The measurements must have been obtained from at least two careful readings on at least two different occasions. What does careful mean? The guidelines provide a six-step tutorial on how, exactly, to correctly measure a blood pressure, which, admittedly, is sorely needed. My patients often have their first blood pressure taken immediately after they have rushed in through downtown traffic, as they’re sipping a large caffeinated beverage. While we always knew this could result in a falsely elevated measurement, it is now officially poor clinical technique resulting in an invalid reading.
The veins can expand and narrow. When veins expand, more blood can be stored in the veins and less blood returns to the heart for pumping into the arteries. As a result, the heart pumps less blood, and blood pressure is lower. On the other hand, when veins narrow, less blood is stored in the veins, more blood returns to the heart for pumping into the arteries, and blood pressure is higher.
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Quitting smoking. Visit Smoking and Your Heart and the National Heart, Lung, and Blood Institute’s Your Guide to a Healthy Heart [PDF – 2MB]. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, you can call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).

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.]
High blood pressure is a common disease in which blood flows through blood vessels, or arteries, at higher than normal pressures. Blood pressure is the force of blood pushing against the walls of your arteries as the heart pumps blood. High blood pressure, sometimes called hypertension, is when this force against the artery walls is too high. Your doctor may diagnose you with high blood pressure if you have consistently high blood pressure readings.
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.

Extremely high levels of blood pressure, i.e. systolic above 180 mm Hg or diastolic above 110 mm Hg requires immediate medical attention. Delayed treatment in such cases may result in various hypertensive emergencies like stroke, heart attack, hypertensive encephalopathy, malignant hypertension, aortic dissection, etc. These conditions may cause death.
ACE (angiotensin converting enzyme) inhibitors are another class of antihypertensive drugs. They reduce the body's levels of angiotensin II, a substance that narrows blood vessels. This means that arteries are more open (dilated) and the blood pressure is lower. ACE inhibitors can be used alone, or with other medications such as diuretics. Side effects of ACE inhibitors can include skin rash, dry cough, dizziness, and elevated potassium levels. Women who are pregnant, planning to get pregnant, or breastfeeding should not take ACE inhibitors.
Extremely high levels of blood pressure, i.e. systolic above 180 mm Hg or diastolic above 110 mm Hg requires immediate medical attention. Delayed treatment in such cases may result in various hypertensive emergencies like stroke, heart attack, hypertensive encephalopathy, malignant hypertension, aortic dissection, etc. These conditions may cause death.
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.
Blood pressure monitors for use at home can be bought at drug stores, department stores, and other places. Again, these monitors may not always give you a correct reading. You should always compare your machine’s reading with a reading from your doctor’s machine to make sure they are the same. Remember that any measurement above normal should prompt a visit to the doctor, who can then talk with you about the best course of action.
The primary symptoms of malignant hypertension is a blood pressure of 180/120 or higher and signs of organ damage. Other symptoms of malignant hypertension include bleeding and swelling of blood vessels in the retina, anxiety, nosebleeds, severe headache, and shortness of breath. Malignant hypertension may cause brain swelling, but this symptom is very rare.
^ Aronow WS, Fleg JL, Pepine CJ, Artinian NT, Bakris G, Brown AS, Ferdinand KC, Ann Forciea M, Frishman WH, Jaigobin C, Kostis JB, Mancia G, Oparil S, Ortiz E, Reisin E, Rich MW, Schocken DD, Weber MA, Wesley DJ, Harrington RA, Bates ER, Bhatt DL, Bridges CR, Eisenberg MJ, Ferrari VA, Fisher JD, Gardner TJ, Gentile F, Gilson MF, Hlatky MA, Jacobs AK, Kaul S, Moliterno DJ, Mukherjee D, Rosenson RS, Stein JH, Weitz HH, Wesley DJ (2011). "ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents developed in collaboration with the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension". J Am Soc Hypertens. 5 (4): 259–352. doi:10.1016/j.jash.2011.06.001. PMID 21771565.
Measuring blood pressure in both the lying (supine) and standing positions usually is the first step in diagnosing low blood pressure. In patients with symptomatic low blood pressure, there often is a marked drop in blood pressure upon standing, and patients may even develop orthostatic symptoms. The heart rate often increases. The goal is to identify the cause of the low blood pressure. Sometimes the causes are readily apparent (such as loss of blood due to trauma, or sudden shock after receiving X-ray dyes containing iodine). At other times, the cause may be identified by testing:
High blood pressure is a common disease in which blood flows through blood vessels, or arteries, at higher than normal pressures. Blood pressure is the force of blood pushing against the walls of your arteries as the heart pumps blood. High blood pressure, sometimes called hypertension, is when this force against the artery walls is too high. Your doctor may diagnose you with high blood pressure if you have consistently high blood pressure readings.
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