A blood pressure test measures the force in your arteries as your heart beats. This test is done either as part of a routine health checkup or as a screening for high blood pressure, known as hypertension. Your blood pressure measurement consists of two numbers; your systolic blood pressure, which is the first and higher number that measures the pressure inside your arteries during heartbeats, and your diastolic blood pressure, which is the second and lower number that measures the pressure inside your arteries when the heart rests between beats.
Screening for hypertension is important, as this affects millions of adults in the United States and if left unmanaged, can increase your risk of heart disease, heart attack, and stroke. Although less common, blood pressure tests can also screen for low blood pressure, known as hypotension.
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How often you get your blood pressure checked depends on your age and overall health, so it can vary for each person. The general recommendations are that people aged 18 and older with typically normal blood pressure and no risk factors for heart disease should get checked at least once every two to five years.
People aged 40 and older, or younger with an increased risk of high blood pressure, should get their blood pressure numbers checked every year. People who have been diagnosed with chronic health conditions such as heart disease and high or low blood pressure may need to get checked even more frequently.
If you are at risk of high or low blood pressure, your doctor may also recommend that you frequently check your blood pressure at home and keep a log of the results.
There are a couple things you can do before getting screened to help achieve the most accurate blood pressure reading. These include avoiding tobacco smoke, exercise, and caffeine at least 30 minutes to an hour before your test, as these factors can increase your blood pressure and heart rate. It can also help to wear a short sleeved shirt so the blood pressure cuff is able to be placed more easily around your arm.
For your blood pressure test, you will be asked to sit in a chair with your feet placed flat on the ground. Your arm will be placed on a table or other elevated surface so that it rests at heart level. The blood pressure cuff will be placed around the top part of your arm, with the bottom of the cuff lying just above your elbow. It’s important that the cuff fits well, as the readings can provide inaccurate results if the cuff is too big or too small.
Once the cuff is placed on your arm, your doctor will take either an automated or manual blood pressure reading. For a manual measurement, your doctor will place a stethoscope over the major artery in your upper arm to listen to blood flow. The cuff is then inflated with a small pump, which squeezes the arm as it inflates. Blood flow through the artery is temporarily disrupted due to this inflation.
Your doctor will then slowly release the air in the cuff to restore blood flow, listening to your blood flow and pulse and measuring your blood pressure as this happens. For an automated measurement, the blood pressure cuff automatically inflates and measures your pulse. In this case, a stethoscope is not needed. It takes only about one minute to receive a blood pressure measurement.
Blood pressure is divided into four different categories. If the systolic number is below 120 and the diastolic number is below 80, this means you have normal blood pressure. In this case, all you must do is maintain a healthy lifestyle. If the systolic number is between 120-129 and the diastolic number is below 80, this means you have elevated blood pressure. You should adopt a healthy lifestyle to bring your blood pressure back to normal.
If the systolic number is between 130-139 or the diastolic number is between 80-89, this means you have Stage 1 high blood pressure, and should talk to your doctor about receiving medication. If the systolic number is 140 or higher or the diastolic number is 90 or higher, this means you have Stage 2 high blood pressure, and you should adopt a healthy lifestyle along with taking one or more medications. Stage 1 and 2 high blood pressure mean you are at an increased risk of developing heart disease.
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Invasive therapies may also be used to treat an abnormal heart rhythm, such as electrical cardioversion which sends electrical impulses through your chest wall and allows normal heart rhythm to restart, or catheter ablation which disconnects the pathway of the abnormal rhythm. If your doctor determines that electrical devices are the best course of action, you may be given a permanent pacemaker, an implantable cardioverter-defibrillator (ICD), or biventricular (B-V) pacemakers and defibrillators.