What should your blood pressure be? You’d think there’d be a simple answer to that wouldn’t you? But, then I’d have nothing to write about…
Confusing and contentious
This question causes plenty of debate among medical professionals and you may notice that advice and opinions you receive differ. This is because every few years the advice to doctors does change (and some of us are faster at catching up than others) and also because it is so complex that, being mere mortals, a lot of us can’t always remember exactly! So… you may get slightly different answers from different people.
Anyway, here’s a brief overview of how the land lies at the moment. This is based on recommendations from the National Institute for Health and Care Excellence (NICE) in the UK.
Are you otherwise well?
The first consideration in deciding what your blood pressure should be is whether you suffer from any condition which makes high blood pressure more risky. This includes conditions such as:
- Most forms of kidney disease
- Cardiovascular disease (e.g. angina or maybe you’ve had a heart attack or stroke in the past)
- Heart damage from high blood pressure (e.g. left ventricular hypertrophy)
- Damage to the back of the eye from high blood pressure (hypertensive retinopathy)
If you do suffer from any of these conditions then we like to keep your blood pressure lower than for other people. Exactly how low varies, but often as low as 130/80 mmHg.
Where were you?
The second consideration is where were you when your blood pressure was measured? We know that people get higher readings in clinic and lower readings at home. That means that there are slightly more lenient targets for clinic readings than there are for home readings. We know that home readings or 24 hour ambulatory readings are more reliable indicators of risk, so it’s best to measure away from clinic if possible. But, people do still have measurements taken at clinic so slightly higher targets have been published for that situation.
If you have no conditions that make high blood pressure more risky, the target blood pressure for readings take at home is 135/85mmHg. The equivalent for readings taken in clinic is 140/90mmHg.
Do you even have high blood pressure in the first place?
Finally, there is the issue of how high your blood pressure needs to be for you to be diagnosed with high blood pressure. The numbers above are targets to aim for once you have been diagnosed. To establish a diagnosis there are some other cut-offs (although you will see 135/85mmHg come up again) which I have written about in another post (Do you have stage 1 or stage 2 high blood pressure?) As I write in that post, even if you are above one of these targets, we shouldn’t always treat you with medication…