• Your blood pressure fluctuates throughout the day. Normally, it is at its
highest shortly after you awake in the morning, and it reaches its
lowest level some time while you are asleep. A fluctuation between
maximum and minimum systolic blood pressure levels of about
20mmHg is considered normal.
Blood Pressure Fluctuation
During the Day (Example)
Bevan, Honour & Stott : Clin. Sci (1969)36,329-344
The above is upper arm blood pressure data.
• A rise in blood pressure can be caused by physical exercise, drinking
coffee or tea, smoking, the need to urinate, and other factors.
• Blood pressure is also affected by your physical condition, as well as
stress due to your emotional state, worry, etc.
• A blood pressure reading can also be affected by your posture when
the reading is taken. Normally, your blood pressure will be lower if you
are sitting instead of standing.
• Temperature and humidity can also affect blood pressure. Normally,
winter blood pressure readings tend to be higher than summer
Definitions and Classification of Blood Pressure Levels
Though the general rule of thumb for normal systolic (maximum value)
blood pressure is your current age plus 90, this is not always necessarily
true. The following chart shows some general guidelines for blood
• The following tables show classifications for hypertension (high blood
pressure) according to the World Health Organization (WHO) and the
International Society on Hypertension (ISH) (1999).
Systolic Blood Pressure (mmHg)
Up to 120 120 to 129 130 to 139
Up to 80
80 to 84
85 to 89
90 to 94
90 to 99
Grade 1 Hypertension ("mild")
100 to 109
Grade 2 Hypertension ("moderate")
Grade 3 Hypertension ("severe")
110 or greater
• When diastolic blood pressure is up to 90mmHg, systolic blood
pressure greater than 140mmHg is classified as Isolated Systolic
Hypertension, while systolic blood pressure within the range of 140 to
149mmHg is classified as Subgroup: Borderline Isolated Systolic
140 or greater
140 to 149
Borderline: Subgroup Isolated
Up to 90
Why is high blood pressure a cause for concern?
As its name implies, high blood pressure causes arteries to be exposed
to high pressure, and can cause lesions in the arteries that supply blood
to brain, heart, liver, and other vital organs. Left untreated, high blood
pressure can lead to loss of heart function, hardening of the arteries, and
a host of other problems like those described below.
• Aneurysms in the brain's blood vessels, which can lead to stroke
• Enlargement of the heart, which can lead to heart failure
• Narrowing of blood vessels in the kidney, which can lead to kidney
• Premature hardening of the arteries throughout the body, especially
those in the heart, brain, and kidneys, which can lead to heart attack,
stroke, or kidney failure
140 to 159
160 to 179
140 to 149
Systolic Blood Pressure (mmHg)
What does low blood pressure indicate?
Some symptoms of low blood pressure are chronic fatigue, dizziness,
shoulder stiffness, palpitation of the heart, and shortness of breath. Be
sure to contact your physician if you suffer from any of these symptoms.
Monitoring Blood Pressure Levels on Your Own
When is the best time to take readings?
You should take readings during which you are most relaxed and stable.
It is also important to take readings at the same times everyday, every
morning, noon, and night, for example. Of course, you can also take
readings at any other time you wish, but the important thing is to take
blood pressure readings an integral part of your overall health control
Be sure to keep records.
Your blood pressure will fluctuate with changes in your physical
condition and even the weather. Because of this, you should keep a
record that includes not only measured values, but also information
about your physical condition and surrounding conditions. Try making it
your goal to build an entire year of daily records.
• You can make copies of the "BLOOD PRESSURE RECORD" at the
back of this manual and use them to keep track of changes in your
blood pressure and pulse measurements.
Is there anything I should do before taking a reading?
First of all, try to relax. Take five or six deep, cleansing breaths. Also,
note the following pointers.
Take readings in a quiet location.
Select a comfortable location that is free of loud noise and vibration, and
is neither overly hot nor cold. A temperature of about 20°C is best.
Take readings while you are calm.
Avoid times when you are worried or otherwise emotionally upset, and
after eating, exercise, or drinking coffee.
Maintain good posture during readings.
Keep your arm and wrist at about the same height as your heart. It is
also important to be free if tension.
Take readings at the same time everyday.
Remember that blood pressure is constantly changing. Try to take your
readings at the same time each day.
Why are values produced by readings I take at home
different from values produced when my doctor takes
Slight tension caused by a visit to the doctor or a hospital can cause
blood pressure readings taken there to be a bit higher. This, of course,
assumes that you are following the correct procedures when taking your
readings at home.
It could be due to a condition called "white-coat hypertension."
"White-coat hypertension" is a condition caused by the atmosphere that
is present in a hospital. It is an emotional condition, and does not
indicate a physical problem. It is important to be relaxed while taking a
blood pressure reading.
Controlling Blood Pressure
How you live your daily life is an important factor in achieving good blood
pressure. Improved living habits and patterns can actually decrease the
chance of high blood pressure. The first step on the road to proper living
is eliminating overexertion and stress.
The following are some proven tips for developing good living habits and
enjoying the benefits of good blood pressure.
• Reduce salt intake.
• Go to bed early and get up early.
• Eat regular meals every morning, noon, and night.
• Get enough sleep.
• Set aside enough time for yourself in order to get some stress relief.
• Try to achieve a balance between your mental and physical well