The information below is designed to help you understand what your latest blood pressure readings may mean for your health -- and to provide tips on what you can do to get or keep your blood pressure in a healthy zone.
NOTE: This information isn't a substitute for medical advice provided by your doctor. If you think you might have hypertension or elevated blood pressure, be sure to discuss your blood pressure concerns with a doctor or nurse, who can help you factor in other important information, such as other medical problems you may have. In particular, the information below may not always apply to those who are very old, very frail, or have multiple chronic medical conditions. View the full blood pressure chart.
Definitions of blood pressure terms
Systolic (the upper number in the reading) is the pressure in the arteries when the heart beats; it measures how hard the heart muscle is working to pump blood throughout the body.
Diastolic (the lower number in the reading) is the pressure of the blood against the blood vessel walls between heartbeats when the heart is relaxed.
What a blood pressure reading of 138/87 means
Readings between 130/80 and 139/89 usually indicate STAGE 1 HYPERTENSION, which means the force of the blood pressure in your arteries is higher than normal, putting you at increased risk of life-threatening problems such as heart attacks and stroke. Blood pressure in this range can also damage organs such as the heart and the kidneys, especially in people who already have chronic medical problems affecting these parts of the body.
If you're already being treated for hypertension, and your blood pressure is in this range, you may need to have your medications adjusted.
If you've never been diagnosed with high blood pressure before, you may have developed hypertension. Hypertension is defined as a systolic blood pressure at least 130, or a diastolic blood pressure at least 80. For a new diagnosis, hypertension should be confirmed on at least 2 office visits after an initial screening.
What to do if your blood pressure reading is 138/87
Discuss your blood pressure concerns with your doctor. If you're already on medications, they probably should be adjusted. If you aren't on medications, it may be reasonable to start with a trial of lifestyle changes, although many people ultimately need medication to get their blood pressure into the normal range.
Ask your doctor to check for other conditions that can worsen high blood pressure, such as sleep apnea.
Ask your pharmacist or doctor if you're on any medications that can worsen high blood pressure (these can include NSAIDs, as well as some antidepressants).
Monitor your blood pressure regularly to make sure it responds to the treatment plan.
Consider getting a home blood pressure monitor that uses an arm cuff and check your BP every few days to make sure it responds to medication. (Wrist and finger monitoring systems don't give accurate results.) Write down each reading, indicating the date and time, and bring this record to the doctor when you visit.
Make lifestyle changes:
Lose weight or maintain healthy weight.
Increase physical activity.
Lower salt intake to less than 2g per day (most Americans get 5 to 10 grams a day).
Caring for those ages 80 and over
The treatment of high blood pressure in this range has been debated for years among geriatricians and other experts in the care of older adults. In most cases, geriatricians prefer to not start or increase blood pressure medications unless an older person's systolic pressure is often above 140. (This is assuming that the older person doesn't have heart failure or another chronic medical condition that will benefit from better blood pressure control.)
Here's why: Although research studies have shown that adults ages 70s to 80s do benefit from treatment of high blood pressure, almost all the studies involved getting people's blood pressures down from a starting average systolic of 170 to a systolic in the 140s.
In general, the higher the starting blood pressure, the more likely it is that someone will benefit from a reduction of 20mm or so. (This seems to be true in middle-aged adults as well.)
On the other hand, as people get older or more chronically ill, they become more likely to develop side effects from blood pressure medications, such as dizziness when they first stand up. For this reason, if there's been any concern about falls or dizziness, make sure that blood pressure has been checked for "postural" or "orthostatic" changes. Some older people feel better once their blood pressure medications have been reduced a bit.
Sources: Leslie Kernisan, MD; Robert Ostfeld, MD, M.Sc., FACC; Farrokh Sohrabi, MD; Carolyn Strimike, RN, MSN