Upper and lower pressure: what is it?

Read in this article:

What is blood pressure?
What pressure is called upper and lower?
What does syastolic blood pressure mean?
What you need to know about diastolic pressure?
Why does the lower pressure change?
Pulse pressure: what is considered normal?
How to measure blood pressure correctly?
Why is it important to use a blood pressure monitor regularly?

Blood pressure is one of the objective indicators that allows us to assess the state of human health and the quality of work of internal organs. Thanks to modern tonometers, anyone can find out their blood pressure in a few minutes. However, you need not only to be able to use such devices, but also to understand what the numbers on the monitor mean.

What is blood pressure?

Tonometers record the blood pressure on the walls of the arteries, which is why it is called arterial pressure. In other words, the indicator means how much the level of fluid pressure in the circulatory system is higher than atmospheric pressure.

If we describe the whole process in simple words, it will look like this:

The heart muscle contracts;
The aortic valve closes;
The heart receives highly oxygenated blood from the lungs;
The following reduction occurs;
Blood moves to all organs.

The entire circulatory system is involved in the formation of blood pressure, including the blood itself, which supplies tissues with oxygen, removes waste products, and provides thermoregulation. BP shows how well these functions are performed.

Normal values of indicators in men and women

The normal diastolic pressure in an adult largely depends on his gender.

It has been scientifically proven that representatives of the stronger sex have lower (diastolic) blood pressure levels that are always slightly higher than those of the weaker half of humanity.

Scientists explain this fact by the physiological characteristics of the female and male body. Since men have greater muscle mass and are in a different weight category, for optimal supply of nutrients to internal organs and systems they require powerful blood flow, which increases the degree of arterial resistance.

According to the current classification, diastolic pressure in the stronger sex is normally from 76 to 85 mm Hg. Art.

In the fair sex, lower blood pressure levels are influenced by factors such as pregnancy, premenstrual syndrome, menstrual periods, and the onset of menopause.

Hormonal changes that occur in the female body throughout life affect the heart, the size of vascular and arterial lumens, blood flow, circulatory and microcirculation processes.

On average, the norm of lower pressure in women varies from 70 to 84 mm Hg. Art.

According to statistics, men are most susceptible to diastolic hypertension at a young age (up to 50-55 years), and the fair sex, as a rule, encounters this disease upon the onset of menopause.

This is explained by the fact that during menopause, levels of the hormone estrogen in the female body decrease sharply, which increases the likelihood of developing cardiac diseases, hypertension, diastolic hypertension, and atherosclerosis.

The danger of diastolic hypertension

What pressure is called upper and lower?

When the heart contracts, it creates a push for blood movement. This phase of the work of the heart muscle is called systole, and the indicator recorded at this moment is called upper or systolic pressure.

Before a new contraction, the heart relaxes as much as possible, the diastole phase begins, and at this moment the minimum pressure is recorded. It shows the degree of blood pressure on the vessels during the period between heart contractions.

Diagnostics

Systolic blood pressure can be determined using a special device - a tonometer.

In addition, the patient may be recommended the following types of diagnostic studies:

Vascular Dopplerography;
Cardiogram of the heart;
General and biochemical blood test;
ECHO.

It is important to learn how to independently determine systolic pressure in order to prevent the development of a pathological process and promptly seek help from qualified specialists!

What does systolic blood pressure indicate?

Any deviations of indicators from the norm indicate malfunctions in the functioning of one or another body system. Both values or only one of them can increase or decrease. For example, an increase in systolic pressure occurs when:

Overactive thyroid gland – thyrotoxicosis, when the thyroid gland secretes too many hormones;
Severe anemia, when the type of blood circulation changes;
Slowing of the pulse - bradycardia, ineffective operation of the aortic valve, when the upper pressure increases due to increased blood release;
A decrease in the elasticity of the aorta, an increase in the density of its walls - most often the cause is atherosclerosis of a large vessel in old age.

An increase in only the upper pressure without changes in the lower is called systolic arterial hypertension. But such a deviation does not always indicate a disease. So, with significant sports loads, an increase in upper pressure is also observed, and this is not considered a deviation from the norm.

Causes and symptoms of increased systolic pressure

The following reasons can provoke an increase in upper blood pressure:

Atherosclerosis;
Undesirable age-related changes;
Smoking and alcohol abuse;
Insufficient physical activity, sedentary lifestyle;
Cardiovascular pathologies;
Frequent stressful situations and psycho-emotional shocks.

Causes of increased pressure

Often, increased systolic blood pressure does not manifest itself in any way, which threatens the progression of the pathological process and the development of dangerous complications, such as a heart attack or stroke.

You can suspect an increase in upper blood pressure by paying attention to the following clinical signs:

Cardiopalmus;
Edema;
Decreased sensitivity of fingers;
Sleep disorders;
Unreasonable anxiety, irritability, nervousness, sudden mood swings,
Deterioration of hearing, sensation of ringing and noise in the ears.

If such symptoms occur, the pressure should be measured using a tonometer and measures should be taken to stabilize lower blood pressure.

What you need to know about diastolic pressure?

The diastolic pressure indicator characterizes the degree of resistance of blood vessels and their permeability to blood. The health of the vascular system is determined by two main factors: the elasticity of their walls and the functioning of the kidneys. The human body contains a large amount of fluid; without its circulation, metabolism is impossible, and blood plays a crucial role in this process. It passes through the kidneys, which act as a kind of filter, regulate water-salt balance and remove toxins from the blood along with urine.

With this mechanism, an increase in diastolic pressure is usually associated with a violation of the removal of fluid from the body, an increase in its volume and an increasing load on the walls of blood vessels. If lower blood pressure exceeds normal levels for a long time, the risk of heart attacks and strokes increases. If it decreases for a long time, problems arise with the supply of oxygen to tissues and organs. Because of this, dizziness and fainting occur, especially during physical activity.

The causes of low diastolic pressure may be bleeding, prolonged hunger and dehydration, allergies with anaphylactic shock. The indicator decreases with insufficient production of the hormone renin, which regulates vascular tone. The decrease also occurs due to stress, fatigue and tuberculosis.

Reasons for increasing and decreasing lower indicators

Minor deviations from the norm in diastolic indicators in an adult or child are observed under stress, nervous and physical fatigue; the values change under the influence of weather and climate. Lower pressure increases during training, physical work, after eating salty, sweet, spicy foods, tonics and alcoholic drinks.

Unstable blood pressure in pregnant women

During pregnancy, isolated hypotension can occur in the early stages due to toxicosis, dehydration, and hormonal imbalance. An increase in diastolic blood pressure occurs after week 20, the main reasons being weight gain and fluid retention in the body. Hypertension is almost always diagnosed in multiple pregnancies, polyhydramnios, diabetics, and women who are about to become mothers for the first time.

Important! The most dangerous causes of isolated hypertension in pregnant women are preeclampsia and eclampsia. With these pathologies, gestosis develops, the likelihood of placental abruption and premature birth increases, and severe swelling appears. This condition is extremely dangerous for a child - the baby may be born with congenital defects.

Causes of high lower pressure

Diastolic readings often increase in people who lead an unhealthy lifestyle - smoke, abuse alcohol, and indulge in junk food. Sometimes it is enough to adjust your diet, get rid of addictions, and move more for high blood pressure to normalize.

Why does lower blood pressure increase:

prolonged stress;
chronic diseases of the adrenal glands;
diseases of the thyroid gland, heart, blood vessels;
obesity;
injuries and diseases of the musculoskeletal system.

What does hypertension mean from a psychosomatic point of view? Psychologists say that the reason for high blood pressure is selfishness, the desire to set difficult goals for oneself. This allows a person to achieve success in his career, but has a negative impact on the condition of blood vessels.

Causes of low diastolic pressure

The primary cause of decreased diastolic indices is vegetative-vascular dystonia. For a more accurate diagnosis, you should visit a cardiologist, neurologist, or endocrinologist. From a psychosomatic point of view, hypotension can be a consequence of low self-esteem, hidden fears, grievances, and depression.

Low diastolic pressure - what does it mean:

kidney disease, dysfunction of the excretory system, hypofunction of the adrenal cortex;
cardiovascular diseases, myocardial dysfunction;
endocrine system disease;
severe allergies;
ulcers;
varicose veins;
the presence of malignant tumors;
large blood loss, anemia;
diseases of inflammatory, infectious origin.

A sharp decrease in blood counts can be caused by overheating, prolonged stay in a stuffy room, or dehydration. Hypotension is a consequence of shock, severe stress, chronic lack of sleep, and low-calorie diets.

Physiological hypotension is a decrease in blood pressure in healthy people against the background of genetic predisposition and asthenic body type. At the same time, the person does not suffer from unpleasant symptoms of the disease and copes well with physical and mental stress.

Why does the lower pressure change?

An increase in lower pressure may be associated with:

Narrowing of the lumen in the renal arteries, their increased tone;
Kidney diseases;
Significant excess weight;
Myocardial dysfunction;
Diabetes mellitus;
Changes in the concentration of hormones in the blood.

When diastolic pressure deviates from the norm, a person feels a loss of strength, chills in the lower extremities, and drowsiness. A nagging headache appears, sweating increases, concentration decreases and memory deteriorates. Possible discomfort in the heart area, arrhythmia. This is why it is important to measure your blood pressure regularly so that if there are any abnormalities, you can immediately consult a doctor.

Causes and signs of low systolic pressure

A reduced upper blood pressure may be due to the following factors:

Bradycardia (slow heartbeat);
Traumatic brain injuries;
Diabetes mellitus (due to increased blood clotting rates characteristic of this disease);
Impaired function of the heart valves;
Overwork and excessive physical exertion, causing the development of hypotension;
Pregnancy (due to hormonal changes occurring in the female body).
Reduced upper systolic pressure is manifested by the following symptoms:
Increased drowsiness, lethargy, apathy;
Headache;
Attacks of dizziness;
Fainting conditions;
Memory problems;
Excessive sweating.

With low systolic blood pressure, the patient also requires competent medical care!

Symptoms of low blood pressure

Pulse pressure: what is considered normal?

Systolic pressure is considered normal in the range of 110-130 units, but with age this figure increases to 140 units. For diastolic pressure, the norm is 65-80 units; with good vascular elasticity, the indicator will be closer to the upper limit of the norm.

The difference between upper and lower pressure is also important. It is called pulse pressure and is normally 40 units; 120/80 is considered ideal. An increase in the gap to 65 units indicates a serious risk of developing heart and vascular diseases. In such a situation, malfunctions of the heart muscle provoke rapid wear and tear of the walls of arteries and veins, which accelerates the aging process.

In old age, the difference between syastolic pressure and diastolic pressure of 50 units indicates precisely that natural wear and tear occurs in the body, the walls of blood vessels have become less elastic.

A pulse pressure value of 60 units indicates a risk of heart disease and the need to urgently visit a doctor. If the tonometer shows a difference of about 20 units, most likely the blood pressure was measured incorrectly. With such a gap, the person’s health condition is critical.

Therapy

Reduced or increased systolic blood pressure requires competent, comprehensive treatment. For these purposes, the following methods are used:

Physiotherapeutic procedures;
Drug therapy;
Diet therapy;
Lifestyle correction and giving up bad habits;
Carrying out preventive measures.

Therapy for low and high levels of upper blood pressure has certain specifics.

Elevated systolic blood pressure

With increased upper pressure, the patient requires complex treatment, including:

Drug therapy;
Special diet;
Electrosleep.

To stabilize upper blood pressure, diuretics, adrenergic blockers, and calcium channel antagonists are prescribed. Vasodilator drugs (Captopril, Fosinopril, Spirapril) have a good effect.

All medications must be used strictly as prescribed by the doctor.

Diet is also of great importance. The patient will have to exclude fatty, fried, salty foods, semi-finished products, confectionery, and alcoholic beverages from the menu.

The basis of the diet should be fruits, vegetables, dairy products, fish and seafood.

Low upper pressure

For reduced systolic blood pressure, the following treatment methods are recommended:

Cryotherapy;
Massage;
Taking medications with a high caffeine content;
Magnetotherapy;
Reflexology.

A diet for low upper blood pressure involves including sweets, hot, spicy, salty foods, and fatty meats in the patient’s daily diet.

How to measure blood pressure correctly?

To obtain reliable blood pressure readings, you need to take measurements in a quiet environment at room temperature. For about an hour, it is not advisable to smoke or drink strong coffee or tea. For half an hour you need to eliminate physical activity. Your feet should be on the floor and your hands should rest freely at heart level.

There are a few more simple rules:

During the measurement, you cannot move, talk or cross your legs;
The cuff should fit snugly on the arm, but not squeeze it;
If several measurements are required, at least 5 minutes must elapse between them;
The cuff is selected so that it covers at least 80% of the shoulder circumference. If you have to hold the Velcro with your hand, the results will be incorrect;
In the absence of back support, the indicators may be overestimated.

Doctors often refer to the so-called “working pressure”. The fact is that, depending on the state of the body and its individual characteristics, the interval of the upper and lower indicators may differ for different people. Working blood pressure is the blood pressure at which a person remains in good health. This could be, for example, 130/90 or 115/80.

There is only one way to determine your working pressure: measure it regularly. Then you can find out what values the tonometer shows when a person feels well. This is an important nuance, since with a reduced operating pressure the same 130/90 can be considered as a significant increase, although the numbers themselves are within the norm.

Different blood pressure targets for the heart and brain: myth or reality?

Materials and methods

For the new analysis, the researchers used data from the ALLHAT antihypertensive therapy trial to estimate patterns of risk of cardiovascular events and total mortality associated with different values of systolic and diastolic blood pressure simultaneously.

The researchers presented their results as a "heat map"—a visual representation of the lowest and highest risk for any given systolic/diastolic pressure combination.

The new analysis was published in the Oct. 26 issue of the Journal of the American College of Cardiology.

results

During a mean follow-up period of 4.4 years, the study, which included 33,357 participants, had 2,636 myocardial infarctions, 866 heart failures, 936 strokes, and 3,700 deaths.

Results showed that for the combined outcome of all-cause mortality, myocardial infarction, and heart failure, a U-shaped relationship was observed with both systolic and diastolic blood pressure measures, but the blood pressure associated with the lowest risks differed for each specific outcome.

For example, systolic / diastolic pressure 140-155 / 70-80 mmHg. Art. was associated with the lowest risk of all-cause mortality compared with 110-120/85-90 mmHg. Art. for myocardial infarction and 125-135/70-75 mm Hg. Art. for heart failure.

In contrast, the association of systolic and diastolic blood pressure and stroke was linear, with lower values of both measures consistently associated with lower risk of stroke.

The published paper demonstrates that the optimal blood pressure target may also depend on which outcome doctors are most interested in—myocardial infarction, heart failure or stroke, or the risk of a future stroke or heart attack.

According to the authors, when we look only at cardiac events such as myocardial infarction and heart failure, we see a traditional J-shaped curve with higher risks at both extremes.

But we don't see this for stroke, where lower values are consistently better for both diastolic and systolic pressure.

Identifying patients at higher risk of one type of cardiovascular disease than another can be very challenging.

There is no simple calculator to try to figure out whether a patient is at greater risk of stroke or heart attack, and many of the risk factors are the same.

But if someone has a history of stroke, it makes them focus more on stroke as a future event that clinicians will be especially keen to prevent.

Likewise, patients with a history of heart disease are likely to be at higher risk of having a heart attack.

The guidelines provide a rough estimate, but the specific goal must be individualized for each patient. This is the art of medicine.

The authors note that current data alone cannot determine optimal blood pressure targets for patients at this time, given that a retrospective observational analysis was performed.

Moreover, the achieved blood pressure associated with the lowest risk of these outcomes in the ALLHAT study may differ from the blood pressure combinations reported in other studies and may have used different measurement methods.

The authors concluded that the simultaneous consideration of systolic/diastolic pressure and an associated cardiovascular risk heat map, individualized by patient risk factors, for clinical blood pressure control will need to be evaluated in future prospective studies.

The analysis showed that there was no J-shaped curve between stroke risk and systolic or diastolic blood pressure, and the association remained linear up to a blood pressure level of 110/55 mmHg. Art. So for stroke prevention, the old blood pressure adage, “the lower the better,” is true, say the study authors.

“This is the main conclusion for practicing cardiologists - if it were not dangerous for the heart, the brain would prefer an optimal cerebroprotective systolic blood pressure of 110-120 mmHg. Art.,” comment the editors.

They note that this is consistent with the observation that, through autoregulation, the brain can maintain relatively constant blood flow despite large fluctuations in perfusion pressure.

But, unlike the brain, cardiac perfusion occurs predominantly during diastole, so excessively low diastolic blood pressure can impair myocardial blood supply.

The results of the ALLHAT study are consistent with the results of the 2003 INVEST study, which observed a progressive predominance of myocardial infarction over stroke with low diastolic blood pressure among 22,576 participants with hypertension and coronary artery disease.

In INVEST, the lower limit of diastolic blood pressure for myocardial infarction was 82.7 mmHg. Art., which is close to the value obtained in ALLHAT, equal to 84 mm Hg.

The researchers note that hypertension and coronary artery disease are major contributors to end-organ heterogeneity, and patients in both ALLHAT and INVEST had a high prevalence of coronary artery disease; It is not surprising that in some younger and healthier populations, many of whom have neither hypertension nor coronary artery disease, target organ heterogeneity cannot be demonstrated even after several adjustments.

The editors say that the fact that 2 large prospective randomized trials of hypertension demonstrated end-organ heterogeneity (with optimal protective blood pressure differing for stroke risk and myocardial infarction risk) is leaving clinicians faced with uncomfortable choices aimed at preventing heart attacks over time. counting cerebrovascular events or vice versa.

They give the example of a 76-year-old stable patient with coronary artery disease who had recently suffered a transient ischemic attack and had a blood pressure of 148/68 mmHg.

According to the latest ALLHAT analysis, to provide optimal cerebroprotection, systolic pressure should be reduced by 28 mmHg. Art. to a level below 120 mmHg. Art. however, due to stable coronary artery disease, the patient's diastolic pressure should remain in the 80 mmHg range. Art., i.e. increase by 16 mm Hg. Art.

The editors believe that a possible solution to this situation is to try to reduce one of the risk factors through revascularization, citing studies showing that the J-shaped curve with lower diastolic blood pressure and myocardial infarction is present only in nonvascularized patients with coronary artery disease, then how after revascularization a different clinical picture is expected.

They note that this raises a provocative question: When there is an urgent need to lower blood pressure due to cerebrovascular disease in patients with stable coronary artery disease, should coronary revascularization be performed prophylactically, even if this would be contrary to recent results from the ISCHEMIA trial?

What is a person's lower blood pressure responsible for?

The blood ejected during systole quickly passes through the arteries, reaching small capillaries and vessels. The walls of these vessels, contracting, resist the incoming blood flow, and the greater this resistance, the higher the diastolic blood pressure. Therefore, a person’s lower pressure is responsible for the degree of resistance of blood vessels to blood flow. The higher it is, the worse the permeability of the vessels, the greater the resistance they provide to the blood. Conversely, the lower the resistance, the lower the diastolic readings.