Blood Pressure Readings: What Do They Really Mean?

Hypertension Stage 2

Hello, Doctor: I would like to ask you again: Is it possible to have a systolic blood pressure under 120 and a diastolic blood pressure greater than 90? Or a systolic blood pressure greater than 140 and a diastolic blood pressure less than 90? If so, what kind of health issues might this indicate? My father believes that the device is malfunctioning.
How should I persuade him?

sindy, 30~39 year old female. Ask Date: 2009/04/20

Dr. Bu Shiyun reply Cardiology

When measuring blood pressure, it is possible to have elevated diastolic pressure or isolated systolic pressure.
However, there are many variables that can affect blood pressure readings, so it is more valuable to take multiple measurements while at rest and record them for comparison.
If possible, measuring 3 to 4 times a day for documentation to share with the physician is recommended (of course, if blood pressure is already well-controlled, frequent measurements may not be necessary).
If there is suspicion of an issue with the device, it is advisable to measure the blood pressure of someone with "normal" readings or take the device to a hospital to compare it with a calibrated machine.

Reply Date: 2009/04/20

More Info

Understanding blood pressure readings is crucial for maintaining cardiovascular health. Blood pressure is measured in millimeters of mercury (mmHg) and is expressed as two numbers: systolic pressure (the higher number) and diastolic pressure (the lower number). Systolic pressure measures the force of blood against the artery walls when the heart beats, while diastolic pressure measures the same force when the heart is at rest between beats.

To address your question, yes, it is indeed possible to have a systolic blood pressure (SBP) below 120 mmHg while having a diastolic blood pressure (DBP) above 90 mmHg. This condition is known as isolated diastolic hypertension. It can occur in certain populations, particularly in younger individuals or those with specific health conditions. Conversely, it is also possible to have a systolic blood pressure above 140 mmHg while the diastolic blood pressure remains below 90 mmHg, a condition referred to as isolated systolic hypertension. This is more common in older adults and can be a sign of increased cardiovascular risk.

Potential Health Implications
1. Isolated Diastolic Hypertension: This condition can indicate that the arteries are not relaxing properly, which may lead to increased workload on the heart. It can be associated with conditions such as obesity, kidney disease, or hormonal imbalances. If left untreated, it can increase the risk of heart disease and stroke.

2. Isolated Systolic Hypertension: This is often seen in older adults due to the stiffening of large arteries. It can also be influenced by factors such as atherosclerosis, where plaque builds up in the arteries. Isolated systolic hypertension is a significant risk factor for cardiovascular events, including heart attacks and strokes.

Addressing Concerns About Blood Pressure Readings
If your father believes that the blood pressure readings are inaccurate, it is essential to ensure that the device being used is calibrated correctly and that the readings are taken under appropriate conditions. Blood pressure can fluctuate based on various factors, including stress, activity level, and even the time of day. Here are some tips to ensure accurate readings:
- Use a Validated Device: Ensure that the blood pressure monitor is clinically validated for accuracy. Automatic arm monitors are generally more reliable than wrist or finger monitors.

- Proper Technique: Blood pressure should be measured while sitting comfortably with the back supported, feet flat on the floor, and the arm at heart level. Avoid caffeine, exercise, and smoking for at least 30 minutes before measuring.

- Multiple Readings: Take multiple readings at different times of the day to get a more accurate picture of blood pressure trends. It’s often recommended to take readings in the morning and evening.

- Consult a Healthcare Professional: If there are persistent discrepancies in readings, or if there are concerns about hypertension, it is advisable to consult with a healthcare provider. They may recommend a 24-hour ambulatory blood pressure monitoring to assess blood pressure over a full day and night cycle.

Conclusion
In summary, both isolated diastolic and systolic hypertension are possible and can indicate underlying health issues that may require further evaluation. It’s important to approach blood pressure management holistically, considering lifestyle factors such as diet, exercise, and stress management. Encouraging your father to seek a professional opinion if there are doubts about the readings can help alleviate concerns and ensure that any potential health issues are addressed promptly.

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