Blood Pressure

Blood pressure is defined as the pressure that is exerted by the blood on the walls of the blood vessels, particularly the arteries. Blood pressure is affected by many factors including: the strength of the heart muscle contractions, blood volume and viscosity, overall health of the body’s blood vessels, and the age and health of the individual. When blood pressure is abnormally high, this is called “Hypertension”.

How is blood pressure measured?

Blood pressure is measured as two numbers: “Systolic” Pressure (when the heart muscle contracts pushing blood into the circulatory system) and “Diastolic” Pressure (when the heart relaxes following contraction to allow it to refill with blood). Blood pressure readings are expressed as systolic pressure “over” diastolic pressure and written as: 120/80 This level is the “benchmark” for a healthy resting blood pressure.

For the blood pressure to be accurately measured, a person should be sitting quietly for at least 5 minutes. The blood pressure cuff should be placed on the bare (not over clothing) upper arm, and 2 or 3 separate measurements made over several minutes, and the average of the readings recorded.

When am I at risk?

If your resting blood pressure is consistently above the benchmark 120/80 level at rest, you may be at increased risk for many of the adverse effects of hypertension over time. These can include any combination of the following: a stroke caused by bleeding from or blockage of arteries in the brain, damage to the retina of the eye with loss of vision, coronary artery heart disease, heart attack, heart failure, kidney damage leading to kidney failure, and vascular atherosclerotic changes (“hardening of the arteries”) including the development of areas of stenosis (severe narrowing with restriction of blood flow) and aneurysms (weakening of areas of the artery walls causing ballooning with pressure on surrounding tissues or rupture with bleeding).

For both men and women, long term exposure to elevated blood pressure has also been found to be a cause earlier sexual dysfunction (erectile dysfunction in men and vaginal effects in women leading to decreased desire, arousal and difficulty achieving orgasm).

Blood pressure guidelines

It is likely that almost one in four persons in the U.S. has high blood pressure (hypertension). Almost a third of those are unaware, because there are usually no symptoms until the blood pressure becomes dangerously high or has existed for long enough for secondary symptoms to develop. Until recently, the generally accepted standard for classification of blood pressure readings has been that published by the Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, and reproduced in the table below.

JNC Blood Pressure Guidelines
Category	Systolic Reading	and/or	Diastolic Reading	Recommendation
Normal	Less than 120	AND	Less than 80	Check every 2 years
Pre-hypertension	120-139	OR	80-89	Check every year
Stage 1 hypertension	140-159	OR	90-99	See your physician or other healthcare provider for advice
Stage 2 hypertension	160+	OR	100+	See your physician or other healthcare provider for advice

In 2017 both the American Heart Association (AHA) and the American College of Cardiology (ACC) called for research-based stricter guidelines for blood pressure classification shown below. Their report additionally notes recommended interventions consisting of lifestyle changes and the use of medication at lower levels of blood pressure than had previously been recommended by the JNC. If the newer guidelines are more universally adopted, it will increase the percentages of people falling into categories of hypertension (with estimates as high as 45%) and will increase the numbers of persons for whom antihypertensive (blood pressure lowering) medications will be recommended. Controversy over the AHA/ACC recommendations continue, but for now, at a minimum, the JNC Guidelines should be set as a goal for blood pressure management, with an awareness that at some point in the future, the stricter guidelines could be implemented.

American Heart Association / American College of Cardiology Blood Pressure Guidelines
Category	Systolic Reading (upper number)	and/or	Diastolic Reading (lower number)
Normal	Less than 120	AND	Less than 80
Elevated	120-129	AND	Less than 80
High Blood Pressure (Hypertension) Stage 1	130-139	OR	80-89
High Blood Pressure (Hypertension) Stage 2	140 or higher	OR	90 or higher
Hypertension Crisis (consult your physician immediately)	higher than 180	AND/OR	Higher than 120

Early detection

Early detection is the key to avoiding acute hypertensive crisis and secondary conditions and complications mentioned above that are associated with long term untreated hypertension. There are blood pressure stations located throughout the IU Bloomington campus, at local area pharmacies, and you are always welcome to come to the Student Health Center to have your blood pressure checked (no charge for BP check only).

The Student Health Center also offers Nutrition Counseling with registered dieticians through our Health and Wellness department. Your first appointment is free, and your student health fee includes one free 60-minute session each semester. Virtual visits are available.

You are also welcome to make an appointment with one of the Student Health Center medical providers for further discussion regarding your blood pressure.

Make changes that matter

Eat a well-balanced, low-salt diet
Limit alcohol (especially avoidance binge drinking: consumption of 5 or more drinks on one occasion)
Enjoy regular physical activity (minimum 30 minutes moderate level exertional exercise at least 5 days per week)
Manage stress

Maintain a healthy weight
Quit smoking/vaping
Take your medications properly
Work together with your health care provider
Limit caffeine and stimulant medications
Maintain a regular sleep pattern

Additional Resources

Further information on blood pressure available at the following sites:

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Blood Pressure

Blood Pressure

How is blood pressure measured?

When am I at risk?

Blood pressure guidelines

Early detection

Make changes that matter

Additional Resources

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