Blood pressure high bottom number what does it mean

Overview

What do your blood pressure numbers mean?

Blood pressure is a measure of the force of blood against the walls of your arteries. Blood pressure readings include two numbers. The first number is the systolic pressure (top number). This is the force of blood on the artery walls as your heart pumps. The second number is the diastolic pressure (bottom number). This is the force of blood on the artery walls between heartbeats.

If the top number stays high, or the bottom number stays high, or both, that means you have high blood pressure (hypertension). It's normal for blood pressure to go up and down throughout the day. Your doctor will give you a goal for your blood pressure.

What can cause blood pressure to go up or down?

It's normal for blood pressure to go up and down throughout the day. Things like exercise, stress, and sleeping can affect your blood pressure. Some medicines can cause your blood pressure to go up. These medicines include certain asthma medicines and cold remedies.

A low blood pressure reading can be caused by many things, including some medicines, a severe allergic reaction, or an infection. Another cause is dehydration, which is when your body loses too much fluid.

When should you call your doctor?

One high or low blood pressure reading by itself may not mean you need to call for help. If you take your blood pressure and it is out of the normal range, wait a few minutes and take it again. If it's still high or low, use the following guidance.

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

• Your blood pressure is much higher than normal (such as 180/120 or higher).
• You think high blood pressure is causing symptoms such as:
  • Severe headache.
  • Blurry vision.
• You are dizzy or lightheaded, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor if:

• Your blood pressure measures higher than your doctor recommends at least 2 times. That means the top number is higher or the bottom number is higher, or both.
• You think you may be having side effects from your blood pressure medicine.

Credits

Current as of: March 9, 2022

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine

High Blood Pressure/Hypertension

Not what you're looking for?

What is high blood pressure?

Blood pressure is the force of the blood pushing against the artery walls. The force is made with each heartbeat as blood is pumped from the heart into the blood vessels.  This is called systolic blood pressure. Blood pressure is also affected by the size of the artery walls and their elasticity. Each time the heart beats (contracts and relaxes), pressure is created inside the arteries.  When the heart is relaxed, the arteries stay at a lower resting tone to maintain some pressure in the artery. This is called diastolic blood pressure. 

High blood pressure is when the force of the blood is too high during heart contraction or relaxation within the arteries. The arteries may have an increased resistance against the flow of blood. This causes your heart to pump harder to circulate the blood.

What causes high blood pressure?

These factors may cause high blood pressure:

• Being overweight
• Having lots of salt in your diet
• Not getting much physical activity
• Family history of high blood pressure
• High stress levels
• Not getting enough sleep
• Excessive alcohol use
• Kidney disease

Who is at risk for high blood pressure?

More than half of all adult Americans have high blood pressure. You are at risk for it if you:

• Have diabetes, gout, or kidney disease
• Are African American, especially if you live in the southeastern U.S.
• Are middle-aged or older
• Have a family history of high blood pressure
• Eat a lot of high-salt foods
• Are overweight
• Drink a lot of alcohol
• Take birth control pills (oral contraceptives)
• Have depression
• Are pregnant
• Smoke or use e-cigarettes
• Use stimulant drugs such as cocaine or methamphetamine

What are the symptoms of high blood pressure?

High blood pressure often has no symptoms. But you can find out if your blood pressure is higher than normal by checking it yourself or by having it checked regularly by your healthcare provider.

Very high blood pressure can cause symptoms. These include headache, changes in vision, or chest pain.

How is high blood pressure diagnosed?

Blood pressure is measured with a blood pressure cuff and stethoscope by a nurse or other healthcare provider. You can also take your own blood pressure with an electronic blood pressure monitor. You can find one at most pharmacies.

Two numbers are recorded when measuring blood pressure:

• The top number is the systolic pressure. This is the pressure inside the artery when the heart contracts and pumps blood through the body.
• The bottom number is the diastolic pressure. This is the pressure inside the artery when the heart is at rest and is filling with blood.

Both the systolic and diastolic pressures are recorded as mm Hg (millimeters of mercury). This recording represents how high the mercury column in the blood pressure cuff is raised by the pressure of the blood.

Blood pressure is rated as normal, elevated, or stage 1 or stage 2 high blood pressure:

• Normal blood pressure is systolic of less than 120 and diastolic of less than 80 (120/80).
• Elevated blood pressure is systolic of 120 to 129 and diastolic less than 80.
• Stage 1 high blood pressure is when systolic is 130 to 139 or diastolic is 80 to 89.
• Stage 2 high blood pressure is when systolic is 140 or higher or diastolic is 90 or higher.

Even higher blood pressure (with the systolic blood pressure 180 or higher, the diastolic blood pressure more than 120, or both) is called a hypertensive urgency if there are no related symptoms. Or it's called a hypertensive emergency if there are symptoms indicating damage to the brain, heart, or kidneys. If you have a hypertensive urgency, you may need a change in your medicine right away or be evaluated in an emergency room. If you have a hypertensive emergency, you will need to be evaluated in an emergency room; and likely have a stay in the hospital.

A single higher blood pressure measurement does not always mean you have a problem. Your healthcare provider will want to see several blood pressure measurements over a number of days or weeks before diagnosing high blood pressure and starting treatment. Ask your provider when you should call if your blood pressure readings are not in the normal range.

How is high blood pressure treated? 

Treatment for high blood pressure may involve:

Lifestyle changes

These healthy steps can help you control your blood pressure:

• Choose foods that are low in salt (sodium).
• Choose foods low in calories and fat.
• Choose foods high in fiber.
• Stay at a healthy weight, or lose weight if you are overweight.
• Limit serving sizes.
• Get more exercise.
• Drink fewer or no alcoholic beverages.
• Reduce stress.
• Get enough quality sleep.
• Quit Smoking.

Certain medicines

Sometimes you may need to take 1 or more daily medicines to control high blood pressure. Take it exactly as directed.

If you have high blood pressure, have your blood pressure checked routinely and see your healthcare provider to watch the condition.

What are possible complications of high blood pressure?

High blood pressure raises your risk for:

• Heart attack
• Heart failure
• Stroke
• Kidney failure
• Loss of eyesight
• Death

How do I prevent high blood pressure?

You can help prevent high blood pressure with many of the same healthy steps used to treat it. These are:

• Cut back on salt (sodium) in your diet.
• Eat foods that are low in calories and fat, and high in fiber.
• Stay at a healthy weight, or losing weight if you are overweight.
• Exercise more.
• Stop smoking tobacco and e-cigarettes.
• Drink fewer or no alcoholic beverages.
• Get enough sleep.
• Don’t use stimulants or illegal drugs.

Key points about high blood pressure

• High blood pressure is when the force of the blood pushing against the artery walls is too high. This causes your heart to pump harder to circulate the blood.
• Risk factors include being overweight, having a family history of the disease, and being older.
• There are often no symptoms.
• Two numbers are recorded when measuring blood pressure. High blood pressure is when the top number (systolic pressure) is 130 or higher or the bottom number (diastolic pressure) is 80 or higher.
• Lifestyle changes and medicines may help treat high blood pressure.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Steven Kang MD

Medical Reviewer: Ronald Karlin MD

Medical Reviewer: Stacey Wojcik MBA BSN RN

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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