Understanding Blood Pressure: What Your Readings Really Mean and How to Manage Them

Blood pressure is one of the most important health measurements your doctor checks, yet many people don't really understand what those numbers mean. We are writing this blog post to help you understand your readings and take control of your health. 

Nearly 1 in 3 UK adults has high blood pressure, but many don't know it because there are often no obvious symptoms. That's why it's called the "silent killer." Let's break down what you need to know about blood pressure and how to manage it effectively. 

Understanding Your Blood Pressure Numbers 

When your doctor takes your blood pressure, you'll hear two numbers, like "120 over 80" (written as 120/80 mmHg). Here's what they mean: 

The Top Number (Systolic) 

This measures the pressure in your arteries when your heart beats. 

• Below 120: Optimal 

• 120-129: Elevated 

• 130-139: Stage 1 hypertension 

• 140 or higher: Stage 2 hypertension 

• 180 or higher: Hypertensive crisis (medical emergency) 

  
  

The Bottom Number (Diastolic) 

This measures the pressure when your heart is resting between beats. 

• Below 80: Optimal 

• 80-89: Stage 1 hypertension 

• 90 or higher: Stage 2 hypertension 

• 120 or higher: Hypertensive crisis (medical emergency) 

  
  

Why High Blood Pressure Is Dangerous 

Many of my patients ask why they should worry about high blood pressure when they feel fine. The answer is that over time, high blood pressure damages your blood vessels and organs, often without any symptoms until serious problems develop. 

High blood pressure significantly increases your risk of: 

• Heart attack and heart failure 

• Stroke 

• Kidney damage 

• Vision problems 

• Cognitive decline and dementia 

For every 20 mmHg increase in systolic blood pressure, your risk of heart disease and stroke doubles. 

How to Check Your Blood Pressure at Home 

Home monitoring helps you track your blood pressure between doctor visits. Here's how to get accurate readings: 

Before Measuring 

• Avoid caffeine, exercise, and smoking for 30 minutes 

• Empty your bladder 

• Sit quietly for 5 minutes with your back supported and feet flat on the floor 

• Rest your arm on a table at heart level 

• Put the cuff on bare skin, not over clothing 

When to Measure 

• Take readings at the same times each day (usually morning and evening) 

• Take 2-3 readings one minute apart and record the average 

• If you take blood pressure medication, measure before your morning dose 

Choosing a Monitor 

Look for devices that are clinically validated and have the correct cuff size for your arm. We recommend Omron or Bosch. 

6 Effective Ways to Lower Your Blood Pressure 

1. Follow the DASH Diet 

The DASH (Dietary Approaches to Stop Hypertension) diet has been proven to lower blood pressure as effectively as some medications. 

Key points: 

• Eat more fruits, vegetables, whole grains, and low-fat dairy 

• Reduce salt, saturated fat, and sugar 

• Aim for 4-5 servings each of fruits and vegetables daily 

• Limit sodium to less than 2,300mg per day (ideally 1,500mg) 

Following the DASH diet can lower systolic blood pressure by 8-14 mmHg. 

2. Get Regular Physical Activity 

Regular exercise strengthens your heart and blood vessels. 

Recommendations: 

• Aim for at least 150 minutes of moderate activity weekly (like brisk walking) 

• Include strength training 2-3 times per week 

• Start small if you're currently inactive even 10 minutes daily helps 

Regular exercise can reduce systolic blood pressure by 5-8 mmHg. 

3. Maintain a Healthy Weight 

Even modest weight loss can significantly impact blood pressure. Each kilogramme lost can reduce blood pressure by approximately 1 mmHg. 

Tips: 

• Aim for 5-10% weight reduction initially 

• Focus on reducing waist circumference 

• Combine dietary changes with increased physical activity 

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4. Reduce Salt Intake 

Excess salt causes your body to retain fluid, increasing blood volume and blood pressure. 

Practical steps: 

• Read food labels (look for "low sodium" products) 

• Cook more meals at home 

• Use herbs, spices, and lemon instead of salt for flavour 

• Reduce salt gradually to allow your taste buds to adjust 

Reducing sodium can lower systolic blood pressure by 2-8 mmHg. 

5. Limit Alcohol 

Excessive alcohol is strongly linked to high blood pressure. 

Guidelines: 

• Men and women: Maximum 14 units per week, spread over several days  

• Include several alcohol-free days each week 

Moderating alcohol can reduce systolic blood pressure by 2-4 mmHg. 

6. Manage Stress 

Chronic stress contributes to high blood pressure through hormonal changes. 

Effective techniques: 

• Mindfulness meditation (10-15 minutes daily) 

• Deep breathing exercises 

• Regular physical activity 

• Adequate sleep (7-9 hours nightly) 

Regular stress management can lower systolic blood pressure by 2-10 mmHg. 

Understanding Blood Pressure Medications 

When lifestyle changes aren't enough, medications may be necessary. Here are the main types: 

ACE Inhibitors 

• Examples: Ramipril, Lisinopril 

• Common side effects: Dry cough, dizziness 

• Best for: Patients with diabetes or heart problems 

  
  

ARBs (Angiotensin II Receptor Blockers) 

• Examples: Losartan, Candesartan 

• Common side effects: Dizziness (less likely to cause cough than ACE inhibitors) 

• Best for: Those who can't tolerate ACE inhibitors 

  
  

Calcium Channel Blockers 

• Examples: Amlodipine, Felodipine 

• Common side effects: Ankle swelling, flushing 

• Best for: Older patients, African Caribbean patients 

  
  

Diuretics 

• Examples: Indapamide, Bendroflumethiazide 

• Common side effects: Increased urination, possible electrolyte imbalances 

• Best for: Older patients, African Caribbean patients 

  
  

Important Medication Tips 

• Take medications at the same time each day 

• Never stop taking your medication without talking to your doctor 

• Tell your doctor about any side effects 

• Be aware that some over-the-counter medications can raise blood pressure 

  
  

When to Contact Your Doctor 

Seek medical advice if: 

• Your blood pressure is consistently above 140/90 mmHg 

• You experience side effects from your medications 

• You have severe headaches, vision problems, chest pain, or difficulty breathing along with high readings 

• Your readings vary widely from day to day 

  
  

Taking Control of Your Blood Pressure 

Here are steps you can take today: 

1. Know your numbers through regular blood pressure checks 

2. Start with one or two lifestyle changes you can maintain 

3. Take medications exactly as prescribed if needed 

4. Keep a log of your readings to share with your doctor 

5. Attend regular check-ups with your healthcare team 

Remember that managing blood pressure is a long-term commitment. Small, consistent changes can have a significant impact on your health and reduce your risk of serious complications. 

At Bristol Health Hub we are passionate about empowering patients to take control of their blood pressure through evidence-based lifestyle and medical interventions. 

Frequently Asked Questions 

Can a single high reading indicate hypertension? 

No, a diagnosis requires multiple elevated readings on different days. Blood pressure naturally fluctuates throughout the day. 

Is it normal to have different readings in each arm? 

Small differences (less than 10 mmHg) are normal. Larger differences should be discussed with your doctor. 

Can I stop my medication once my blood pressure is controlled? 

Generally, no. When your medication works well, it means it's doing its job, not that you no longer need it. Always consult your doctor before changing your medication. 

Can I lower my blood pressure without medication? 

For mild hypertension, lifestyle changes may be enough. These include the DASH diet, regular exercise, weight management, reduced salt intake, and stress management. More severe hypertension typically requires medication along with lifestyle changes.