Blood Pressure Readings: Key Questions Answered by a Family Physician

Q: Blood Pressure Readings: Key Questions Answered by a Family Physician

Hello： 1. <br>Blood pressure is variable and can be influenced by physical activity, eating, emotions, etc. <br>Therefore, it is generally recommended to measure blood pressure when the body and mind are in a calm state. <br>Based on your two measurements, it seems that the secon

Questions about measuring blood pressure?

Hello Dr.
Lin,
Today, when I measured my blood pressure, I found that the first reading showed elevated systolic and diastolic values, but subsequent measurements were significantly lower.
I have three blood pressure monitors at home, and they all showed similar results.
The specific measurements are as follows: today (12/1), the first reading was approximately between 120-129/88-92; the second and subsequent readings were around 105-115/77-81.
I would like to ask Dr.
Lin the following questions:
Q1.
Based on the above and the measured values, which reading should I consider as accurate? Since all three blood pressure monitors at home showed similar results, I am unsure of my correct blood pressure value.
Q2.
In the past, I have only had elevated diastolic pressure while my systolic pressure remained within the normal range (130).
After going for a walk today, my first reading at home showed normal systolic pressure, but the diastolic pressure was 92.
One minute later, the second measurement showed the diastolic pressure dropped to around 80.
Dr.
Lin, with a normal systolic pressure but a diastolic pressure of 92, does this indicate hypertension?
Q3.
Following up on the previous question, if my systolic pressure is normal and my diastolic pressure is solely elevated within the range of 90-100, do I need to take medication to lower my blood pressure? Are there any non-pharmacological methods to manage it?
Q4.
Dr.
Lin, generally speaking, if the systolic pressure is normal and only the diastolic pressure is elevated within the range of 90-100, what kind of harm could this cause to the body?
Thank you, Dr.
Lin.

Kris, 40~49 year old female. Ask Date: 2023/12/01

Dr. Lin Zhebin reply Family Medicine

Hello: 1.
Blood pressure is variable and can be influenced by physical activity, eating, emotions, etc.
Therefore, it is generally recommended to measure blood pressure when the body and mind are in a calm state.
Based on your two measurements, it seems that the second measurement was likely taken after resting, so typically the second measurement is considered the more accurate one.
2.
If your diastolic pressure remains above 90 for an extended period, it would technically be classified as hypertension.
However, since your diastolic pressure drops below 90 after resting for one minute, it is advisable to consistently measure your blood pressure during a calm state (for example, before breakfast in the morning).
If your diastolic pressure consistently exceeds 90, then seeking medical attention would be recommended.
3.
If your diastolic pressure remains above 90 for a prolonged period, it would indeed be classified as hypertension, and considering antihypertensive medication may be appropriate.
Of course, in addition to medication, lifestyle changes are also crucial: reducing sodium intake, limiting alcohol consumption, losing weight, quitting smoking, following the DASH diet, and exercising, among others.
4.
Whether systolic or diastolic pressure is elevated, prolonged high blood pressure can lead to health complications, primarily cardiovascular diseases such as stroke and myocardial infarction, and may also affect other organs such as the eyes and kidneys.

Reply Date: 2023/12/01

More Info

Hello! Thank you for your questions regarding blood pressure readings. Understanding blood pressure can be quite complex, especially when you notice variations in readings. Let's address your questions one by one.

Q1: Which blood pressure reading should I consider as accurate?
When measuring blood pressure, it’s important to take multiple readings to get a more accurate assessment. The first reading can often be higher due to a phenomenon known as "white coat syndrome," where anxiety about being in a medical setting can temporarily raise blood pressure. In your case, since you have observed that the first reading is consistently higher than subsequent readings, it would be prudent to consider the average of the later readings as more reflective of your true blood pressure. Ideally, you should take measurements at the same time each day, in a relaxed state, and after resting for at least five minutes. If you consistently see a pattern of higher readings, it may warrant further investigation.

Q2: Is a systolic reading of 130 with a diastolic reading of 92 considered high blood pressure?
According to the American Heart Association, a blood pressure reading of 130/80 mmHg or higher is classified as hypertension. In your case, while your systolic pressure is normal, a diastolic pressure of 92 mmHg falls into the category of Stage 1 hypertension. It’s important to note that isolated diastolic hypertension can occur, and it is essential to monitor this closely. If your diastolic pressure remains elevated, it may require lifestyle modifications or further evaluation by a healthcare provider.

Q3: Should I take medication if my systolic pressure is normal but my diastolic pressure is elevated?
The decision to start medication for hypertension is based on several factors, including the overall cardiovascular risk profile, the presence of other health conditions, and lifestyle factors. If your diastolic pressure consistently remains elevated, it may be beneficial to discuss this with your physician. They may recommend lifestyle changes such as dietary modifications (reducing sodium intake, increasing potassium-rich foods), regular physical activity, weight management, and stress reduction techniques. If these measures do not sufficiently lower your diastolic pressure, medication may be considered.

Q4: What are the potential risks of having a normal systolic pressure but elevated diastolic pressure?
Isolated diastolic hypertension can be concerning, particularly if it persists over time. Elevated diastolic pressure can lead to increased workload on the heart and may contribute to the development of cardiovascular diseases, including heart failure and stroke. It can also be associated with other conditions such as kidney disease. Therefore, it is crucial to monitor your blood pressure regularly and consult with your healthcare provider to determine the best course of action.

In summary, while your systolic pressure appears to be in a normal range, the elevated diastolic pressure should not be overlooked. Regular monitoring, lifestyle changes, and discussions with your healthcare provider are key steps in managing your blood pressure effectively. If you have any further questions or concerns, please feel free to reach out. Thank you for your inquiry, and I wish you good health!

Similar Q&A

Managing High Blood Pressure: Essential Questions for Your Family Doctor

Hello Doctor: My uncle is in his 50s, standing 176 cm tall and weighing around 60-70 kg. Today, he visited a family medicine clinic due to neck pain (which he feels is similar to a stiff neck). The doctor measured his blood pressure, which was over 170, nearly 180, and diagnosed ...

Dr. Lin Zhebin reply Family Medicine
Hello: 1. Hypertension can be managed by a primary care physician, unless it affects the kidneys or heart, in which case referral to a nephrologist or cardiologist may be considered. Additionally, tests related to hypertension typically include blood tests, urinalysis, electrocar...

Managing Hypertension: Understanding Home vs. Clinic Blood Pressure Readings

Hello Doctor, (1) I have been monitoring my blood pressure since I was 18, and it was recorded at 160/90. Subsequently, during regular check-ups at the hospital, it has consistently been above 179/95. By the age of 30, I started taking antihypertensive medication, specifically ...

Dr. He Dongjin reply Cardiology
Hello, that's correct. White coat syndrome can cause blood pressure readings in the hospital to reach as high as 170/100. Therefore, current treatment guidelines suggest that monitoring blood pressure at home is more important. How can we overcome this issue to ensure that t...

Understanding Hypertension Management: Questions About Diagnosis and Treatment

I started experiencing daily blood pressure readings around 140/98 and symptoms of dizziness and headaches at the end of February, so I went to see a cardiologist. The doctor prescribed antihypertensive medication before waiting for the test results. A week later, the blood tests...

Dr. Zhang Guoji reply Internal Medicine
1. If you have concerns about the original physician's management, you should discuss it with the physician during the outpatient visit to understand their perspective and resolve your issues, as each physician may have different thoughts and approaches. Asking other physici...

Understanding Hypertension: Symptoms, Risks, and Family History

Hello, Doctor: I have been suffering from a cold for 1 to 2 months without recovery. Last week, my blood pressure readings were between 170-150 for systolic and 120-105 for diastolic, and this persisted for 3 to 4 days. In the last couple of days, my readings have returned to 142...

Dr. Zhu Nianfeng reply Cardiology
When experiencing a cold or feeling unwell, blood pressure may increase; however, it may stabilize upon recovery. Since your age and recent diastolic pressure are unknown, an immediate assessment cannot be made. Please measure your blood pressure a few more times and inform us of...