High BP means blood pushes too hard on the artery walls.
BP is written as two numbers, such as 120/80. The top number is the push while the heart squeezes; the bottom number is the push while it rests between beats. High BP (hypertension) usually causes no symptoms at all.
In plain words.
Readings of 140/90 or more in a clinic, or 135/85 or more at home, repeated on different days, are usually called high BP. Some guidelines start from 130/80. One high reading is not a diagnosis: BP rises with worry, pain, rushing or a cup of tea.
Over years, high BP strains the heart, brain, kidneys and eyes, and raises the risk of a heart attack and a stroke. That is why it is called silent, and why measuring matters more than how you feel.
Most high BP has no single cause; it grows with age, weight, salt, alcohol, too little activity, poor sleep and family history. Sometimes another illness or a medicine is behind it, such as painkillers or kidney or hormone problems, and he will look for that.
What the two numbers mean
Each heartbeat sends a surge of blood into the arteries: the top number. Between beats the pressure falls back: the bottom number. Healthy arteries stretch with each surge.
The push stays high, beat after beat. Over years the artery walls thicken and stiffen, and the heart has to work harder to pump against them.
Go to hospital now if
- The top number is above 180, or the bottom number above 120, with headache, blurred vision, breathlessness, chest pain or confusion: call 112.
- There is chest pain, a drooping face, sudden weakness of an arm or leg, or trouble speaking, whatever the reading: call 112.
- You are pregnant or recently delivered, and the BP is 140/90 or more with headache, blurred vision, pain under the right ribs, or swelling of the face or hands, or 160/110 or more even if you feel well.
Call 112 or go to the nearest emergency department. Ambulance: 108 (102 in some states).
Speak to a doctor the same day if
- The top number is above 180 or the bottom above 120, but you feel well: sit quietly for five minutes and measure again. If it is still that high, speak to a doctor today. Keep taking your usual tablets as normal, but do not take extra ones or put a tablet under the tongue to bring it down fast. If you have chest pain, breathlessness, weakness, trouble speaking or blurred vision, call 112.
Tests that help.
Not everyone needs every test. He decides which ones are worth doing for you.
| Test | What it tells |
|---|---|
| Home BP readings | A week of readings, morning and evening, two each time. Often more useful than a single clinic reading. |
| Creatinine and urine protein | Whether the kidneys are affected, and which medicines suit you. |
| Sodium and potassium | Some BP medicines change these, so they are checked before and after starting. |
| Fasting sugar or HbA1c | Diabetes and high BP often come together. |
| Lipid profile | Cholesterol, for your overall heart risk. |
| ECG | Whether the heart has been strained by the pressure. |
Have it ready.
Tick them off as you gather them. The ticks stay on this phone only.
Online, or in person?
Do not stop BP medicines on your own because the readings look normal: the medicine is often why they are normal.
A video call can
- Go through your home readings and reports
- Look for causes and for medicines that may be raising the BP
- Start or adjust medicines, check for side effects, and follow up
- Look at your whole heart risk, not only one number
Needs a visit in person
- Listening to the heart and feeling the pulses
- Looking at the back of the eye
- Blood tests and an ECG, at a laboratory or clinic
- A very high reading with symptoms: that is an emergency
Talk it through with Dr. Arya.
Bring your reports and medicines to a video consultation. He goes through them with you, in plain words, and says clearly if you need to be seen in person.
Book a video consultationDr. Prabhat Arya · MBBS, MD (Internal Medicine) · Delhi Medical Council Reg. No. DMC-83759