What is the limit for high blood pressure? See how to identify | health

High pressureor hypertensionis the sustained elevation of blood pressure to levels above 140×90 mmHg, known as “14 by 9”. According to the World Health Organization (WHO), 50.7 million Brazilians aged 30 to 79 have the disease, which is normally silent and can cause cardiovascular disease and kidney failure, but can be controlled.

Generally measured in millimeters of mercury (mmHg), blood pressure has two readings: systolic blood pressure (the pressure in the arteries when the heart is beating) and the diastolic blood pressure (the pressure in the arteries when the heart is at rest between beats).

There are also measurements by levels: the higher the values, the greater the severity. They can be classified as grades 1, 2 and 3.

According to cardiologist Fernando Lamego, medical guidelines usually classify blood pressure as follows:

• Normal: up to 120×80 mmHg
• Prehypertension: 120-139×80-89 mmHg
• Stage 1 hypertension: 140-159×90-99 mmHg
• Stage 2 hypertension: 160×100 mmHg
• Stage 3 hypertension: greater than 160×100 mmHg

– These categories are just general guidelines, and blood pressure assessment should be carried out by a healthcare professional. Diagnosis and treatment of hypertension may vary depending on other risk factors and individual medical conditions. If you are concerned about your blood pressure, it is recommended that you seek medical advice for a more accurate and appropriate assessment in your case. – warns the cardiologist.

• Systolic blood pressure: refers to the pressure in the arteries when the heart is beating, that is, during the contraction of the heart muscle. This number is the highest value and represents the force of the blood against the artery walls at the time the heart is pumping blood to the rest of the body.
• Diastolic blood pressure: refers to the pressure in the arteries when the heart is at rest between beats, that is, during the period of relaxation of the heart muscle. This number is the lowest value and represents the residual pressure in the arteries when the heart is not pumping blood.

In the example 120×80 mmHg, which is considered normal blood pressure, 120 is the blood pressure when the heart is beating and 80 is the blood pressure when the heart is at rest between beats. The “12 by 8” is a simplification.

Blood pressure can vary throughout the day and depending on the activities carried out and the emotions felt. Having high blood pressure at one time of the day does not mean that the individual has chronic high blood pressure.

According to the SBC, it is normal for blood pressure to be slightly higher during the day than at night. The limit should not exceed 135×85 mmHg during the day and 120×80 at night.

– It is logical that, with this, we have to take an average and check how much this pressure is above this average. And when I calculate the 24-hour average, I use the value of 130 by 80 as a reference – explains cardiologist Camillo Junqueira.

There are situations that can temporarily raise blood pressure:

• Physical activity: during physical exercise, blood pressure tends to increase to provide more oxygen and nutrients to the muscles;
• Stress and anxiety: Stressful or emotionally difficult situations can cause an increase in blood pressure due to the release of stress hormones such as adrenaline;
• Caffeine or nicotine consumption: consumption of caffeine (present in coffee, teas, soft drinks and other products) and nicotine (present in cigarettes and tobacco products) can increase blood pressure;
• Heavy meals: after a meal rich in fats and carbohydrates, blood pressure may increase due to the increase in blood flow necessary to digest food;
• Medicines: Certain medications, such as decongestants, weight loss medications, steroids, and antidepressants, can cause elevations in blood pressure as a side effect.

As there are possibilities for variations, It’s important to monitor your blood pressure regularly and pay attention to any consistent patterns of high blood pressure. There is a test called Ambulatory Blood Pressure Monitoring (ABPM) that measures blood pressure over a 24-hour period, which helps with diagnosis.

– The severity and frequency of high blood pressure spikes can vary from person to person, and it is important to monitor these variations to ensure that there are no concerns about cardiovascular health – ponders Fernando.

Although the painting is normally silent, Pay attention to possible signs of high blood pressure: headache (especially in the neck region), dizziness, ringing in the ears, weakness and blurred vision.

The diagnosis of high blood pressure is carried out by measuring blood pressure with a device called a sphygmomanometer, the use of which is normally accompanied by a stethoscope.

Tests to detect high blood pressure include:

• Blood pressure measurement: The healthcare professional wears an inflatable cuff around the arm, which is inflated and then deflated while listening to the heartbeat with a stethoscope. The results are expressed as two numbers, for example, 120×80 mmHg, representing systolic and diastolic blood pressure.
• Ambulatory Blood Pressure Monitoring (ABPM): is a method in which the patient wears a portable device that measures blood pressure regularly for 24 hours. This can provide a more comprehensive view of the blood pressure pattern throughout the day and night;
• Home Blood Pressure Monitoring (MRPA): Patients can be instructed to measure their own blood pressure at home using a blood pressure monitor. This may be useful for assessing blood pressure in a more natural setting and providing additional information about blood pressure control;
• Laboratory tests: In some cases, blood tests may be ordered to evaluate possible risk factors, such as cholesterol and glucose levels and kidney function.

For the diagnosis of hypertension, reference values ​​generally follow medical guidelines. However, diagnosis and treatment must be personalized, taking into account individual issues, medical history and other risk factors.

– Hypertension often does not present obvious symptoms, which is why regular blood pressure measurement is crucial, especially in people with risk factors, such as a family history of hypertension, advanced age, obesity, among others – points out Fernando.

Eating well and controlling your weight help reduce blood pressure

The map is the exam that helps in diagnosing chronic hypertension. It will show whether the patient is suffering pressure spikes or whether hypertension is sustained, that is, whether it occurs throughout the day.

– The ABPM test is often used to evaluate blood pressure in patients with suspected white coat hypertension (when blood pressure is higher in the doctor’s office than in other situations) or to monitor the effect of antihypertensive treatment at over time. Performing ABPM is important for several reasons, and it is especially useful for understanding blood pressure patterns throughout the day and distinguishing between real hypertension and situations in which blood pressure may be temporarily high – explains Fernando.

According to Camillo, MAPA is the only test that can compare blood pressure during the day and night and analyze the drop in blood pressure at night.

There are two types of devices that are used to measure blood pressure, arm and wrist devices.. They can be purchased and used at home for home monitoring – which does not exclude the need for medical supervision.

• Benefits: are considered more accurate than wrist ones. They may be easier to use for some people, especially older people;
• Considerations: Correct arm and cuff position is crucial to ensuring accurate readings. It is more sensitive to body movements during measurement.

• Benefits: they are portable, compact and generally more comfortable to use. They can be a convenient option for regular monitoring;
• Considerations: The wrist position must be accurate, and the arm must be at heart level to obtain the most reliable readings. They may be sensitive to movement and awkward positioning.

• Be sure to choose a clinically validated device. Validation indicates that the device has passed rigorous accuracy tests;
• Choose the cuff that suits your arm size. Inadequate cuffs can result in inaccurate readings;
• Follow the manufacturer’s instructions and guidance from healthcare professionals to ensure accurate readings.

• Regardless of the type of device chosen, consistency in measurements is essential for monitoring blood pressure over time. Always measuring at the same time of day, under the same conditions, gives a more accurate view of changes in blood pressure;
• The accuracy of blood pressure measurement using automatic devices is generally considered appropriate, except in cases of atrial fibrillation (type of arrhythmia), in which measurement performed using aneroid devices (manual) is more indicated.

Fernando Lamego is an orthomolecular cardiologist at Instituto Nutrindo Idealis (@nutrindoideais)/Niterói.

Camillo Junqueira has a master’s degree and doctorate in Medicine and professor of Cardiology at Unigranrio University | Afya.