Essential Guide to Understanding High Blood Pressure

What is the Ideal Blood Pressure in Men & Women?

The average blood pressure for 18-39 year-old males should be around 119/70 mmHg while for females it should be 110/68 mmHg. For middle-aged adults, for men between 40 and 59 years of age your blood pressure should be around 124/77mmHg and for women 122/74mmHg. For older individuals who are 60 and above, for males, blood pressure should range around 133/69mmhG and for women over 60 years old around 139/68. 

Ideal blood pressure (average BP in healthy adults) is a reading which falls within the range of 90/60mmHg and 120/80mmHg.

The first number is known as the systolic blood pressure. This number represents the pressure which is exerted as blood is ejected into the arteries. The second number represents the pressure that the blood exerts within the arteries between different heartbeats. 

High blood pressure is any measurement taken which is either 140/90mmHg or higher whereas a lower blood pressure includes readings of 90/60mmhG and below.

Why is an Accurate Blood Pressure so Important?

Blood pressure is a measurement that records the pressure that circulating blood places on the surrounding blood vessels, with the majority of the pressure caused due to the heart contracting, causing blood to pump throughout the circulatory system. 

Blood pressure readings are a common measurement used to monitor not only your general health but also helps to diagnose a range of other diseases or illnesses where change of blood pressure may be a symptom. 

Examples of this include obesity and high stress levels which can cause elevated blood pressure levels and pregnancy and dehydration which are often correlated with low blood pressure levels. 

Why Do Men Have Higher Blood Pressure Than Women?

Due to the physiological differences between men and women as well as men often being larger in size the average blood pressure for men and women is different. 

Blood pressure can not only differ by gender, however, as the ideal blood pressure for an individual also depends on age, as infants and younger children tend to have lower blood pressures, aside from those afflicted with certain medical conditions.

Dr. Ting says,

Blood Pressure differences by ethnicity is an important marker as well, with individuals of African, African Caribbean and South Asians being at an increased risk of developing high blood pressure when compared to other ethnicities. 

What Causes Hypertension (or High Blood Pressure)?

High blood pressure which can also be known as hypertension can occur for a wide variety of reasons. Some individuals are genetically predisposed to having higher blood pressure levels, depending on what ethnicity you are as mentioned above and whether or not any of your immediate family also suffered from high blood pressure, due to genetic mutations which may be inherited from your parents or certain genes which run in your family. 

Most causes of hypertension are actually unknown. This is known as Essential or Primary Hypertension. This is often diagnosed after ruling out secondary causes in a patient, either through meticulous history-taking, diagnostic procedures and/or medication review

AGE

Physical bodily changes can also cause your blood pressure to increase. Blood pressure tends to be higher for older adults and systolic blood pressure tends to increase as you get older, while diastolic pressure tends to fall. Additionally, arteries tend to become narrower with advancing age and pressure receptors known as baroreceptors which are located within the heart tend to become less sensitive with age. All these factors contribute to the increased risk of developing hypertension in older people. 

HABITS

Recreational habits such as smoking, and drinking can also result in hypertension. Smoking has been found to elevate both heart rate as well as blood pressure while you smoke. This is due to the addictive compound nicotine, which is one of the major components in cigarettes, alongside tobacco and tar. 

Smoking triggers activates your sympathetic system which is responsible for your flight or fight response and the chemicals associated with this change cause an increase in blood pressure therefore habitual smoking over time can cause a higher risk of developing hypertension by speeding up the rate of arterial damage and aging regardless of whether you are a younger or an older smoker and it can also increase your chances of developing atherosclerosis.

Alcohol, which is another highly popular recreational habit, has also been associated with increased blood pressure. While the mechanism behind how alcohol leads to hypertension is not entirely understood it is thought to be caused by the impact alcohol has on the nervous system, the impairing effects alcohol has on baroreceptors and how alcohol triggers the sympathetic system. 

Drinking too much alcohol can cause your blood pressure to rise to unhealthy levels however significant damage may be incurred if this behaviour is sustained over a period of time. Additionally, certain alcohols can also cause you to gain weight or potentially have unwanted side effects with any medication you may be taking at the time, which can lead to elevated blood pressure. 

In the short term, high blood pressure can be extremely damaging to your circulatory system. Damage to your arteries from high blood pressure can cause the structure of your arteries, which are typically elastic and strong to allow blood to pass easily through them, to become narrowed. 

This is due to the inner lining of the arterial walls becoming damaged and as a result less elastic and flexible. Saturated fats can also collect within your arteries and form hardened plaques. In the long term, the high blood pressure which passes through your affected arteries may suffer from an aneurysm which can potentially rupture and result in internal bleeding which is life-threatening depending on the location where the aneurysm forms. 

How Can I Accurately Measure My Blood Pressure at Home? 

The best method is to use a sphygmomanometer and stethoscope that your primary care doctor would use in their clinic. These tools are the gold standard in accurately measuring your blood pressure, however it requires trained healthcare professionals to calibrate, maintain their functioning and accurately determine the differences in the sounds heard on the stethoscope as external pressure is gradually decreased on the arm cuff.

In order to keep track of your blood pressure without having to go to the hospital, you can invest in a home blood pressure monitor. To get the most accurate readings it is important to measure blood pressure in the morning as well as in the evening every single day. Take readings three times during each time period in order to check that the results are consistent and that any inconsistent results can be discarded. 

Microlife is a highly renowned medical diagnostic device company that developed their patented home blood pressure monitors. Omron blood pressure monitors are another suitable alternative.

How Can I Naturally Control My Blood Pressure?

One way to take control of your blood pressure naturally is by striving to maintain a healthy diet as well as taking part in regular exercise. Food groups that you should focus on include fruits, vegetables, lean protein such as white fish and salmon, whole grains, and consuming healthy fats such as avocado. 

You should try to avoid consuming too much fast food, processed foods and food items which are high in saturated fats which can lead to further complications. 

Beetroot juice has also been found to reduce blood pressure significantly due to the positive effects the nitrate concentration of beetroot juice exerts on blood pressure. 

When Should I Visit My Doctor About High Blood Pressure?

While you should get your blood pressure checked yearly, it is important to see a doctor about your blood pressure if you experience symptoms such as headaches, dizziness, sleep issues, sweating and nosebleeds so they can investigate the matter further. 

You should only take medications for high blood pressure after being approved by your doctor as the medication must be only taken as instructed and may have potential interactions between other medications you are taking and certain hobbies such as running and weightlifting.

What are the Common Blood Pressure Medications & Their Side Effects?

Common medications for high blood pressure include ACE inhibitors, beta-blockers such as propranolol, diuretics, and angiotensin-receptor blockers. 

Side effects of these medications may include sexual dysfunction, nausea, pounding heartbeat, feeling faint and reduced appetite. Never stop taking your medication without consulting your doctor as it can be highly dangerous.

Why Can’t I Control My High Blood Pressure?

Managing your health, or of family members with chronic illness requires a great deal of patience and perseverance. It is unlikely for even the most dedicated fitness enthusiast to lower their high blood pressure (and keep it stable) within just a few weeks. The causes of high blood pressure are multifactorial (related to genetics, environment, health choices and others) and so you must consider what are the factors you as an individual can control.

Non-modifiable factors that may contribute to high blood pressure:

Male sex

Aging

Genetics

Family history

Environmental stress/pollution

Effective control of high blood pressure depends on these modifiable factors:

Controlling stress

Improving eating habits

Decreasing alcohol intake

Smoking cessation

Frequent physical activity

Medication compliance

Diagnosing secondary causes of high blood pressure (eg. hormone/metabolic imbalances)

When Should You Consult a Medical Specialist About Your High Blood Pressure?

Most cases of high blood pressure can be managed with the combined efforts of a dedicated primary care physician of a general practitioner and a team of allied healthcare professionals such as a dietician, physical therapist, mental health therapist and even purchasing remote patient monitoring devices – such as wearable heart rate monitors, blood glucose monitors and home blood pressure monitors depending on the doctor’s advice (and medical insurance coverage).   

However there are common instances where patients have gone by decades without effective control of their high blood pressure. Obviously such cases pose an elevated risk of multiple organ damage and lowered life expectancy. Hypertension patients are at a very high risk of chronic kidney disease, retinal damage leading to blindness, strokes and heart attacks.

It is highly advised to seek tertiary level of healthcare consultation to assess all the factors that may be contributing to a suboptimal management of high blood pressure.

This infographic will explain why second opinions are a good idea to properly be diagnosed with chronic diseases, such as hypertension.

The following reasons may make it advisable to seek specialist review:

Long term poor control of high blood pressure

Evidence of organ failure eg. chronic kidney disease

Past History of stroke (or blindness known as a transient ischaemic attack)

Doubts/confusion about the effectiveness or relevance of their blood pressure medications

Extensive side effects of current blood pressure medications – that may require substitution

Comorbidities that may complicate high blood pressure management (eg. poor diabetes management)

Morbid obesity

Pregnancy with high blood pressure

Children with recorded high blood pressure

Any adult younger than < 55yrs with a high blood pressure recording

Strong family history of heart disease

…..and many other reasons may be applicable

Can Telemedicine Help Me Control My High Blood Pressure?

Regular follow up with a qualified healthcare professional is the cornerstone in proper chronic disease management. Virtual specialist consults with Telemedicine are an ideal way to easily consult with the right specialist, to describe your unique health issues, communicate all of your queries and doubts about your care, not just a ‘cookie-cutter’ generic treatment plan for everyone. 

With telemedicine you can select the right physician who is experienced with chronic disease management, especially when you have high blood pressure and other complications. The remote consult is ideal for follow up, prescription refills, medical second opinions and lifestyle counselling to help manage certain factors in your life that may affect your health concerns.

The first visit is best done in-person so that a trained healthcare professional can carry out a full physical examination, blood pressure checks and certain laboratory diagnostic procedures to properly diagnose sustained high blood pressure as a case of primary hypertension.

Follow up visits can be done via telemedicine as it is more convenient for you, from your home or office and gain the necessary feedback or prescription changes. The popularity of remote patient monitoring with medical wearables has a great potential in better assessment of your long term health and compliance.

Specialised telemedicine will be required when your high blood pressure management raises significant concerns as mentioned before (poor control, comorbidities, concerns, side effects, complications etc). In these cases you may require the immediate medical review, or second opinion, from an experienced inter.al medicine specialist.

The Internal Medicine specialist may review your case by a more thorough history taking, review of your primary physician’s management plan, prescriptions and even counsel you on practical steps to take.

How Can a VIOS Provider Help Me Manage My High Blood Pressure?

VIOS is a Global Specialist Telemedicine solution that is specifically designed to help patients like you, or your parents, to easily choose the right specialist for a more personalised review of your health needs.

With quick direct payment options, you can easily select and purchase an appointment with your preferred provider, without prior authorisation, without extensive paperwork and at your preferred time, wherever you are.

Our extensively curated network of healthcare specialists are seasoned experts in their specialised fields. With several years of clinical experience and high grade training to help manage complex issues affecting chronic disease patients.

A secure and encrypted ‘digital-clinic’ provided by the Zoom for Healthcare platform, VIOS Patients have an easier way to communicate with their specialist, share health records privately and talk for as long as needed.

This simple infographic will show you how quickly and easily you can use the VIOS platform to book a specialist appointment.