People unaware of healthy blood pressure study Research suggests that most Americans lack knowledge pertaining to what constitutes a healthy blood pressure reading, even though blood pressure measurements are typically part of both routine and urgent health visits.
A study published in Medical Decision Making last month reported that Americans, who felt confident in their knowledge of blood pressure readings, lacked understanding of the normal upper limit for healthy blood pressure levels which is 120/80 mm Hg.
Approximately 52% of adults in the United States are living with hypertension, and just 25% of them have it under control.
But because high blood pressure doesn’t typically cause symptoms (it’s often referred to as the “silent killer”) the only real way to know if you have it is through routine blood pressure measurements—and even then, personal knowledge of normal or healthy blood pressure readings can either benefit or hinder future health outcomes.
Overestimation of Blood Pressure Results Could Cause Postponed Medical Attention.
Bruine de Bruin and her team conducted a survey of over 6,500 U.s. adults to explore their knowledge and confidence in understanding blood pressure readings.
The study included 1,342 individuals with hypertension and no associated conditions, and 795 subjects who had hypertension in combination with other disorders (e.g., cardiovascular or kidney diseases, diabetes); these results were further analyzed after accounting for factors such as socioeconomic status and educational level.
Results from the survey indicated that 64% had confidence in their knowledge of blood pressure readings, but only 36% accurately identified 120/80 mm Hg as the upper limit for a healthy blood pressure reading.
The comparison between participants who expressed confidence in their understanding of the readings and those who accurately identified healthy readings showed greater differences in the groups with high blood pressure. Of those with only hypertension, 78% expressed confidence while 47% were accurate; while of those who had both hypertension and comorbidities, 81% expressed confidence yet only 40% were accurate.
The researchers discovered that patients who felt confident in their understanding of blood pressure readings would act to intervene for stage 2 hypertension readings, but showed lower promptness when it came to taking action with stage 1 readings.
Researchers theorize that an overconfidence in one’s abilities, making them less likely to take action, could have a negative impact on their health.
Dr. Bruine de Bruin noted that the most concerning discovery was the lack of knowledge on what constitutes a standard or healthy blood pressure level, yet they still felt confident in their understanding which might lessen their motivation to pursue medical care.
How to Interpret Blood Pressure Readings
A blood pressure reading has two numbers. Systolic blood pressure, the first number, is the pressure in your arteries when your heart pumps blood through the body. Diastolic blood pressure, the second number, is the pressure when your heart is at rest. Generally, lower numbers are preferable. In 2017, American Heart Association and American College of Cardiology changed their thresholds for healthy blood pressure based on data from SPRINT (Systolic Blood Pressure Intervention Trial), which defined healthy blood pressure as less than 120/80 mm Hg.
Recently, the threshold for diagnosing high blood pressure was reduced to 120/80 mm Hg. This is lower than what most clinics use, which is 130/80 mm Hg. According to Willie E. Lawrence Jr., MD, FAHA, FACC and cardiologist at the Center for Better Health and Wellness in Benton Harbor, Michigan, this new threshold is becoming more widely accepted.
Blood Pressure Categories are classified according to current guidelines.
A normal blood pressure reading is less than 120/80 mm Hg.
Blood pressure levels between 120 to 129 mm Hg and below 80 mm Hg.
Stage 1 Hypertension is indicated by systolic readings between 130-139 mm Hg or diastolic readings between 80-89 mm Hg.
Stage 2 Hypertension is defined as a systolic blood pressure level of 140 millimeters Mercury (mm Hg) or higher, or a diastolic blood pressure level of 90 mm Hg or higher.
Hypertensive Crisis is defined as a systolic blood pressure of greater than 180 mm Hg and/or diastolic blood pressure of greater than 120 mm Hg.
Dr. Lawrence commented that most clinics do not accurately record blood pressure readings, and patients should be aware of the right techniques for accurate measurement in order to have a stronger advocacy in the clinic.
Dr. Lawrence advised that health care providers wait five minutes after the patient moves to the examination room for an accurate blood pressure reading. Additionally, best practices suggest the patient have their legs uncross, arm at the same level as device, bladder emptied and back supported. Furthermore, they should not be engaging in conversation nor listen to someone speaking, and use a cuff of appropriate size.
Dr. Lawrence stated that the patient should be aware of what practices their healthcare provider should carry out, as it is their health at stake, Additionally, they suggested that patients should have no hesitations in pointing out any errors made by their healthcare provider.
Dr. Lawrence suggests beginning with a validated device if you’re taking your own blood pressure at home.
He noted that accurate blood pressure control is unlikely to be achieved without a properly calibrated home measurement device.
If you decide to self-monitor your blood pressure at home, Dr. Lawrence recommends looking at validatebp.org which has a list of evaluated devices. Follow the recommended instructions such as sitting in a quiet area and ensuring the cuff fits properly for an accurate reading.
Knowing the high blood pressure thresholds can help a patient advocate for their needs if they have elevated readings.
The cutoffs for patient readings are important to be aware of. If you are above these cut-offs, it should be mentioned during the doctor’s visit, according Dr. Bruine de Bruin.
Blood pressure can be managed.
Dr. Lawrence stated that as people age, their arteries and blood vessels typically become more rigid, increasing the likelihood of high blood pressure. Furthermore, diet, exercise habits, co-existing conditions such as diabetes, and lifestyle changes are often involved in the treatment of high blood pressure.
Dr. Lawrence observed that lifestyle interventions are the foundation of managing hypertension, though it can be difficult for those who have been following unhealthy habits to establish new ones and the changes may not manifest quickly.
People with blood pressure readings in stage 1 or higher usually requires one medication to relax their blood vessels, and two medications for stage 2; such as diuretics, beta-blockers and alpha-blockers, calcium channel blockers, or ACE inhibitors.
According to Dr. Lawrence, there is no failure in treating high blood pressure with medication when lifestyle changes are unsuccessful.