Question 1

What is a normal blood pressure?

Accepted Answer

According to the American Heart Association (2017 guidelines), normal blood pressure is defined as systolic below 120 mmHg AND diastolic below 80 mmHg. Elevated blood pressure is 120–129/below 80. Stage 1 Hypertension is 130–139/80–89. Stage 2 Hypertension is 140+/90+. Hypertensive crisis requiring immediate attention is above 180/above 120. The previous definition of 'normal' (below 140/90) was updated in 2017 based on cardiovascular outcome evidence at lower thresholds.

Question 2

How should I measure blood pressure accurately at home?

Accepted Answer

For accurate home blood pressure readings: (1) Sit quietly for 5 minutes before measuring with back supported, feet flat; (2) Don't measure within 30 minutes of caffeine, exercise, smoking, or a heavy meal; (3) Use a validated upper-arm cuff (wrist devices are less reliable); (4) Measure at the same time daily (morning before medications is most informative); (5) Take 2 readings at least 1 minute apart and average them; (6) Record readings for 7 days to give your physician a reliable picture. One-off readings are often higher than true baseline (white coat effect).

Question 3

What causes high blood pressure?

Accepted Answer

Primary (essential) hypertension accounts for 90–95% of cases and has multiple contributing factors: excess sodium intake, physical inactivity, obesity (each 10 kg of excess weight raises BP by approximately 3–4 mmHg), high alcohol intake, smoking, stress, and genetic predisposition. Age-related arterial stiffening also elevates systolic pressure. Secondary hypertension (5–10% of cases) is caused by an identifiable condition: kidney disease, thyroid disorders, sleep apnoea, or certain medications.

Question 4

Can lifestyle changes lower blood pressure without medication?

Accepted Answer

Yes — lifestyle interventions can reduce blood pressure by 10–20 mmHg in many cases. Evidence-based measures: (1) DASH diet reduces systolic BP by 8–14 mmHg; (2) Reducing sodium intake from high to moderate reduces by 5–6 mmHg; (3) Regular aerobic exercise reduces systolic by 5–7 mmHg; (4) Weight loss of 10 kg reduces by approximately 5–10 mmHg; (5) Limiting alcohol to 1–2 drinks/day reduces by 2–4 mmHg; (6) Quitting smoking reduces by 5–10 mmHg within months. Combined, these interventions can match the effect of a single antihypertensive medication.

Question 5

What blood pressure reading is a medical emergency?

Accepted Answer

A hypertensive crisis is defined as systolic above 180 mmHg and/or diastolic above 120 mmHg. This requires urgent medical attention. If accompanied by: severe headache, visual changes, chest pain, shortness of breath, or confusion — this is a hypertensive emergency requiring immediate emergency services (call emergency services). Even without symptoms, a reading above 180/120 requires same-day medical assessment to prevent stroke, heart attack, or kidney damage.

Category	Systolic (mmHg)	Diastolic (mmHg)	Risk
Normal	<120	<80	Low
Elevated	120–129	<80	Moderate
Stage 1 Hypertension	130–139	80–89	High
Stage 2 Hypertension	≥140	≥90	Very High
Hypertensive Crisis	>180	>120	Emergency
Low (Hypotension)	<90	<60	See doctor

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