The contents of this page have been produced by a team of physicians and experts of the Italian Institute of Telemedicine in compliance with the recommendations of the latest medical and scientific guidelines. Institutional communication not subject to authorisation pursuant to the Ministerial Decree 23/02/2006.
What is blood pressure?
We often hear about it, but what is the definition of blood pressure? From a physical point of view it is simply the force exerted by the blood pumped by the heart against the arterial walls.
When we measure the blood pressure we can detect two types of values: the pressure is called “maximum” or systolic, during the heart contraction phase and “minimum” or diastolic, when the heart relaxes between a contraction and the next one.
In some cases the blood pressure can increase and reach too high values, which remain over time. This condition, called hypertension, takes place when the maximum pressure is over 140 mmHg (millimetres of mercury, blood pressure measure unit) or the minimum one is over 90 mmHg. A condition which if lasting over time can lead to the development of more or less serious cardiovascular disease.
Hypertension in figures
Hypertension affects approximately 40% of adult people (15 million Italians and one billion and a half of people in the world) and only one out of four of them monitors and treats this condition. This is not always due only to the lack of interest towards one’s own health; as a matter of fact, hypertension in most cases gives no problems, just rarely some headache, dizziness or buzzing in the ears, and often the symptoms appear only many years later, when hypertension has already caused vascular, cardiac, cerebral and renal damages and, as a consequence, the arising of serious cardiovascular complications. Actually hypertension is the main cause of cardiovascular diseases and of death in the world (280 thousand deaths a year in Italy and 8,5 million in the world).
Below you’ll find a list of the most common diseases caused by hypertension
- Heart failure
- Myocardial infarction
- Atrial fibrillation
- Renal insufficiency
- Aneurism or aortic rupture
- Lower limbs arterial occlusion
- Vascular cognitive deficiency and dementia
The risk factors of hypertension
For most patients the cause for the increase of the pressure values is unknown, so we speak of “essential” hypertension, although there are some known risk factors which increase the likelihood to develop hypertension:
- Old age
- Family relationship (one or both parents hypertensive)
- Overweight and obesity
- Sedentary lifestyle
- Use of medications or of substances which can let the pressure increase (ex. contraceptive pill, anti-inflammatory drugs, cortisone, nasal spray decongestants, amphetamines, cocaine)
How to diagnose hypertension
Only a regular blood pressure measurement allows an early detection of hypertension and to check the effectiveness of the therapy for the prevention of the cardiovascular complications. Hypertension should not be underestimated: it is often symptom-free and therefore the blood pressure measurement is really important.
The measurement of pressure can be performed at the physician’s, but also at home with the home self-measurement or also at the pharmacy. For a more accurate assessment of hypertension the physician can also require a 24-hour ambulatory blood pressure recording, which shall assess the pressure behaviour during everyday life including the night sleep.
Blood pressure measured by the physician or at the pharmacy is usually naturally higher than the one measured at home or over 24 hours.
Hypertension pressure values
- Blood pressure measured at the medical practice or at the pharmacy (average value of 2-3 measurements): ≥140/90 mmHg
- Blood pressure measured at home (average value over a week): ≥135/85 mmHg
- Blood pressure measured over 24 hours (average value): ≥130/80 mmHg
Here below you’ll find a list of easy rules to follow to correctly measure the blood pressure:
- Always use a good quality and clinically validated electronic measurement device, preferably measuring at the upper arm
- Perform two measurements two minutes after each other in the seated position and after 5 minutes rest
- The measurement must be performed, if possible, away from food and before taking medicines
- Avoid coffee, cigarettes, alcohol and exercise within the thirty minutes before the measurement
- If the measurement is performed at home, it’s a good practice to perform two measurements in the morning upon waking up and two in the evening before dinner. All this must last at least one week before the control at your doctor’s surgery
- Apply the upper-arm cuff on the arm with the highest pressure or generally on the non-dominant arm
- Always use an upper-arm cuff of a size suitable for your own arm
- Always hold the upper-arm cuff at the same height as your heart during the measurement, laying it on the table, remaining motionless and silent, with your back against the backrest of the chair and without keeping your legs crossed
- We recommend, during the measurement, to check the possible arising of any arrhythmia, and namely of the atrial fibrillation, risk factor of the stroke.
How to treat hypertension
The treatment of the hypertension focuses first of all on a correct lifestyle, which is unfortunately not always sufficient. In this case it is necessary to consult the physician, who shall advise a treatment to be regularly followed. It’s important to always and carefully follow the instructions of your physician, avoiding any do-it-yourself treatment.
A healthy lifestyle: an important help to prevent and to treat hypertension
The rules to maintain healthy lifestyles are just a few and easy. Over time these rules can make the difference and give significant results. Here they are:
- Minimize the stress
- Make regularly aerobic exercise, (fast walking or bicycle at least 30 minutes a day or 3 / 4 times a week at least)
- Keep your body weight and waist circumference within their limits, paying attention to the overweight (for every extra kg in weight there is a pressure increase equal to 1 millimetre of mercury)
- Eat fish and vegetables
- Avoid food rich in animal fats (saturated) and cholesterol
- Limit the consumption of salt no more than 5 g per day (one spoon a day) reducing both the one you add to the food and the one of the food itself, such as for sausages, cheese, canned food, cubes, dried foods
- Limit the consumption of alcohol, no more than 1-2 glasses of wine per day, as it can raise your pressure or can anyway make difficult its monitoring
- In any case avoid spirits
- Limit the consumption of coffee, no more than 2-3 cups a day and preferably decaffeinated coffee
- Do not smoke.
In case the physician should advise a therapy based on anti-hypertensive drugs, it should be continued without limitation. It can be suspended only in very rare cases and always based on the judgement of the physician. The medications must be taken every day at the same time: they operate by reducing the blood pressure, with various mechanisms, and so contain the risk of cardiovascular complications.
All patients receiving treatment shall undergo a medical check and a blood testing at least once a year.