There are numbers to track and new terms to learn when taking care of our health, and sometimes it feels like too much all at once, or it can be unclear. One of the most common checks at the doctor’s office is a blood pressure measurement. You may have seen it written as two numbers, such as “120 over 80.” But what do those numbers really mean, and why should we care about them?
To best understand blood pressure, we need to think of the heart like a water pump and your blood like water flowing through garden hoses (your blood vessels). Each time the heart pumps, it pushes blood through the vessels. The force exerted by blood pushing against the vessel walls is called blood pressure. It tells us how hard the heart is working to move the blood.
The two numbers that your healthcare team uses are called systolic and diastolic.
- Systolic (first number) is the pressure when the heart squeezes and pushes blood out.
- Diastolic (second number) is the pressure when the heart relaxes and fills with blood again.
Blood pressure is important because it affects the efficiency of blood circulation throughout the body. If blood pressure remains too high for an extended period, it can damage the heart, brain, kidneys, and eyes. High blood pressure can raise the chance of having a heart attack, stroke, kidney problems, or trouble seeing. However, the good news is that many people can lower their risk by modifying their habits, taking medication if necessary, and collaborating with their healthcare team.
If you or someone you love has been told their blood pressure is high or low, you may feel worried. That is normal. Many people feel the same way. The good news is that blood pressure is something we can understand, manage, and improve.
Normal and Not Normal Blood Pressure
Doctors use these numbers to determine if blood pressure is normal, slightly high, or high (also known as high blood pressure, or hypertension). Centers for Disease Control and Prevention (CDC) explains standard ranges adults should know:
- Normal: Less than 120/80 mm Hg
- Elevated: Systolic 120–129 and diastolic less than 80
- High (hypertension): 130 or higher for systolic, or 80 or higher for diastolic.
- Low (hypotension): happens when the numbers are too low and the body doesn’t get enough blood flow. Symptoms can include feeling dizzy, faint, weak, or very tired. It can be caused by dehydration, certain medications, sudden changes in position (such as standing up quickly), or specific illnesses. If someone is experiencing dizziness or faintness, seek medical attention immediately.
Doctors do not base a diagnosis on one reading. They look at many readings over time. They may check blood pressure at the clinic, ask the person to take home readings, or use a 24-hour monitor that checks pressure throughout the day. The decision also depends on other health risks, such as age, diabetes, or a history of heart disease. If readings are consistently above the cutoffs, doctors may diagnose it as high blood pressure and recommend steps to lower it.
What can Make Blood Pressure Go Up or Down?
Many things change blood pressure. Some things you cannot change, and others you can:
Things you can’t change (risk factors):
- Getting older
- Family history (if a parent had high blood pressure)
- Some medical conditions
Things you can change:
- Salt (sodium) – in the diet, eating less salt helps.
- Weight – staying at a healthy weight helps.
- Physical activity – being active often helps keep blood pressure lower.
- Alcohol and smoking – cutting back or quitting helps.
- Stress – managing stress can help some people.
Making healthy choices and following a care plan with the doctor helps keep blood pressure in a safer range.
How is blood pressure measured?
Blood pressure is measured using a cuff that is placed on the arm. This can be done at the doctor’s office, at home with an automatic cuff, or at a pharmacy. There are rules to follow so the number is accurate. Here are the steps for a correct reading at home or in the clinic:
- Sit down in a chair with your back supported. Keep your feet flat on the floor.
- Rest for 5 minutes before the check. Stay calm and quiet.
- Bare arm the cuff should go on bare skin, not over clothes.
- Arm at heart level rest the arm on a table or pillow, so it is at the same height as the heart.
- Do not talk while the reading is taking place.
- Take two or three readings one minute apart and write them down. Many health groups recommend multiple readings over time before determining if blood pressure is high.
Home blood pressure checks can help
Home blood pressure monitoring can help you see how your blood pressure changes throughout the day. It also helps determine if the reading at the doctor’s office is accurate, or if a person becomes nervous at the clinic (this is known as the “white coat” effect). Increasingly, guidelines advise doctors to utilize home readings to aid in diagnosing and managing high blood pressure. Home checks can help caregivers feel more involved and provide their healthcare team with better information.
Choosing a Good Home Blood Pressure Cuff
Not all blood pressure monitors are the same. The type of device you choose can affect the accuracy of the numbers. Here are the main types and what to know about each:
Upper-arm cuff monitors
- What it is: A cuff goes around the upper arm and tightens to measure blood pressure.
- Why it’s best: Most doctors and health groups say this is the most accurate kind for home use.
- Tips: Make sure the cuff fits the arm size (too small or too large cuffs can give wrong readings). Look for one that is “clinically validated.” Standard adult cuff sizes are small adult for arm circumferences of 20-25 cm (7.9-9.8 inches), regular adult for arm circumferences of 25.1-32 cm (9.9-12.6 inches), large adult for arm circumferences of 32.1- 40 cm (12.6-15.7 inches), and extra-large adult for arm circumferences of 40.1- 55 cm (15.8- 21.7 inches). The cuff should fit snugly but not be so tight that it’s uncomfortable.
Wrist cuff monitors
- What it is: A smaller cuff goes around the wrist.
- Why people use it: Easier to put on for some older adults or people with large arms.
- Downside: These are often less accurate because the wrist arteries are smaller and more sensitive to movement. To be more accurate, the wrist must be held at heart level. A study of 721 people found wrist devices often gave readings off (higher) by ≥ 5 mmHg compared to upper-arm measurements; many were off by ≥ 10 mmHg.
Ambulatory blood pressure monitors (24-hour monitors)
- What it is: A cuff connected to a small machine worn on a belt or shoulder. It checks blood pressure multiple times over 24 hours.
- Why it’s used: Gives doctors a better picture of blood pressure during the day and night.
- Where to get it: Usually provided by a doctor’s office or clinic, not bought for home use.
Cuffless blood pressure monitors
- What it is: Newer devices that measure blood pressure without a cuff. They may use a sensor in a watch, a phone, or a patch that checks blood flow in the skin or arteries.
- Why people like it: Comfortable and easy. No squeezing cuff.
- Downside: These devices are still being studied. Many are not as accurate as upper-arm cuffs, and only a few have been approved by regulators. For now, most doctors recommend using a validated upper-arm cuff rather than relying solely on cuffless devices.
Tips on how to choose the right one
- Pick an automatic, upper-arm cuff rather than a wrist cuff if possible. Upper-arm devices are usually more accurate.
- Buy a cuff that fits your arm size, as an improper fit can affect the accuracy of the measurement reading. Measure your upper arm and refer to the size guide on the cuff box for guidance.
- Look for models that have been validated in studies (some brands say “clinically validated” on the package).
- Bring the cuff to the clinic and compare it with the clinic machine to make sure it reads close to the doctor’s reading.
Tracking Progress
A simple paper or digital notebook works. Each entry should say:
- Date and time
- Blood pressure numbers (e.g., 128/76)
- Which arm was used
- How the person felt (okay, dizzy, tired)
- Any medicines taken that day or changes
Bring this log to doctor visits. It helps the health team know what to do next. Many apps and devices also let you print or share the readings.
Management
Management often involves two components: lifestyle changes and medication. The best steps depend on the person’s readings, age, and other health issues.
Lifestyle Changes Doctors Often Recommend
- Eat more fruits and vegetables and fewer salty foods.
- Be active and walk or move most days of the week.
- Keep a healthy weight.
- Limit alcohol and don’t smoke.
- Manage stress and sleep well.
Medications
If lifestyle changes are insufficient or blood pressure is too high, doctors may prescribe medication. There are many types of blood pressure medicines. The doctor will select one that best suits the person’s health needs and monitor for any side effects. Caregivers can help by keeping a list of medications and ensuring the person takes them as prescribed by the doctor.
Making a Blood Pressure Plan with the Health Team
A good plan has clear steps. Caregivers and patients can ask the doctor:
- What blood pressure number should we try to reach?
- What medicine should the person take and when?
- What side effects should we watch for?
- When should we come back for a check-up?
- How often should I check my blood pressure?
Write these answers down or keep them on your phone so you and the caregiver know what to do each day.
Small everyday steps that help control blood pressure
You don’t have to change everything at once. Small steady steps can help:
- Cook with herbs and spices instead of salt.
- Walk 10 minutes after a meal. Add 5 minutes every week.
- Swap one salty snack for a piece of fruit each day.
- Keep medicines in a pill box and set phone alarms for when to take them.
- Ask a friend or family member to join you for walks or healthy meals.
Myths and facts
- Myth: You will always feel high blood pressure.
Fact: High blood pressure often has no symptoms. That’s why checking it is essential. - Myth: If I feel fine, I don’t need medicine.
Fact: People can feel fine and still have high blood pressure that can harm the heart or kidneys over time. Follow the doctor’s plan. - Myth: Salt is the only thing that affects blood pressure.
Fact: Salt is important, but weight, activity, medicines, stress, and sleep also matter.
When to call for help (urgent signs)
If a person has any of these, get medical help right away:
- Chest pain or pressure
- Trouble breathing
- Sudden weakness or trouble talking
- Fainting or being hard to wake up
- Very fast or uneven heartbeat
These could be signs of a serious problem and you should call emergency services right away.
How Caregivers Can Help
Caregivers play a significant role in helping a loved one manage their blood pressure. Here are practical ways to help:
- Learn: Know what the blood pressure numbers mean and the target range for your loved one.
- Record: Buy a validated upper-arm home cuff that fits and keep a log of home readings with date and time. Many devices store readings too. Make sure the person rests for 5 minutes before readings
- Remind: Help with taking medicines, refilling prescriptions, and going to doctor visits.
- Support healthy habits: Help plan meals with less salt, encourage walks or light exercise, and help them get enough sleep.
- Watch for problems: If the person feels dizzy, faint, or has chest pain or shortness of breath, get medical help right away.
- Talk with the health team: Share home readings and any changes in how the person feels. Caregivers can help doctors by providing clear information and discussing any side effects that occur, such as dizziness or swelling. Call for help if there are urgent signs (chest pain, sudden weakness, trouble breathing).
- Cultural and food habits: Food is part of culture. Instead of removing favorite foods, try making recipes with less salt or using fresh ingredients. Practical, respectful changes are more effective than sudden, drastic ones.
You Are Not Alone
Understanding blood pressure can feel overwhelming at first, but remember, you don’t have to carry this journey alone. Whether you are checking your own blood pressure or caring for someone you love, every small step makes a difference. Writing down readings, helping with medicines, cooking a lower-salt meal, or simply offering encouragement all add up over time.
High or low blood pressure is not a personal failure; it is a health condition, and with the proper support, it can be managed. Many people live long, whole lives by working closely with their healthcare team, making steady changes, and relying on family and caregivers.