Hypertension can rarely be felt. This is fatal because it is a risk to your heart and brain. What readings constitute hypertension and what can be done to prevent it? How do you measure it properly?
High blood pressure, which is medically known as arterial hypertension, is an insidious illness. About one in four adults in Switzerland have high blood pressure – and usually don’t feel it or are casual about it. The consequences thereof are only identified when it is too late: high blood pressure damages the heart, brain, kidneys and eyes. Hypertension is the greatest risk factor for many types of cardiovascular disease like stroke, heart attacks and cardiac insufficiency. In order to prevent sequelae, the Swiss Heart Foundation recommends that everyone aged 18 or over have their blood pressure tested at least once a year.
The blood supplies organs and tissues with nutrients and oxygen. A certain amount of pressure is required for it to be able to flow properly. It is regulated by the interplay of heartbeat, blood volume and blood vessels. Two values are measured each time and displayed as “millimetres of mercury” (mmHg): the upper or systolic reading describes the pressure at the moment when the heart muscle contracts, thus pumping blood into the vessels. The lower, diastolic reading is the lowest point in the relaxation phase when the heart relaxes and refills with blood.
Normal blood pressure or too high?
The ideal blood pressure is 120/80 mmHg (= millimetres of mercury). Blood pressure of 140/90 or more is considered too high. The normal readings change over the course of our lives: they are lower in infants than in senior citizens. Short-term fluctuations are also normal: physical exertion, stress, anxiety and pain increase the pressure, whereas the latter drops after meals and while we are asleep.
Blood pressure table
Classification of normal blood pressure readings according to the World Health Organization (WHO):
|Lower/diastolic reading (mmHg)|
|Ideal blood pressure||Below 120||Below 80|
|Normal blood pressure||120-129||80-84|
|High normal blood pressure||130-139||85-89|
|Slight hypertension (level 1)||140-159||90-99|
|Medium hypertension (level 2)||160-179||100-109|
|Severe hypertension (level 3)||180 or over||110 or over|
When is blood pressure too high? Readings of 140 or over (upper blood pressure) and 90 (lower blood pressure) are considered to be high blood pressure.
Tips on measuring your blood pressure: how to measure it properly
- You should preferably measure your blood pressure in the morning on an empty stomach, right after getting up and before taking any medication.
- Tighten the cuff of your blood pressure monitor as much as possible on your naked upper arm, about 1 to 2 cm above the bend of your elbow. Ensure that rolled up sleeves don’t press tightly against your arm. If you are using a wrist blood pressure monitor: raise the height of your forearm to heart level using a cushion.
- Relax your arm and place it unstretched and with your palm facing upwards onto an armrest or table. It is important to ensure that the cuff is at heart level during the measurement.
- Relax for one minute before the measurement: sit up straight in a comfortable position, breathe calmly and evenly, and think about something nice.
- Start the measurement. Don’t move during this time, don’t speak and don’t touch the device.
- Perform the first measurement on both arms; from then on, always measure the side with the higher readings.
- Once the blood pressure measurement has finished, the readings of the upper, systolic and lower, diastolic blood pressure appear on the display (for example: 125/85 mmHg).
- The best thing to do is enter the readings on a blood pressure pass or form. The Swiss Heart Foundation provides them.
- You should also make a note of any unusual circumstances or complaints which could have an effect on the readings and take these details to your next medical check-up.
High blood pressure in brief
- Definition: blood pressure of 140/90 mmHg or more
- Possible consequences: heart attacks, cardiac insufficiency, stroke, renal failure, circulatory disorders in the legs and amblyopia
- Possible symptoms: usually none; rarely dizziness, headache or tinnitus – at an advanced stage, also symptoms of secondary diseases like tightness in the chest (angina pectoris), shortness of breath, water retention and impaired vision
- Causes: unhealthy lifestyle and hereditary factors
- Treatment: lifestyle changes (lots of exercise and sport, lose weight, low-salt diet, quit smoking, etc.), possibly antihypertensive medication; in case of secondary hypertension: treat the underlying disease
- Important: in case of a sudden, massive increase in blood pressure, call the emergency doctor immediately (emergency number: 144)
Preventing and treating high blood pressure
Are your readings too high? After being diagnosed with high blood pressure, it is important that patients are well looked after. The aim of treatment is to permanently lower their blood pressure readings to the normal range. In case of slight hypertension, it is generally sufficient to make appropriate lifestyle changes: enough exercise, normal weight, a balanced, low-salt diet, only a little alcohol, quit smoking and a healthy attitude to stress. If none of these measures help a particular patient, antihypertensive medication is administered. Your attending physician devises a suitable treatment plan with you and advises you on a heart-healthy lifestyle.
Low blood pressure – what do I do?
Dizziness and cold feet are typical signs of very low blood pressure – as long as no other complaints occur, there is no danger. Simple measures like sport, contrast showers or increased salt and liquid intake usually help to return the blood pressure to the normal range.
Author: Daniela Schori
Publication date: 6 September 2019
Dr Robert C. Keller, Managing Director of the Swiss Heart Foundation
Dr Robert C. Keller is the Managing Director of the Berne-based Swiss Heart Foundation. He has long-standing experience in the field of cardiovascular diseases and heads up the areas of research and prevention at the foundation. Dr Keller provided the editorial team with advice.