A reduction from 8% to 6% of cardiovascular events is known as an absolute risk reduction of 2%. This may seem small, but the translation is not small when applied to real world people. This can be understood more easily as something called “number needed to treat” which is calculated by 1 divided by the absolute risk reduction. In this case, an absolute risk reduction of 2% translates to a “number needed to treat” of 50 (1 divided by 0.02 = 50). This means that 50 people need to have a BP down to < 120/80 in order for 1 cardiovascular event to be prevented. In the context of many other things we do in our life (medical treatment or not), this is really good!

Electrocardiogram (ECG): This tests the heart's electrical activity. This test is more commonly used for patients at high risk of heart problems, such as hypertension and elevated cholesterol levels. The initial ECG is called a baseline. Subsequent ECGs may be compared with the baseline to reveal changes which may point to coronary artery disease or thickening of the heart wall.
Beta-blockers cause the heart to slow down and so some of their side effects can be traced to that mechanism of action. Dizziness, weakness, fatigue, and fainting are possible. Beta-blockers also affect the respiratory system, so other side effects include shortness of breath, difficulty breathing, and chest pain. Beta-blockers should not be withdrawn suddenly, as that could result in a heart attack or sudden death.
Understanding the normal BP range with age can help the doctor and you to estimate your cardiovascular health. Blood pressure levels can fluctuate significantly from one reading to the next and it is important to remember that just one abnormally high reading does not signify that you have high blood pressure. Doctors usually use an average of multiple blood pressure readings taken over a period of several days to arrive at a diagnosis of high blood pressure.
One reason to visit your doctor regularly is to have your blood pressure checked. Routine checks of your blood pressure will help pick up an early rise in blood pressure, even though you might feel fine. If there's an indication that your blood pressure is high at two or more checkups, the doctor may ask you to check your blood pressure at home at different times of the day. If the pressure stays high, even when you are relaxed, the doctor may suggest exercise, changes in your diet, and, most likely, medications.
Instead of an arbitrary goal to “lose weight,” talk with your doctor about a healthy weight for you. The Centers for Disease Control and Prevention (CDC) recommends a weight loss goal of one to two pounds a week. That means starting off eating 500 calories less per day than what you normally eat. Then decide on what physical activity you can start in order to reach that goal. If exercising five nights a week is too hard to work into your schedule, aim for one more night than what you’re doing right now. When that fits comfortably into your schedule, add another night.
A desired blood pressure is less than 120/80. In people who are considered to be healthy, low blood pressure without experiencing any symptoms is commonly not a concern and does not need to be treated. Low blood pressure may be a sign of an underlying issue, particularly in seniors, where it might cause inadequate blood floor to their heart, vital organs, and brain.

Cirrhosis of the liver is the most common cause of portal hypertension. In cirrhosis, the scar tissue (from the healing of liver injury caused by hepatitis, alcohol, or other liver damage) blocks the flow of blood through the liver. Blood clots in the portal vein, blockages of the veins that carry blood from the liver to the heart, parasitic infection (schistosomiasis), and focal nodular hyperplasia are also causes of portal hypertension.
Many expert groups recommend a slightly higher target of 150/90 mmHg for those over somewhere between 60 and 80 years of age.[99][100][101][105] The JNC-8 and American College of Physicians recommend the target of 150/90 mmHg for those over 60 years of age,[13][106] but some experts within these groups disagree with this recommendation.[107] Some expert groups have also recommended slightly lower targets in those with diabetes[99] or chronic kidney disease with protein loss in the urine,[108] but others recommend the same target as for the general population.[13][103] The issue of what is the best target and whether targets should differ for high risk individuals is unresolved,[109] although some experts propose more intensive blood pressure lowering than advocated in some guidelines.[110]

Researchers at the University of Melbourne and Macquarie University have uncovered unusual activity between neurons controlling breathing and blood pressure during the development of essential hypertension. Essential hypertension, which is high blood pressure with no known cause, affects 30% of the global population and is a major contributor to cardiovascular disease.

Primary (or essential) hypertension is when the cause is unknown. The majority of hypertension cases are primary. When there is an underlying problem such as kidney disease or hormonal disorders that can cause hypertension, it is called secondary hypertension. When it is possible to correct the underlying cause, high blood pressure usually improves and may even return to normal.
Understanding the normal BP range with age can help the doctor and you to estimate your cardiovascular health. Blood pressure levels can fluctuate significantly from one reading to the next and it is important to remember that just one abnormally high reading does not signify that you have high blood pressure. Doctors usually use an average of multiple blood pressure readings taken over a period of several days to arrive at a diagnosis of high blood pressure. 

About This Image: Person receiving a blood pressure test. Medical research shows that as we age blood pressure rises slightly to accommodate an increased demand of oxygen and nutrients. It is completely natural for the first number (systolic) to be 100 plus our age. A recent study by a group of UCLA researchers came very close to corroborating Dr. Piette's guide for blood pressure of 100 plus your age for men, subtracting 10 for women, and this is after this rule had been in use for five or more decades. Are we now being taught that Dr. Piette's guide for blood pressure is wrong merely for drug company profit?
Normal blood pressure is below 120/80. New guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC) published in November of 2017 consider blood pressure elevated between 120/80 and 129/80. High blood pressure or hypertension is now classified as stage 1 if your systolic reading falls between 130 and 139 or your diastolic reading is between 80 and 89. A measure of 140/90 or higher is now considered stage 2 hypertension. A hypertensive crisis is defined as a systolic rate over 180 or a diastolic rate above 120. An elevated blood pressure means that the heart must work harder to pump blood. High blood pressure can also damage the walls of the arteries. Over time, hypertension increases the risk of heart disease, kidney disease, and stroke. It is estimated that one in three adults in America are affected by hypertension.
Current strategies for controlling cardiovascular disease (CVD) risk factors, such as high blood pressure and high cholesterol, are not widely used as standard practice. CDC developed this guide to provide health professionals with evidence-based strategies for effective and sustainable CVD prevention, including health and economic impact and potential for reducing health disparities.

Keeping track of your blood pressure is important. Your doctor can help you learn how to check your blood pressure at home. Each time you check your own blood pressure, record your numbers and the date. Send or take the log of your blood pressure readings with you for appointments with your doctor. Return to Screening for reminders on how to prepare for blood pressure testing.
With age, comes an increased risk for systolic hypertension which can be aggravated by severe atherosclerosis. According to one study, the diuretic chlorthalidone (Hygroton) had significant benefit in elderly patients with systolic hypertension. Along with a diuretic, some calcium channel blockers, ACE inhibitors and angiotensin II receptor blockers may also be good choices. However, beta blockers may not be as effective for hypertension in those over 60; though they may be good choices if co-existing heart disease is present. It also may be preferable in elderly patients to give two high blood pressure medications at a low dose versus one at a higher dose.
A slow heart rate (bradycardia) can decrease the amount of blood pumped by the heart. The resting heart rate for a healthy adult is between 60 and 100 beats/minute. Bradycardia (resting heart rates slower than 60 beats/minute) does not always cause low blood pressure. In fact, some highly trained athletes can have resting heart rates in the 40s and 50s (beats per minute) without any symptoms. The slow heart rates are offset by more forceful contractions of the heart that pump more blood than in non-athletes. However, in many patients bradycardia can lead to low blood pressure, lightheadedness, dizziness, and even fainting.

The new guidelines stem from the 2017 results of the Systolic Blood Pressure Intervention Trial (SPRINT), which studied more than 9,000 adults ages 50 and older who had systolic blood pressure (the top number in a reading) of 130 mm Hg or higher and at least one risk factor for cardiovascular disease. The study's aim was to find out whether treating blood pressure to lower the systolic number to 120 mm Hg or less was superior to the standard target of 140 mm Hg or less. The results found that targeting a systolic pressure of no more than 120 mm Hg reduced the chance of heart attacks, heart failure, or stroke over a three-year period.
If elevated blood pressure levels are accompanied by diabetes, kidney disease, or cardiovascular disease, your doctor may suggest blood pressure medication as well lifestyle changes. If elevated levels are your only condition, lifestyle changes can help prevent blood pressure from rising. The following are lifestyle changes that may help lower blood pressure:
The range of systolic blood pressure for most healthy adults falls between 90 and 120 millimeters of mercury (mm Hg). Normal diastolic blood pressure ranges between 60 and 80 mm Hg. Current guidelines define normal blood pressure range as lower than 120/80. Blood pressures over 130/80 are considered high. High blood pressure increases the risk of damaging the arteries, which leads to the development of:
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure.
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.
Some high blood pressure medications initially cause drowsiness, dizziness, and lightheadedness. Some even cause fainting on the first dose. The body usually adjusts to the effects of these medications and the side effects disappear. Consuming alcohol during the early phase of antihypertensive treatment could be risky because alcohol can also cause dizziness, drowsiness, and lightheadedness.
Blood pressure often increases in stages. A person in her thirties may have mild to moderately elevated blood pressure readings. As she ages, blood pressure may continue to slowly rise. If someone develops high blood pressure before the age of 50, the risk of heart attack and stroke is greatly increased. If untreated, high blood pressure can reduce life expectancy by 10 or more years.
^ Jump up to: a b Semlitsch, T; Jeitler, K; Berghold, A; Horvath, K; Posch, N; Poggenburg, S; Siebenhofer, A (2 March 2016). "Long-term effects of weight-reducing diets in people with hypertension". The Cochrane Database of Systematic Reviews. 3: CD008274. doi:10.1002/14651858.CD008274.pub3. PMID 26934541. Archived from the original on 23 March 2016. Retrieved 9 March 2016.
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A person consistently showing blood pressure higher than 140/90 over several readings is considered to have hypertension. Doctors advise these people to make effective lifestyle changes to help lower their blood pressure, such as maintaining a healthy weight, including exercise in their daily routine, limiting salt and alcohol intake, and quitting smoking. The doctors will also recommend medication for hypertension depending on how much higher the BP is as compared to the normal blood pressure range and any other health problems that the patient faces.
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