully, you may need 2 or more medicines, each working in a different way. We all react differently to medicines, so it may take some time to find the combinations and doses that suit you best.It is important to tell your doctor about any other health products you are taking — this includes eyedrops, ointments, over-the-counter preparations, herbs and supplements.It is also important to follow your doctor’s instructions about taking blood pressure medicines.You cannot tell how your blood pressure is doing by the way you feel. Regular check-ups are essential and it is unwise to change your own dose of tablets.If your blood pressure is not responding well to treatments, your doctor may refer you to a cardiologist (specialist in heart conditions and high blood pressure).Side effectsLike all medicines, those for high blood pressure may occasionally cause side effects. These vary among medicines and from person to person, and often decrease with time or by your doctor adjusting your dosage.If your blood pressure gets too low on the medicine, you may feel faint or dizzy, particularly when you stand up. Try standing up slowly to reduce this, and stay close to the bed or chair for a moment in case you need to sit or lie down again. If this side effect continues, see your doctor for review.You should let your doctor know about any reactions you have to the medicines. With the range of blood pressure medicines now available, it is nearly always possible to find one that will give you minimal or no side effects.Check-upsIf you have had high blood pressure, you need to have regular checks throughout your life. This is true even if you are not currently receiving any treatment, or if you are being treated by diet and lifestyle changes or with medicines.Your doctor will advise you about how frequently you should have your blood pressure checked, but generally speaking it will be at least every 6 months.In the early stages of treatment, you may need to be seen weekly or fortnightly, but once your blood pressure is controlled, checks may be spaced out to once every 3 or 6 months.If you have high blood pressure, it’s also worth being checked for other conditions that may further increase your risk of cardiovascular disease, such as diabetes and high cholesterol.High blood pressure often runs in families. Suggest to others in your family that they also have their blood pressure measured. Last Reviewed: 8 February 2017
Your doctor may also use a device called an ophthalmoscope to look at the blood vessels in your eyes. Doctors can see if these vessels have thickened, narrowed, or burst, which may be a sign of high blood pressure. Your doctor will also use a stethoscope to listen to your heart and the sound of blood flowing through your arteries. In some cases, a chest x-ray and electrocardiogram may be needed.

Isolated systolic hypertension can be caused by underlying conditions such as artery stiffness, an overactive thyroid (hyperthyroidism) or diabetes. Occasionally, it can be caused by heart valve problems. It is the most common form of high blood pressure in people older than age 65, but it is possible for younger people to be affected by this type of high blood pressure as well.


But it’s not all bad news. Yes, hypertension contributes to a lot of serious conditions, but blood pressure treatment options are very effective. And the first step, of course, is knowing if you have high blood pressure. You can check your blood pressure for free at many pharmacies nationwide. CVS “Minute Clinics” and Walgreens Blood Pressure screening both offer in-store blood pressure test.
 3. National Vascular Disease Prevention Alliance. Guidelines for the management of absolute cardiovascular disease risk; 2012. https://www.heartfoundation.org.au/images/uploads/publications/Absolute-CVD-Risk-Full-Guidelines.pdf (accessed Feb 2017). myDr myDr provides comprehensive Australian health and medical information, images and tools covering symptoms, diseases, tests, medicines and treatments, and nutrition and fitness.Related ArticlesHeart: how your heart pumps blood around your bodySee our diagram showing how your heart pumps blood to the organs and tissues of your body. Blood pressure: what is your target?Why is blood pressure important? Find out why (and how) doctors measure blood pressure, whAnimation: how your heart pumpsView our animated diagram of the heart beating and see how blood is pumped through the heart.High blood pressure treatments If you have high blood pressure your doctor may recommend lifestyle measures, such asHigh blood pressure should be treatedHaving hypertension (high blood pressure) increases your risk of serious conditions such as stroke aAdvertisement

As you get older, high blood pressure, especially isolated systolic hypertension, is more common and can increase your risk of serious health problems. Treatment, especially if you have other medical conditions, requires ongoing evaluation and discussions with your doctor to strike the best balance of reducing risks and maintaining a good quality of life.
Your heart is a muscle about the size of your fist. It’s made up of four chambers and contains four valves. The valves open and close to let blood move through the chambers and into and out of your heart. According to the American Heart Association, your heart beats 60 to 100 times per minute, or about 100,000 times per day. As it beats, blood is forced against your artery walls.

Medicines are available if these changes do not help control your blood pressure within 3 to 6 months. Diuretics help rid your body of water and sodium. ACE inhibitors block the enzyme that raises your blood pressure. Other types of medicines— beta blockers, calcium channel blockers, and other vasodilators—work in different ways, but their overall effect is to help relax and widen your blood vessels and reduce the pressure inside the vessel. [See also the free government publication “Medicines to Help You: High Blood Pressure” (PDF) from the US Food and Drug Administration.]
Sodium (salt) sensitivity: Some people have high sensitivity to sodium (salt), and their blood pressure increases if they use salt. Reducing sodium intake tends to lower their blood pressure. Americans consume 10-15 times more sodium than they need. Fast foods and processed foods contain particularly high amounts of sodium. Many over-the-counter medicines also contain large amounts of sodium. Read food labels and learn about salt content in foods and other products as a healthy first step to reducing salt intake. Fast food restaurants also make the salt and calorie content of their food available to consumers at their restaurants,
Not everyone is sensitive to sodium, meaning that not all individuals who eat a high sodium diet will develop high blood pressure as a result. Rather than acting as your own test subject to see if you are salt-sensitive or not, it is advisable to try to follow the American Heart Association's recommendation of less than 1,500 milligrams of sodium (less than 1 teaspoon of table salt) per day. Remember that this is a goal amount for the average of what you eat. If you overindulge in salty foods on day, balance your intake with very low sodium foods the next.
Recent research shows that lowering your blood pressure below these levels decreases your risk of heart attacks and all-cause mortality. That’s right—lowering your blood pressure has a direct impact on your life expectancy. In fact, a person with a systolic pressure of 135 has double the risk of heart disease as someone with a systolic pressure of 115. Same goes for a diastolic pressure of 85 instead of 75. 10 points might not seem like much, but every blood pressure increase has a big impact on your health.
Cut down on salt. As you get older, the body and blood pressure become more sensitive to salt (sodium), so you may need to watch how much salt is in your diet. Most of the salt comes from processed foods (for example, soup and baked goods). A low-salt diet, such as the DASH diet, might help lower your blood pressure. Talk with your doctor about eating less salt.
Because high blood pressure doesn’t cause symptoms, once you’ve been diagnosed with it, it’s critical to measure your blood pressure regularly. This is true even if you’re taking blood pressure medication. And whether you’ve got high or low blood pressure, tracking your systolic and diastolic numbers is a great way to gauge how well lifestyle changes or medications are working.
However, sometimes a high reading can occur temporarily and then your numbers will return to normal. If your blood pressure measures at this level, your doctor will likely take a second reading after a few minutes have passed. A second high reading indicates that you’ll need treatment either as soon as possible or immediately depending on whether or not you have any of the symptoms described above.

Isolated systolic hypertension can be caused by underlying conditions such as artery stiffness, an overactive thyroid (hyperthyroidism) or diabetes. Occasionally, it can be caused by heart valve problems. It is the most common form of high blood pressure in people older than age 65, but it is possible for younger people to be affected by this type of high blood pressure as well.
Diastolic pressure is the force exerted by the blood on the walls of arteries as it flows through these blood vessels between heartbeats. In IDH, the diastolic pressure is generally elevated because tiny arteries, called arterioles, in the body are narrower than usual. This compresses the blood flowing through the arterioles, thus raising the pressure.
A later study, published in the Journal of Hypertension, found similar results. Researchers analyzed data from 4,680 participants aged 40 to 59 years from 17 different areas in Japan, China, the United Kingdom, and the United States. They looked at blood pressure, cholesterol levels, and diet over the previous 24 hours. The results showed that cholesterol was directly related to blood pressure for all participants.
Exercise every day. Moderate exercise can lower your risk of high blood pressure. Set some goals so you can exercise safely and work your way up to exercising at least 30 minutes a day most days of the week. Check with your doctor before starting an exercise plan if you have any health problems that are not being treated. You can find more information about exercise and physical activity at Go4Life.
Isolated systolic hypertension occurs when the top number of a blood pressure reading (systolic blood pressure) is high and the bottom number (diastolic blood pressure) is normal. Isolated systolic hypertension is most common along older adults, but is also found in young and middle-aged adults. It’s important for patients with isolated systolic hypertension to work with their doctors to determine the best possible treatment to achieve a healthy blood pressure and reduce risk of complications.
Aneurysm. Over time, the constant pressure of blood moving through a weakened artery can cause a section of its wall to enlarge and form a bulge (aneurysm). An aneurysm can potentially rupture and cause life-threatening internal bleeding. Aneurysms can form in any artery throughout your body, but they're most common in your body's largest artery (aorta).
Recent research shows that lowering your blood pressure below these levels decreases your risk of heart attacks and all-cause mortality. That’s right—lowering your blood pressure has a direct impact on your life expectancy. In fact, a person with a systolic pressure of 135 has double the risk of heart disease as someone with a systolic pressure of 115. Same goes for a diastolic pressure of 85 instead of 75. 10 points might not seem like much, but every blood pressure increase has a big impact on your health.
Blood tests may be done to assess risk factors for heart disease and stroke as well as looking for complications of hypertension. These include complete blood count (CBC), electrolytes, BUN (blood urea nitrogen), and creatinine and GFR (glomerular filtration rate) to measure kidney function. A fasting lipid profile will measure cholesterol and triglyceride levels in the blood. If appropriate, blood tests may be considered to look for an underlying cause of high blood pressure (secondary hypertension)including abnormal thyroid or adrenal gland function.
DASH diet: DASH (Dietary Approaches to Stop Hypertension) is a diet plan from the National Heart, Lung, and Blood Institute that helps lower blood pressure. On this plan, you eat a diet rich in fresh fruits and vegetables, low-fat dairy products, whole grains, fish, poultry, beans, seeds, and nuts. The diet is low in saturated fat, cholesterol, sugars, red meat, and salt.
Though essential hypertension remains somewhat mysterious, it has been linked to certain risk factors. High blood pressure tends to run in families and is more likely to affect men than women. Age and race also play a role. In the United States, blacks are twice as likely as whites to have high blood pressure, although the gap begins to narrow around age 44. After age 65, black women have the highest incidence of high blood pressure.
Heart disease, stroke, and other cardiovascular (blood vessel) diseases are among the leading cause of death and now kill more than 800,000 adults in the US each year. Of these, 150,000 are younger than age 65. These diseases are also two of the leading causes of health disparities in the US. Treatment of these diseases accounts for 1 in every 6 US health dollars spent. Two main reasons people have heart disease or stroke are high blood pressure* and cholesterol, which are common, deadly, and preventable. Nearly 2 out of 3 adults with high cholesterol and about half of adults with high blood pressure don’t have their condition yet under control. Clearly, other steps are needed to gain control of these health risks.
Elevated blood pressures in the medical setting may not necessarily reflect the individuals real status. "White coat hypertension" describes a patient whose blood pressure is elevated because of the stress of the visit to the doctor or other healthcare professional, and the worry that their blood pressure might be elevated. Repeated blood pressure checks at the doctor's office or the use of a home blood pressure monitoring device may be used to confirm that you have high blood pressure.
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HDL cholesterol: Two types of cholesterol are found in your bloodstream: HDL and LDL. HDL is the “good” kind. It acts as a scavenger, picking up extra cholesterol and taking it back to your liver. When a doctor tests your blood for cholesterol levels, you want your HDL levels to be high. HDL levels of 60 or more help to lower your risk for heart disease.
Nuts, legumes, and seeds are rich in magnesium, protein, and fiber. Walnuts are full of omega-3 fatty acids, which may help lower your risk of heart disease. Enjoy as many as five servings of these foods each week. That’s 1/3 cup of nuts, 2 tablespoons of seeds, or a 1/2 cup of cooked dried beans or peas in each serving. Grab a handful of seeds or nuts as a snack. Or add beans to your salads or soups.
Because high blood pressure doesn’t cause symptoms, once you’ve been diagnosed with it, it’s critical to measure your blood pressure regularly. This is true even if you’re taking blood pressure medication. And whether you’ve got high or low blood pressure, tracking your systolic and diastolic numbers is a great way to gauge how well lifestyle changes or medications are working.

Blood pressure control is a lifelong challenge. Hypertension can progress through the years, and treatments that worked earlier in life may need to be adjusted over time. Blood pressure control may involve gradually making lifestyle changes like diet, weight loss, exercise, and possibly taking medicine if necessary. In some situations, medications may be recommended immediately. As with many diseases, you and your doctor should work together to find the treatment plan that works for you.


Many people also need medicine to control their high blood pressure. Your doctor will tell you if you need medicine, and monitor its effects. Blood pressure medicines don’t cure high blood pressure, but they help to control it. You have to keep taking the medicines regularly, often for the rest of your life. Don’t stop taking your medicine without talking to your doctor first. 
A meta-analysis of individual patient data from randomized controlled trials found the lowest diastolic blood pressure for which cardiovascular outcomes improve is 85 mm Hg for untreated hypertensives and 80 mm Hg for treated hypertensives.[5] The authors concluded "poor health conditions leading to low blood pressure and an increased risk for death probably explain the J-shaped curve".[5] Interpreting the meta-analysis is difficult, but avoiding a diastolic blood pressure below 68–70 mm Hg seems reasonable because:
Healthcare professionals use a stethoscope and a manual sphygmomanometer to measure your blood pressure. Typically they take the reading above your elbow. The sphygmomanometer has a bladder, cuff, bulb, and a gauge. When the bulb is pumped it inflates the bladder inside the cuff, which is wrapped around your arm. This inflation will stop the blood flow in your arteries. The stethoscope is used to listen for sound of the heartbeat, and no sound indicates that there is no flow. As the pressure is released from the bladder, you will hear the sound of the blood flowing again. That point becomes systolic reading. The diastolic reading is when you hear no sound again, which means that the blood flow is back to normal.
Your heart is a muscle about the size of your fist. It’s made up of four chambers and contains four valves. The valves open and close to let blood move through the chambers and into and out of your heart. According to the American Heart Association, your heart beats 60 to 100 times per minute, or about 100,000 times per day. As it beats, blood is forced against your artery walls.
Kidney artery aneurysm. An aneurysm is a bulge in the wall of a blood vessel. When it occurs in an artery leading to the kidney, it's known as a kidney (renal) artery aneurysm. One potential cause is atherosclerosis, which weakens and damages the artery wall. Over time, high blood pressure in a weakened artery can cause a section to enlarge and form a bulge — the aneurysm. Aneurysms can rupture and cause life-threatening internal bleeding.
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