Why you should have a blood pressure test

Having a blood pressure test is an important step to take to maintain good health and prevent disease. This is because high blood pressure indicates poor blood vessel function and is a risk factor for heart disease, which is a leading cause of mortality all over the world.

High blood pressure – hypertension – also increases the risk of stroke and kidney failure.

Overview

Medical professionals perform a blood pressure test using a manual or electronic blood pressure meter, also known as a sphygmomanometer.

The test reveals your systolic and diastolic blood pressure score. The systolic score is written above the diastolic score, such as 120/80 mmHg, with 120 being the systolic score and 80 the diastolic.

Systolic blood pressure is the highest pressure our beating heart can achieve; it is what we feel as our pulse. A score of lower than 140/90 mmHg is normal for an adult, but the systolic number is especially important because people with lower systolic blood pressure often have a longer life expectancy.

Taking steps to lower your blood pressure can prolong your life. For every 1 mmHg you reduce your systolic blood pressure by, you reduce your risk of heart attack by 2 per cent. The lower you can get your score, the more you improve your health.

Another way to look at the age of our blood vessels is to measure their stiffness. As we age, blood vessels generally become less elastic, commonly known as hardening of the arteries. Doctors measure this by using an ultrasound probe on our wrist or finger.

How a blood pressure test is undertaken

A medical professional will measure systolic blood pressure with a pressurized cuff to block off circulation in the arm. As the pressure in the cuff lowers, the point at which your pulse restores and blood first begins to flow is the systolic blood pressure.

Who performs the test?

Nurses, general practitioners and trained medical specialists.

Cost

Most people’s health insurance qualifies them to receive a free blood pressure test by a doctor or nurse.

When and how often?

You should have a blood pressure test every 2 years if you are between 18 and 40 years old, and annually if you’re 40 and over and in good general health.

Anyone who has a score of 140/90 or higher, or is at risk for vascular disease, should have a blood pressure test more frequently.

Some factors that can predispose people to high blood pressure and therefore mean they should have a blood pressure test more than once a year include age, gender, and family history or a genetic predisposition to high blood pressure.

Other factors that may increase an individual’s risk of high blood pressure include obesity, smoking, excess alcohol consumption, low potassium intake, high sodium intake, high stress levels, insufficient vitamin D or K intake, and a sedentary lifestyle, which includes less than 30 minutes of physical activity on most days.

Issues

There are no significant risks associated with having a blood pressure test, though people with a shunt for kidney dialysis should have their blood pressure checked in their other arm.

People using home blood pressure testing equipment, or free machines that test blood pressure at malls and pharmacies, may not always give accurate results.

You should always undertake such a test at least two or three times because a single measurement can be misleading. People who get poor scores should consult their doctor for a blood pressure test.

Even when you have a test at your doctors’ office, high results can sometimes be a result of ‘white coat syndrome’, a phenomenon in which patients have higher blood pressure readings because they are anxious about their visit to the practitioner.

Some clinics may even advise anxious or nervous patients to use home kits, or ambulatory blood pressure monitoring, to obtain readings that are more accurate.

Tips

It is important to check your blood pressure regularly, and follow the blood pressure guidelines to prevent adverse events, such as damage to end organs including the retina, kidneys and blood vessels in the heart and brain due to persistently elevated blood pressure.

The blood pressure guidelines in Australia, for example, say people with low or moderate absolute cardiovascular disease risk (persistent blood pressure above or equal to 160/100 mmHg or 140/90 mmHg, respectively) should have anti-hypertensive therapy.

The decision to treat at lower blood pressure levels should consider absolute cardiovascular disease risk and/or evidence of end organ damage, together with accurate blood pressure assessment.

In selected high cardiovascular risk populations, aiming for a target of less than 120 mmHg systolic can improve cardiovascular outcomes. If you’re targeting this, you should see your doctor for a close follow up to identify treatment related adverse effects including hypotension, syncope, electrolyte abnormalities and acute kidney injury.

A 2015 meta-analysis of patients with uncomplicated mild hypertension (systolic blood pressure range of 140–159 mmHg) demonstrated that blood pressure lowering therapy is beneficial (reduced risk of stroke, cardiovascular death and all cause mortality).

Further, a 2015 trial comparing lower with higher blood pressure targets in selected high cardiovascular risk populations found improved cardiovascular outcomes and reduced mortality, with an increase in some treatment-related adverse events.

References

Last reviewed 03/Jun/2017

 

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