Blood Pressure
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25. Although healthy people can have a broad range of BP, there is no sharp cut-off between normal and high. Instead, like blood cholesterol levels, the lower the reading, the better. Normal BP is considered to be 120/80 but healthy zone extends either side. The risk of complications may begin to rise above BP of 115/70 that has been considered “low normal”. Cut-off point for high BP (hypertension) is considered to be 140/90.
Notes: (i) BP should initially be measured in both arms, and all subsequent determinants should be performed in the arm with the highest pressure. (ii) The position of the arm during the BP measurement can be a source of variation in readings. (iii) BP should always be measured in the standing as well as lying down or sitting position, as rested and relaxed as possible. This is because postural hypertension is especially common in diabetic and elderly patients. (iv) If your systolic and diastolic readings conflict each other, use the number that puts you in the higher category of hypertension. For example, a reading of 114/85 puts you under pre-hypertension because of high diastolic pressure, even though systolic is below normal.
Symptoms of high blood pressure
26. The vast majority of people with mild or moderate hypertension may not produce any symptoms and as such may not often be diagnosed for many years by which time the person has subtle evidence of damage to heart, brain or kidneys. These are serious problems, which is why you should never wait until you feel ill before having your BP checked. The current advice is that everyone over the age of 30 should have a regular routine BP check.
27. The first symptoms may appear in the form of pain towards the back of the head and neck on walking in the morning, which soon disappears. Some of the other usual symptoms of hypertension (not in any order) are: (i) aches and pains in the arms, shoulder region, legs and back; (ii) frequent urination; (iii) excessive perspiration; (iv) palpitations and irregular heart beat; (v) heaviness in the head and eyes; (vi) headaches; (vii) muscle cramps; (viii) general weakness, fatigue, tiredness and lethargy; (ix) restlessness and nervous tension; (x) irritability; (xi) blurred vision; (xii) nausea; and (xiii) insomnia or wakefulness.
28. Late symptoms of more serious nature could be: (i) hypertensive heart disease with enlarged heart; (ii) possible left ventricular failure; (iii) myocardial infraction; (iv) possible senility; and (v) cerebral haemorrhage and paralysis.
