Pragmatic answer, enough elevation of blood pressure to matter. Untreated hypertension reduces life expectancy.
Systolic and diastolic blood pressure are the peak and trough of the wave of pressure transmitted along the arteries by your heartbeat.
Systolic matters more. Life insurance company statistics for men aged 35 when taking out a policy, showed reduced life expectancy of 4 years at 130mmHg systolic pressure, 9 years at 140mmHg and 16 years at 150mmHg.
Practical answer, indirectly by squashing the artery flat and slowly releasing the squash while listening or feeling for the return of flow down the artery.
The mmHg refers to the height of a mercury column maintaining the squash. Mercury manometers are still the gold standard by which other blood pressure measuring devices are checked.
If you own one of the latter, you should ask your doctor or a technician to check it against exactly that standard, once a year or so.
Using a mercury manometer and an appropriate size¹ arm cuff, one listens for the first squirting sound as the pressure is slowly reduced. The pressure now is the systolic.
The first flow through the narrowed artery is quite turbulent, as from a tap turned fully on.
The next reading is taken as the point when all sound vanishes, when smooth ("laminar") flow is restored. This is approximately the diastolic - not exact, but close enough.
Ideal answer (gold standard) - with 24 hour monitoring.
Readings obtained this way correlate best with eventual outcomes.
Next best is to measure your own blood pressure at home, then readings taken by a nurse and least useful are readings taken by your doctor.
I'm a doctor, and I take a lot of blood pressure readings. I do my best to ensure people are feeling comfortable and at ease, BUT one is visiting the doctor because of serious stuff - ones health. No matter how well you get on with your doctor, there will always be that element of concern - even in the absence of a "white coat."
Definitely don't wait. Strike while the iron is hot. Anything you do to reduce your blood pressure will help you to feel better in other ways.
Well, almost anything.
I'm not talking about tasteless² food nor about pharmaceutical drugs. They have their place, but not when first told about your blood pressure being elevated.
Malignant hypertension³ used to have 50% mortanlity in 12 months. High blood pressure symptoms, including waking with headache at the back of ones head and ringing ears, are quite uncommon.
One could have a stroke anytime, and the risk of this complication is reduced within a few months of starting effective treatment.
Despite these possibilities, there is seldom any need to immediately go for drug treatment, if one is prepared to change the underlying causes of the condition.
For most people, more exercise and less food are good starters. Less and better quality may be needed. The content of minerals such as calcium, magnesiium and potassium is important. One may have specific food intolerances which are increasing the blood pressure (even without causing any othe symptoms.)
Dr. Jonathan Wright⁴ also lists reducing insulin levels, biofeedback, vitamins C and D, tryptophan, taurine, arginine, co-enzyme Q10, omega 3 DHA, olive lea, sarpaganda and chelation for heavy metals.
I think the RESPeRATE device is useful.
You can have your own page on this site, be anonymous if you prefer, and help other people or get useful opinions.
1. The standard size for adult arms up to 12 inches diameter, then the next larger cuff. Your doctor should have measured your arm if there is any doubt which to use.
2 Somewhere between 5-15% of (mostly long standing) essential hypertension, responds to reducing dietary sodium chloride. The rest do not.
3. This was extremely high, like 240/140, combined with evidence of damage to both eyes and kidneys.
4. Library of Food and Vitamin Cures, 2011, NewMarket Health Publishing.
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