High blood pressure is one of the biggest concerns of Americans today. At its simplest, blood pressure is necessary for the human body as it measures the rate and strength at which the heart pumps blood throughout the body. Two numbers make up blood pressure: systolic and diastolic. Both numbers are a measure of your overall health.
What is the Difference Between Systolic and Diastolic Blood Pressure?
When a medical professional takes your blood pressure, you get two numbers, usually read as the top number over the bottom number. Your beating heart is what causes systolic blood pressure. It reflects the pressure in the arteries when your heartbeats. The second, or bottom number, is diastolic, which measures the pressure in the arteries when the heart rests between beats. That’s how we get the reading 120 over 80, for instance, which is also written as 120/80 mmHg.
Which is More Important Systolic Blood Pressure or Diastolic Blood Pressure?
Both indicators of blood pressure are important when predicting cardiovascular diseases, but once a person passes age 50, systolic pressure becomes far more important when it becomes a greater indicator or problems such as congestive heart failure, left ventricular hypertrophy, renal failure, and mortality. For those aged 60 and older, increased systolic blood pressure and lower diastolic blood pressure can increase cardiovascular risk.
Elevated systolic blood pressure predicts cardiovascular disease better than increased diastolic blood pressure. Isolated systolic hypertension occurs when the diastolic number is less than 80, and the systolic pressure is 130 or higher. It is the most common form of high blood pressure in people older than 65. Underlying conditions such as stiff arteries, overactive thyroid, heart valve problems, diabetes, and obesity can cause isolated systolic hypertension. Physiological changes in older age explain why hypertension arises in older people. Younger individuals have a highly distensible aorta, which allows it to expand during the systolic portion of the blood pressure cycle, thereby minimizing the rise in blood pressure. Most people experience progressive stiffening of their arteries as they age due to calcium and collagen deposits, leading to an elevation in systolic pressure. This increase in systolic pressure increases left ventricular hypertrophy, while the relatively low diastolic pressure compromises blood flow. Lowering systolic blood pressure remains a major criterion for managing hypertension among people who are middle-aged and older.
What Causes High Systolic Blood Pressure?
Before taking a look at what causes high systolic pressure, let’s look at what is normal systolic blood pressure. Normal blood pressure is considered 120/80 mmHg, with 120 considered the normal systolic number. Systolic pressure below 120 is also considered normal, but only to a certain extent. When the systolic pressure drops below 90, it’s considered hypotension, or low blood pressure. Low blood pressure is dangerous, too, as the body will not get enough oxygen, sometimes resulting in death. A systolic pressure of 120 to 129 is considered elevated blood pressure, while a number from 130 to 139 is considered Stage 1 hypertension. Stage 2 hypertension occurs when the systolic number is 140 or higher, and the diastolic number is 90 or higher.
A hypertensive crisis, defined as a sudden blood pressure spike higher than 180/120 mmHg, requires medical attention. Patients who experience chest pain, shortness of breath, numbness or weakness, back pain, change in vision, or difficulty speaking with an accompanying blood pressure spike should get emergency medical help.
Whether someone has isolated systolic hypertension or another hypertension disorder, it often results in end-organ damage if left unchecked. Early diagnosis, initiating appropriate treatment, and addressing factors that can be modified are essential to decrease morbidity and mortality. When assessing patient history, doctors also look for regular use of non-steroidal anti-inflammatory drugs, along with steroids, estrogen, and even regular ingestion of cocaine. Other symptoms your doctor may look for include tremors, sweating, tachycardia, muscle weakness, depression, thinning skin, loud snoring, and daytime drowsiness. End-organ damage can result in loss of visual acuity, shortness of breath, frequent headaches, and pain in the legs, generally caused by too little blood flow.
High blood pressure generally develops over time as a result of genetic factors or due to unhealthy lifestyle choices. Risk factors include:
- Obesity and sedentary lifestyle
- Diabetes or a family history of the disease
- An unusually high amount of triglycerides, cholesterol, and/or fat phospholipids
- A poor diet consisting of high salt and fat content, process food, and alcohol intake
- Family history of hypertension, renal or cardiovascular disease
Other factors that can result in high blood pressure are pregnancy along with insufficient sleep and high-stress levels. African-Americans are also at higher risk, along with those who use stimulant drugs such as cocaine or methamphetamine. Even using birth control pills can heighten a woman’s risk.
What You Can Do to Lower High Blood Pressure
As people age, they are more likely to require medications prescribed by their doctors to lower blood pressure. Many different types of antihypertensives are available, and each class of drugs has its effects and side effects. When taking blood pressure prescriptions, remember to discuss possible side effects and drug interactions with your doctor.
Commonly used classes of medications include:
- ACE inhibitors
- Calcium channel blockers
- Angiotensin II receptor blockers
- Combined alpha and beta-blockers
- Central agonists
- Peripheral adrenergic inhibitors
Diuretics rid the body of excess salt and water but they also deplete the body of potassium and can increase blood sugar levels in people with diabetes. Gout is also a possibility. Beta-blockers can produce insomnia, slow heartbeat, cold hands and feet, and depression. Alpha-blockers relax the muscle tone of vascular walls and can produce a fast heart rate, dizziness, and a drop in blood pressure upon standing. ACE inhibitors help relax blood vessels, allowing them to open up, thereby reducing blood pressure. These can produce skin rash, loss of taste, and a dry cough.
Angiotensin II receptor blockers inhibit angiotensin, a chemical that narrows the arteries. These drugs block receptors, so the angiotensin fails to constrict the blood vessel and remain open. They can cause dizziness and should not be used by pregnant women as they can cause injury or death to a fetus. Calcium channel blockers prevent calcium from entering the heart and arteries’ smooth muscle cells and can be useful for controlling isolated systolic hypertension. They work by opening narrowed blood vessels, reducing heart rate, and lowering blood pressure. Central agonists help decrease blood vessels’ ability to tense or contract and work in much the same way as alpha and beta-blockers.
Vasodilators can cause the muscle in the blood vessel walls to relax, allowing better blood flow. Side effects can include headaches, swelling around the eyes, heart palpitations, and joint aches.
Peripheral adrenergic inhibitors block neurotransmitters in the brain to reduce blood pressure but are only used unless other medications don’t work. Combined alpha and beta-blockers are only used as an intravenous drip for patients suffering a hypertensive crisis, especially when at risk for heart failure.
Lifestyle changes play a key role in getting and keeping blood pressure down. In many cases, implementing such changes will go a long way toward keeping medication doses low. By making the following changes, you can help lower your blood pressure and keep it low.
1. Lose weight
It’s one of the most effective ways to lower blood pressure because as weight increases, blood pressure increases as the heart must work harder to distribute blood throughout the body. Excessive weight can also contribute to sleep apnea, which further increases your risk. You can expect to reduce blood pressure by approximately one mmHg for every 2.2 pounds lost.
2. Regular exercise
Regular physical activity can reduce high blood pressure by about 5 to 8 mmHg. It’s important to keep going because once exercise stops, this benefit will disappear. Exercises that can help moderate blood pressure include walking, jogging, cycling, swimming, or dancing.
3. Eat healthily and reduce sodium
Consume foods such as whole grains, fruits, vegetables, and low-fat dairy products, sometimes known as the DASH (Dietary Approaches to Stop Hypertension) diet. To change your habits, keep a food diary to monitor what and how much you eat. Consider adding potassium to your diet as it can lessen the effects of sodium on blood pressure. At the same time, reduce sodium as even a small reduction can result in a 5 to 6 mmHg drop.
4. Limit alcohol
Alcohol in moderation can lower your blood pressure, but when you drink too much, it can raise levels by several points while also reducing the effectiveness of blood pressure medications.
5. Quit smoking
Each cigarette smoked increases blood pressure for several minutes after you finish. Stopping smoking helps blood pressure return to normal.
6. Reduce caffeine
The jury is still out on how much caffeine affects blood pressure. For those who rarely consume it, caffeine can raise blood pressure to 10 mmHg, but those who drink coffee regularly may see little effect.
7. Reduce stress
Researchers believe chronic stress contributes to high blood pressure. Occasional stress may also contribute if you react by partaking in unhealthy habits. Know what is causing your stress and take steps to reduce or eliminate it.
Does Pain Affect Systolic or Diastolic Blood Pressure?
Research indicates that people age 14 and older could have higher blood pressure due to acute pain levels. However, the role of chronic pain on blood pressure levels is not well understood. Often, hypertension and concurrent musculoskeletal problems are commonly prescribed analgesics and antihypertensive at the same time.
Sometimes pain and anti-inflammatory medications can cause people to retain water, which can cause kidney problems as well as increase blood pressure. These include indomethacin, acetaminophen, aspirin, naproxen sodium, and piroxicam.
Management of high blood pressure often requires adjustment, especially when an injury occurs that causes someone to decrease their level of activity. Taking a lot of anti-inflammatory pain medications can also cause water retention, which elevates blood pressure.
How Centric Healthcare Can Help
Hypertension is a problem that affects many older people who are chronically ill with a variety of conditions. Often, older people take a variety of medications daily or weekly that include antihypertensives, analgesics, and other prescriptions. Remembering to take multiple medications can be daunting. Our medication therapy management services can help those taking multiple medications by reviewing all drugs in a patient’s regimen and making sure that adverse interactions are unlikely to happen.
We can also provide a variety of home care services such as skilled nursing services, companions, and related care that will take the worry out of caring for a loved one. We are your premier home healthcare organization in Rochester and the Twin Cities in Minnesota. Contact us for a free home care consultation.