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Is Blood Pressure Value Of 130/90 A Cause For Concern?

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Posted on Mon, 12 Oct 2015
Question: Hi Doc,
I have a query regarding blood pressure:
My BP was 130/90 when it was taken in evening by GP. But in my health check-up package (after fasting 12-14 hours) in morning it was 110/80.
Which Blood pressure is considered to be accurate ?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (29 minutes later)
Brief Answer:
Both may be possible.

Detailed Answer:
Hello XXXXXXX

Blood pressure is a measurement of the pressure in your arteries, and it can vary from minute to minute. For this reason, if a patient has rushed a bit to the appointment or is nervous, and if the blood pressure is borderline elevated, I will recheck it again at the end of the appointment to make sure I am not recording what we sometimes call a "white coat effect" (nervousness from seeing a doctor).

In general, we do not consider one blood pressure reading to be significant in itself. To diagnose hypertension, doctors are encouraged to have at least 3 blood pressure readings over a period of time. If a blood pressure reading is borderline elevated, such as the 130/90, and if I am concerned that it is from nervousness from a dr. visit, I have patients retake their blood pressures at home or in the community, several times, and keep a record.

The exception to this rule is if the first blood pressure reading is severely high (hypertensive crisis) or severely low (hypotension) in which case we take action because the patient needs immediate treatment. Your blood pressures were not in an unsafe range.

There can be some variation from one blood pressure machine to the next, but if they are of any quality, the difference won't be great between the machines.

It's possible that your morning fasting blood pressure was taken when you had not had any caffeine (tea, coffee), and had not been stressed by a long day of work or activity, compared with the evening reading.

So what I would recommend is, if you have access to a blood pressure machine, or if not, if your doctor's nurse is willing to have you just come in for BP readings, to keep an index card listing the date, time, and blood pressure readings, and do several of them.

If your readings are consistently over 120 (upper) or over 80 (lower), then consider at first making lifestyle changes such as decreasing salt, alcohol, weight loss if you are overweight, discontinuing cigarettes if you smoke.

If they remain elevated, then see your doctor. High blood pressure is blood pressures over 140 (upper) and 90 (lower). When we see multiple readings over these numbers then we consider starting a blood pressure lowering medicine. My guess is that you will not be in this category, given your reading of 110/80.

I hope this information has been helpful. Please let me know if I can provide further information or clarification.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (15 minutes later)
Thanks doc for this valuable information!

I want clarification of : It is observed that whenever my BP was checked in last one year (may be 4-5 times) the readigs were 130/90, 137/87, 135/85 which I remembered. Do I consider that I reached to Prehypertension stage ?

My details : age 34, weight: 79 kg, hight: 172cm, Smoke: Yes, alcohol : Weekly
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (31 minutes later)
Brief Answer:
Likely given there are 3 readings consistently sl. elevated.

Detailed Answer:
Given these 3 readings, I would say yes, this looks like prehypertension. Still, you may be able to modify your blood pressure and not have to take blood pressure medication.

Weekly use of alcohol can sometimes be a bigger problem than daily use IF you have multiple drinks at a time. Best to cut down to 1 drink/day if that applies to you.

Smoking can be a very difficult thing to give up. It is both physically addictive and psychologically dependency forming. I see you are in XXXXXXX and I am not sure what resources are available to you for help with quitting (if you feel ready to do so) such as support groups, phone quit-smoking counselors, etc.

For medical help with quitting smoking, if you smoke more than 1 pack/day, then your body is likely addicted to nicotine to some extent, and nicotine patches can help. There are also nicotine receptor medications (oral pills by prescription).

I have had patients have considerable success with the drug Zyban for quitting. It is the antidepressant buproprion, but it also helps greatly with urges, specifically the desire to smoke. It can be used with the nicotine patches. Increasingly, research is showing a number of antidepressants may have potential for easing cravings and feeling down during smoking cessation.

Relaxation techniques may help decrease stress that can elevate blood pressure.

A lot of caffeine can elevate BP too, so keep an eye on that.

Salt intake is more questionable. In some people who are "salt-sensitive", decreasing salt can make a big difference in blood pressure. For others, restriction doesn't make as much of a change.

When I see patients who have blood pressures that are in the prehypertensive range (and not elevated because they had come in to office during pain or illnesses that would raise their pressures), I have them try these lifestyle modifications, and recheck in 3-6 months. Three months is sometimes best for helping provide motivation for lifestyle changes.

If a patient has a strong family history of cardiovascular disease, I tend to be more aggressive about starting antihypertensive meds sooner.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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Is Blood Pressure Value Of 130/90 A Cause For Concern?

Brief Answer: Both may be possible. Detailed Answer: Hello XXXXXXX Blood pressure is a measurement of the pressure in your arteries, and it can vary from minute to minute. For this reason, if a patient has rushed a bit to the appointment or is nervous, and if the blood pressure is borderline elevated, I will recheck it again at the end of the appointment to make sure I am not recording what we sometimes call a "white coat effect" (nervousness from seeing a doctor). In general, we do not consider one blood pressure reading to be significant in itself. To diagnose hypertension, doctors are encouraged to have at least 3 blood pressure readings over a period of time. If a blood pressure reading is borderline elevated, such as the 130/90, and if I am concerned that it is from nervousness from a dr. visit, I have patients retake their blood pressures at home or in the community, several times, and keep a record. The exception to this rule is if the first blood pressure reading is severely high (hypertensive crisis) or severely low (hypotension) in which case we take action because the patient needs immediate treatment. Your blood pressures were not in an unsafe range. There can be some variation from one blood pressure machine to the next, but if they are of any quality, the difference won't be great between the machines. It's possible that your morning fasting blood pressure was taken when you had not had any caffeine (tea, coffee), and had not been stressed by a long day of work or activity, compared with the evening reading. So what I would recommend is, if you have access to a blood pressure machine, or if not, if your doctor's nurse is willing to have you just come in for BP readings, to keep an index card listing the date, time, and blood pressure readings, and do several of them. If your readings are consistently over 120 (upper) or over 80 (lower), then consider at first making lifestyle changes such as decreasing salt, alcohol, weight loss if you are overweight, discontinuing cigarettes if you smoke. If they remain elevated, then see your doctor. High blood pressure is blood pressures over 140 (upper) and 90 (lower). When we see multiple readings over these numbers then we consider starting a blood pressure lowering medicine. My guess is that you will not be in this category, given your reading of 110/80. I hope this information has been helpful. Please let me know if I can provide further information or clarification.