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The highs and lows of blood pressure

blood pressure, heart attacks, strokes, high blood pressure, low blood pressure, Systolic, Diastolic, Hypertension, Hypotension,
The highs and lows of blood pressure

You may understand that high blood pressure can increase risk of heart attacks and strokes but do you realise a low blood pressure can be even more dangerous? So what is high, and what his low blood pressure?

When you have your blood pressure measured – do it properly. Even if a Hospital is taking the reading, it is truly surprising how many nurses just do it wrong. For example, never put the inflatable band over clothes; always have both feet on the floor; support the neck; have the elbow of the arm being measured at the same height as your heart; and calm down for 5 minutes before taking the reading. 

After taking your blood pressure, you will be given two figures. 

The higher figure – the Systolic Blood Pressure – is a measure of the highest pressure you pump the blood from your heart, when your heart ‘beats’. This forces the blood around your body.

The lower figure – the Diastolic Blood Pressure – is the lowest level your blood pressure falls to, between beats.

The blood pressure is measured in millimetres of mercury (mmHg) and a ‘target’ ideal level has been set at 120/80. The first number is 120, the second 80. People say, “I was 120 over 80”, if asked with these measurements.

High Blood Pressure (Hypertension)

The ideal Systolic level is 120 mmHg, but it tends to rise as we age, although it doesn’t need to if you eat properly and take exercise. A ‘normal’ level would go up to 140 mmHg. Above this you have high blood pressure, with levels above 170 mm/Hg being cause for real concern. 

The ideal Diastolic level is 80 mmHg, and up to 90 mmHg would be regarded as a little high. Anything over 90 mmHg and it is time to take action.

Danger levels

Everybody knows that high blood pressure is a warning sign of stroke risk or heart attack risk.

But did you know that so too is low blood pressure?

Normal Blood Pressure

Current thinking defines ‘normal’ blood pressure as 120/80 down to 90/60.

Low Blood Pressure (Hypotension)

This is defined as having 

  • Systolic Blood Pressure below 90 mmHg; and/or
  • Diastolic Blood Pressure below 60 mmHg

If one or both of these figures is below the above, you may feel fatigued, thirsty, faint or dizzy, especially when you turn suddenly. Blurred vision is another possibility. 

It may also be a sign of another health issue; and a sudden fall in blood pressure can be dangerous. Endocrine disorders, dehydration, shock and severe infection need to be ruled out.

But one more thing, and this is important – A low Diastolic level is also now being studied as another warning sign of stroke or heart attack risk.

However, there is not much research to back this idea up. 2016 research (1) in the Lancet from a number of International Institutions including Imperial College London, followed 22,672 people across 5 years; all of whom had high blood pressure and were treated for Hypertension.  Results suggested that people over 140 mmHg and/or 80 mmHg had a higher risk of stroke and heart attack. 

However, the research cautioned against over-enthusiastic blood pressure control. The research suggested that people on blood pressure medication be monitored in case levels fell too low.

Patients below 120/70 also had an increased risk of heart attack, though not of stroke. Infact, the lower the blood pressure the better the outcome where stroke was concerned.

Is there a different set of figures for men and women?

From recent research it looks like, at the upper end, there is. In a 2020 study (2) from Cedars Sinai Medical Centre in LA, it looks like heart attack risk starts above 120 mmHg in men, and above 110 mmHg in women. For heart failure, female risk at 110-119 mmHg was the same as for men at 120-129 mmHg. 

For a stroke the same level of risk was observed for women between 120 and 129, as men between 140 and 149 mmHg. 

How can you tackle Blood Pressure warning signs?

First, you may have to come off your blood meds if you are too low!

Next, almost every expert would suggest that you cut your salt intake – it can cause too high or even too low a level.

Then the recommendation would be to eat properly – avoiding saturated fat as much as possible, avoiding processed meats, avoiding empty calorie, refined foods and sugar, eating healthy oils like Extra Virgin Olive oil and oily fish/fish oils, nuts and seeds, whole grains like oats for breakfast, fruits and vegetables. 

And to take exercise – 4 sessions a week of 45-60 minutes where you are out of breath for at least 25 minutes.

Vitamins and minerals are important. Number one is Vitamin D – if you cannot go in the sun with some bare skin for 90 minutes take the American Bone Health’s suggestion and supplement with 2500 IUs a day (67 microgram). Then you should supplement with Magnesium (350 mg per day) and, if over 70 years of age, a trace mineral supplement containing minerals such as Boron and Phosphorus. Folate and sources of plant iron are important, but beware calcium pills.

You really should consult a Doctor whether you are too high, or too low.

Go to: Adopting the Colourful Mediterranean Diet significantly reduces death rate from strokes and heart disease

Go to: What can I eat on a colourful Mediterranean Diet?


  1. https://www.imperial.ac.uk/news/174231/low-blood-pressure-associated-with-heart/
  2. Sex differences in Blood Pressure Trajectories, JAMA Cardiol, 2020 January, 5 (3) 255-262 https://jamanetwork.com/journals/jamacardiology/fullarticle/2758868