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Harvard Commentaries
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Harvard Commentaries
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Heart and Circulatory Conditions Ask The Expert, High Blood Pressure Ask The Expert, Ask The Expert Heart and Circulatory Conditions Ask The Expert, High Blood Pressure Ask The Expert, Ask The Expert
 

I have high blood pressure. But my blood pressure varies a lot during the day, especially the top number. Which blood pressure reading should I use: the lowest, the highest or the average?


February 19, 2013

A:

You’re right that blood pressure varies. If you dash up two flights of stairs or pick up something heavy, it may surge 30 to 40 points or more. The strain doesn’t have to be purely physical. Arriving late for your doctor’s appointment or being worried about work might also cause a temporary spike.

But blood pressure is important as a reflection of the average stress on your arteries. So it’s the average reading that’s important, not the ups and downs.

It sounds like you measure your own blood pressure at home. That’s great. I suggest taking a few measurements during a routine day and then averaging them. As long as you feel fine, don’t get alarmed or misled by an occasional high or low reading.

For many decades, doctors have used readings above 140/90 to define high blood pressure. But recently, we realize that certain people should strive for lower numbers and other people are better off with higher readings.

For example, people with diabetes or kidney disease should aim for a lower average reading, around 130/80. And people over age 80 might do better with a blood pressure of 160/90.

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