Tag Archives: high blood pressure

What’s the ideal blood pressure by age

Credit: Pixabay.

Ideally, we should all strive to have a blood pressure below 120/80mmHg. However, most people have blood pressure readings in the range of 120/80mmHg or 140/90mmHg.

What is blood pressure anyway?

Pressure is simply the amount of physical force exerted on an object. In this case, blood pressure refers to the force exerted by blood pushing against the walls of blood vessels.

When blood pressure is too high, a person’s arteries are subjected to a continuous strain that, in time, can lead to life-threatening cardiovascular disease.

What do the readings of blood pressure mean?

Blood pressure is measured in ‘millimeters of mercury’ (mmHg) and is read for two values. For instance, the optimal blood pressure is 120 over 80 or 120/80mmHg.

The first value represents the systolic blood pressure, which is the highest pressure that the blood reaches when the heartbeats.

The second value is the diastolic blood pressure, which corresponds to the lowest level of blood pressure that occurs when the heart’s muscles relax between beats.

Measuring your blood pressure with a blood pressure monitor is important because having a high reading (hypertension) is not something you can notice or feel.

However, if blood pressure is measured just once and found to be high, it doesn’t necessarily mean that it’s always too high. In order to get a reliable reading, blood pressure has to be measured on several different days while you are resting.

Signs and symptoms of high blood pressure

Usually, people cannot tell they have high blood pressure unless they have it measured. Anything above 140/90 is considered high blood pressure. However, occasionally people with high blood pressure report frequent headaches.

It’s important to note that your blood pressure will vary significantly and a single high blood pressure reading isn’t necessarily a cause for concern. If the reading is above this threshold after weeks of constant measurement, then you can safely presume that you may indeed suffer from hypertension.

Why blood pressure is so important to health

Although a blood pressure of 140 over 90 is considered normal, everyone should strive to lower it even further in order to stave off heart disease and strokes.

For instance, someone with a blood pressure reading of 135/85 is twice as likely to have a heart attack or stroke as someone with a reading of 115/75

An optimal blood pressure is paramount to the structural integrity of your arteries. Imagine a copper pipe in a water supply system — after many years, it will corrode and form micro-wears from all the friction between the water flow and the pipe’s walls. Eventually, it will break, but its operating life can be extended if the water pressure doesn’t cross a critical threshold.

While this analogy isn’t perfect (arteries don’t corrode and some damage can be healed), your arteries will naturally weaken with age after countless liters of blood flowing through them.

High blood pressure increases the risk of having a heart attack, which can cause heart failure. However, poor health outcomes extend beyond the cardiovascular system.

Why your blood pressure is too high

There are a number of reasons why a person may suffer from hypertension.

As we age, blood pressure typically increases due to the wear and tear accumulated by blood vessels over the years. There are also genetic factors that may influence blood pressure. For instance, African-Caribbean and South Asia communities tend to be at a higher risk of high blood pressure. High blood pressure can also run in the family.

All other things being equal, high blood pressure is typically the result of lifestyle choices, particularly diet. Too much salt, not enough fruits and vegetables, and drinking too much alcohol can increase blood pressure. Being overweight and not exercising can also substantially increase the risk of hypertension.

Blood pressure chart

If you made it this far then you now know how to correctly read your blood pressure but perhaps you’re not entirely sure how to interpret the measurement. The chart below is a good place to start, as it shows the ranges of high, low, and normal blood pressure readings.

You may have noticed that only one of the two values needs to be higher or lower to count as either high blood pressure or low blood pressure. For instance, if your top number (systolic blood pressure) is higher than 140, then you have high blood pressure regardless of your bottom value (diastolic blood pressure). Likewise, if your bottom number is higher than 90, then you have high blood pressure regardless of the top number’s reading.

What constitutes high blood pressure by age?

It’s normal for your blood pressure to increase as you age. The table below should give you a rough estimate of what healthy levels should look like.

1 – 280/34 – 120/7583/38 – 117/76
Ideal blood pressure by age.

Can your blood pressure ever be too low?

Low blood pressure, also known as hypotension, is generally anything below 90/60 mmHg. If any of the two values is lower than 90 or 60 for systolic and distolic blood pressure, respectively, this counts as having low blood pressure.

Generally, this is a good thing, because it means that the risk of a stroke or heart disease is minimal. Most people with hypotension do not require treatment.

There may be instances when a person’s blood pressure is low temporarily due to medication. And, sometimes, people can have low blood pressure naturally but this is no reason for concern in and of itself — although, in some instances, low blood pressure has been associated with depression.

However, if a patient feels dizzy or like fainting and blood pressure is low, a doctor’s appointment is warranted.

How to lower your blood pressure

You might be worried by your high blood pressure, but the good news is that it can be lowered to optimal levels with some proper foresight.

Although medication may be prescribed by a doctor in order to lower blood pressure, the safest course of action is to make long lasting lifestyle changes.

Diet is extremely important in this context. First and foremost, patients suffering from hypertension should be mindful of their salt intake. In fact, you may want to cut it out entirely out of your diet. Just remember that most of the salt you eat is actually found in products that are already prepared, such as breakfast cereals, ready-made meals, and bread. Be sure to check the nutritional facts label on the products you select from the supermarket.

Eating more fruits and vegetables can also help to lower blood pressure. A healthy amount is five portions of fruit and vegetables per day, where a portion weighs roughly 80 grams. Watch out for added salts when buying frozen or tinned fruits and vegetables from your local supermarket.

A healthy diet will also help you to mitigate another important risk factor for hypertension: being overweight. Exercising and a low-calorie diet can help you reduce your weight to more healthy levels — your blood pressure drops along with those extra pounds. Additionally, doing cardio also keeps the heart healthy.

Finally, be mindful of your alcohol intake. Both men and women should limit their alcohol consumption to 14 units per week, where a unit is equivalent to a small glass of wine or half a pint of beer.

High blood pressure medication is safe for COVID-19 patients

Credit: Wikimedia Commons.

Since there are many unknowns about the novel coronavirus and how it affects the human body, cardiologists have voiced important concerns surrounding high blood pressure medication. Their calls for urgent research have been met by scientists at the New York University (NYU) Grossman School of Medicine, who thankfully found that high blood pressure medication doesn’t seem to increase the risk of infection or of developing severe forms of COVID-19.

High blood pressure medication is surprisingly safe

The researchers led by Harmony Reynolds, Associate Director at the Cardiovascular Clinical Research Center at NYU, studied the medical history of 12,594 COVID-19 positive patients. Specifically, the researchers analyzed COVID-19 outcomes for those taking medication for high blood pressure.

There was no link between treatment with four common drug classes for high blood pressure — angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta blockers, or calcium channel blockers  — and the likelihood of becoming infected with the coronavirus.

What’s more, there was no additional risk of developing more severe forms of COVID-19 that might require hospitalization in an intensive care unit or the use of mechanical ventilators. The findings appeared in the New England Journal of Medicine.

“With nearly half of American adults having high blood pressure, and heart disease patients more vulnerable to COVID-19, understanding the relationship between these commonly used medications and COVID-19 was a critical public health concern,” said Reynold.

“Our findings should reassure the medical community and patients about the continued use of these commonly prescribed medications, which prevent potentially severe heart events in their own right.”

The drugs included in the study regulate blood pressure by acting upon the renin-angiotensin-aldosterone hormonal system. One important component of this system is angiotensin II, a signaling protein that narrows blood vessels, thereby increasing blood pressure.

Levels of angiotensin II are controlled by the angiotensin-converting enzyme (ACE), which is also the target of many drugs for hypertension.

One version of ACE, ACE2, is abundantly present in the outer membrane of lung cells. The general consensus is that the novel coronavirus attaches itself to ACE2 receptors in lung cells using its ‘spike’ protein.

The use of ACE inhibitors boosts the expression and abundance of ACE2 receptors, and thus potentially increases the number of portals for SARS-CoV-2 to enter cells throughout the body.

This is why many cardiologists were concerned about the impact that medication designed to inhibit ACE might have on the prognosis of COVID-19 patients.

Fortunately, this doesn’t seem to be the case. In fact, ACE inhibitors might actually reduce lung injury.

Earlier last week, researchers at the University of California San Diego School of Medicine launched a clinical trial to investigate whether a drug approved for treating high blood pressure, heart failure, and diabetic kidney disease might also reduce the severity of COVID-19 infections. The trial will include participants from various sites across the United States, including New York, New Jersey, California, Massachusetts, Washington, Texas, and Illinois.

Got a heart condition? High blood pressure? Beware of the flu

Influenza vaccination in patients with high blood pressure is associated with an 18% reduced risk of death during flu season, according to research presented today at European Society of Cardiology (ESC) Congress 2019 together with the World Congress of Cardiology.

“Given these results, it is my belief that all patients with high blood pressure should have an annual flu vaccination,” said Daniel Modin research associate at the University of Copenhagen, Denmark. “Vaccination is safe, cheap, readily available, and decreases influenza infection. On top of that, our study suggests that it could also protect against fatal heart attacks and strokes, and deaths from other causes.”

The study used Danish nationwide healthcare registers to identify 608,452 patients aged 18 to 100 years with hypertension during nine consecutive influenza seasons (2007 to 2016).

The researchers determined how many patients had received a flu vaccine prior to each season. They then followed patients over each season and tracked how many died.

They recorded death from all causes, death from any cardiovascular cause, and death from heart attack or stroke. Finally, they analyzed the association between receiving a vaccine prior to flu season and the risk of death during flu season. 

After adjusting for patient differences, in a given influenza season, vaccination was associated with an 18% relative reduction in the risk of dying from all causes, a 16% relative reduction in the risk of dying from any cardiovascular cause, and a 10% relative reduction in the risk of dying from heart attack or stroke.

He said: “Heart attacks and strokes are caused by the rupture of atherosclerotic plaques in the arteries leading to the heart or the brain. After a rupture, a blood clot forms and cuts off the blood supply. It is thought that the high levels of acute inflammation induced by influenza infection reduce the stability of plaques and make them more likely to rupture.”

In a study published earlier this year in Open Forum Infectious Diseases, investigators from Warren Alpert Medical School of Brown University, NYU School of Medicine, University of Groningen, and University of Toronto combed through published data on all-cause mortality rates among heart failure patients who received the influenza vaccine and found that flu vaccination was associated with a 31% decreased risk of all-cause mortality in those patients.

The effect was more prominent (51% lower risk) during influenza season. The authors drew from eight studies published since 2000, which included a total of 82,354 patients (average age of 65) with heart failure. They found that patients who had received seasonal flu vaccine had a reduced risk of all-cause mortality (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.51 to 0.87), especially during flu season (HR, 0.49; 95% CI, 0.30 to 0.69).

A study in Denmark published in Circulation in December 2018 looked at a cohort of 134,048 patients who were aged 18 years or older and diagnosed with heart failure in the period of January 1, 2003, to June 1, 2015.

The research team, composed of investigators from the University of Copenhagen and Harvard Medical School, found that frequent vaccination and vaccination earlier in the year (before the flu season in Denmark – September to October) were associated with larger reductions in the risk of death compared with intermittent and late vaccination.

Why do people with heart disease need the flu vaccine?

Influenza infection has been associated with an increased risk of heart attacks and worsening of chronic cardiovascular conditions.

Previous research has found that people with heart disease are at least six times more likely to have a heart attack after coming down with the flu. Because of the close relationship between heart failure and respiratory illness, with over half of heart failure complications thought to be triggered by respiratory infection, the role of influenza vaccination, which is widely available at low cost, has been described as a potential disease-modifying intervention.

In addition to the inflammatory effects of influenza infection, which have been linked to increases in atherogenesis, the production of pro-inflammatory cytokines during acute infection may directly depress myocardial contractility. Because of these recent evidences, the authors recommend seasonal flu vaccines for eligible heart failure patients.

Being healthy and obese is impossible – the two are mutually exclusive, researchers say

It’s surprising to me that this has to be said, but … oh well. If you are obese, you’re unhealthy. Even if you have normal blood pressure, cholesterol and blood-sugar, you’re still unhealthy. A study, published in the Annals of Internal Medicine, concluded that so-called “healthy obesity” was a myth.

“Healthy obesity” or “benign obesity” is a relatively new term, which has been used to describe a subset of individuals who are defined as obese based on their Body Mass Index (BMI), but don’t have any other metabolic abnormalities commonly associated with obesity (increased blood pressure, high cholesterol, etc). The BMI is the standard way to measure if someone is obese or not. People with a BMI of 30-40 are considered to be obese. But since obesity has only become a global problem in the past few decades, the long term effects are not as well documented as with other conditions.

Researchers wanted to check the validity behind the ideas of “benign obesity”; in order to do this, they conducted meta-analysis on more than 60,000 people across three weight categories – normal, overweight and obese – in eight studies carried out over the last decade. Meta analysis is a statistical method which focuses on contrasting and combining results from different studies, in the hope of identifying patterns among study results.

Their results showed that while metabolically healthy obese people showed a similar risk of problems compared to those with normal weight in the short term, when they analyzes studies that had ten years of follow up, things were significantly different. Study participants in all weight categories with unhealthy metabolisms showed an increased risk of mortality and cardiovascular problems.

“The main finding is that metabolically healthy obese individuals are indeed at increased risk for death and cardiovascular events over the long term as compared with metabolically healthy normal-weight individuals,” Retnakaran said. “These data suggest that increased body weight is not a benign condition even in the absence of metabolic abnormalities.”.

It’s still not clear exactly why some people have an apparently normal metabolism. Out of the over 60.000 people considered in the study, 8.9% had metabolically healthy obesity while 6% had metabolically unhealthy normal weight. The one thing that appears certain is that estimating someone’s status based on BMI alone is not enough.

“It is important to consider both BMI and metabolic status for estimating long-term risks of these outcomes,” Retnakaran said.

Journal Reference:
Caroline K. Kramer, MD, PhD; Bernard Zinman, CM, MD; and Ravi Retnakaran, MD. Are Metabolically Healthy Overweight and Obesity Benign Conditions?: A Systematic Review and Meta-analysis. Ann Intern Med. 2013;159(11):758-769. doi:10.7326/0003-4819-159-11-201312030-00008

1 in 5 young adults suffering from high blood pressure in the US

Researchers at the University of North Carolina-Chapel Hill have found that more and more young adults are suffering from a condition that has traditionally been the problem of older adults – high blood pressure.

The researchers believe that general problems, such as an unbalanced diet, coffee, and obesity are the main causes for this surge in heart related issues amongst this category of people. Published in this week’s edition of the online journal Epidemiology, the study states that they tested over 14.000 people between the ages of 24 and 32, and found that almost twenty percent were suffering from high blood pressure, a number five times bigger than the generally accepted one.

The thing is, high blood pressure is extremely easy to overlook, especially if you don’t expect it – like anyone in their 20s. Kathleen Mullan Harris, co-author of the paper and interim director at the University of North Carolina Carolina Population Center believes that the findings are results of a dormant epidemic.

“We tend to think of young adults are rather healthy, but a prevalence of 19 percent with high blood pressure is alarming, especially since more than half did not know that they had high blood pressure,” she said.

It is yet another sign of the huge problems obesity brings with itself, especially teamed up with a sedentary and unhealthy lifestyle.