High blood pressure: why is one reading not enough?

High blood pressure often causes no obvious symptoms. A person may feel well while the blood vessels, heart, kidneys and brain are under prolonged strain. Conversely, one higher reading after rushing, coffee or a stressful day does not necessarily mean hypertension. Correct measurements, trends over time and overall health risk assessment provide the safest approach.

What does a blood pressure reading show?

Blood pressure is described by two numbers. Systolic, or upper, pressure reflects arterial pressure when the heart contracts; diastolic, or lower, pressure is the pressure between beats. Readings are affected by health, movement, talking, pain, anxiety, a full bladder, recent smoking, caffeine and an incorrectly sized cuff.

A diagnosis is therefore not usually based on a single incidental reading. The doctor considers repeated measurements, symptoms, other conditions and cardiovascular risk factors. Home measurements or 24-hour monitoring may help show changes during work, rest and sleep.

How to measure blood pressure at home

Sit quietly for at least five minutes beforehand. Support your back, keep your feet flat on the floor and do not cross your legs. Rest your arm on a table at heart level, with the cuff on bare upper-arm skin. Do not talk during measurement. Take two readings about one minute apart and record them.

Unless your doctor advises otherwise, morning and evening readings over several consecutive days are useful. Also record your pulse, medication and unusual circumstances, such as pain or poor sleep. This diary is much more useful at a consultation than one remembered number.

Overall risk matters, as well as the number

The same blood pressure can mean different risks for two people. The doctor considers age, smoking, cholesterol, glucose metabolism, kidney function, cardiovascular disease, body weight and family history. A treatment plan may therefore include lifestyle changes, further tests, an ECG or medication.

Do not stop or change blood pressure medication on your own. If dizziness, weakness or other symptoms occur, contact a doctor to assess measurement quality, medication effects and possible side effects.

What can you do day to day?

Regular physical activity, a balanced diet, less salt, stopping smoking, moderate alcohol consumption and a healthy body weight help reduce cardiovascular risk. However, lifestyle measures do not replace prescribed treatment when medication is needed.

When should you book a consultation?

Consider a consultation if:

·     readings repeatedly exceed the limit advised by your doctor;

·     blood pressure readings fluctuate substantially;

·     you have headaches, palpitations, breathlessness or reduced exercise tolerance;

·     you have diabetes, kidney disease or previous cardiovascular disease.

How can KIRSH help?

KIRSH cardiologists Dr. Dainis Gilis, Dr. Sergejs Pikta, Dr. Jānis Pudulis and Dr. Madara Ventiņa help assess symptoms, cardiovascular risk and necessary investigations.

Sources

·     2024 ESC guidelines for managing elevated blood pressure and hypertension

·     World Health Organization: hypertension

Medical note: this article is for information only. It does not replace an individual medical consultation, diagnosis or treatment plan.