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Is A Blood Pressure Of 130/70 Too High? Plus, What Do Those Numbers Mean?

"Is a blood pressure of 130/70 anything to worry about?"

It's a good question, and one doctors didn't regularly field until the Joint National Committee of the American Heart Association announced its hypertension criteria in 2017. It was the first criteria upgrade since 2003. Though it's been around a while, it still causes some confusion, as not everyone is up to speed on the latest guidelines.

For years, the upper limit of normal blood pressure (BP) for all adults was 140 systolic pressure (SBP) over 90 diastolic pressure (DBP) mmHg. Higher numbers usually required treatment. With 130/70, you'd have been the envy of every hypertensive! Sorry, but that has changed.

Although it is still true that no healthy adult man or woman should have a blood pressure greater than 140/90, there are now additional guidelines to identify those at high risk for developing hypertension and cardiovascular complications.

TL;DR: Nowadays, 130/70 is, in fact, considered a cause for concern but not an emergent situation.

Related: This Is the Early Heart Attack Symptom That's Missed the Most Often, According to Cardiologists

"A reading of 130/70 mmHg falls under the category of stage 1 hypertension according to guidelines from the American College of Cardiology and the American Heart Association," explains Dr. Rigved Tadwalkar, MD, a board-certified consultative cardiologist at Providence Saint John's Health Center. "So, yes, it is a cause for attention. Although not an emergency, it is definitely a wake-up call to address your cardiovascular health."

If you have hypertension, you're not alone. The American Heart Association reports that about half of U.S. Adults have high blood pressure. Understanding what constitutes as high blood pressure, what those numbers mean anyway and how to treat and prevent hypertension are all ways to take the reigns of your health. Cardiologists discussed blood pressure numbers and ways to manage yours.

What Is Normal Blood Pressure?

According to the American Heart Association, a "normal" blood pressure is less than 120/80.

This chart can help you determine your numbers, based on the American Heart Association's criteria.

Normal

Less than 120 and

Less than 80

Elevated

120-129 and

Less than 80

Stage 1 Hypertension

130-139 or

80-89

Stage 2 Hypertension

140 or higher or

90 or higher

Hypertensive crisis (immediate attention needed)

Higher than 180 and/or

Higher than 120

It's a lot of numbers (OK, two). Still, what do they really measure, anyway?

"When you check your blood pressure, it gives two numbers over a fraction," explains Dr. Wahaj Aman, MD, a cardiologist with UTHealth Houston Heart & Vascular and Memorial Hermann. "The top number, known as systolic pressure (SBP) is the pressure in your arteries when your heart contracts. The number represents the effort your heart is using to course blood through your circulatory system."

As for diastolic?

"Diastolic blood pressure is the 'bottom number' when you measure your blood pressure and this represents the resting tone of your arteries or the pressure when your heart is in between beats and in the relaxed state, filling up with blood," says Dr. Mary Greene, MD, a cardiologist with Manhattan Cardiology in NYC and contributor to labfinder.Com.

Related: Cardiologists Say This Fatty Food Is Actually Great for Heart Health

What Does It Mean To Be Pre-Hypertensive?

You'll notice pre-hypertensive is not listed as a category in the above chart taken from the AHA guidelines. There's a reason for that: "Prehypertension is no longer a formal category based on recent definitions," Dr. Tadwalkar says. "Previously, it referred to blood pressure readings that were higher than normal but not yet high enough to be classified as stage 1 hypertension."

Dr. Tadwalkar says people were told they were "pre-hypertensive" if their systolic blood pressure values were in the 120-129 range but their diastolic numbers remained under 80 mmHg.

"This category is now called "elevated" blood pressure," Dr. Tadwalkar says. "In any case, these readings do indicate an increased risk of developing hypertension in the future."

Related: Want to Improve Your Heart Health Quickly? Here's How, According to Doctors

What Blood Pressure Stages Require Drug Treatment?

The answer to this question varies. Generally: "Medications are typically started when blood pressure is over 140/90mmHg," Dr. Aman says. In other words, hypertension stage 2 or crisis, the latter of which actually requires immediate medical assistance.

For stage 1 hypertension, the American College of Cardiology recommends medication for patients who have "already had a cardiovascular event such as a heart attack or stroke," or for those at "high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol)."

For most people with elevated or stage 1 hypertension, lifestyle interventions are typically recommended first, Dr. Greene says. These can include:

Diet, such as the Dietary Approaches to Stop Hypertension (DASH diet), an eating plan of low-sodium foods, fruits, vegetables, and low-fat dairy products

Exercising

Limiting alcohol consumption

Stress management

Weight management

Getting 7 to 8 hours of sleep each night

"Remember that even small changes in your lifestyle can significantly impact your blood pressure and your overall cardiovascular health," Dr. Tadwalkar says. "Think of it as an investment for the future. If you have any concerns about your blood pressure, consult your doctor to discuss the best course of action for you."

Whether you're taking medication or using lifestyle approaches, it's crucial to attend follow-up appointments and take your blood pressure at home as directed by your healthcare team.

"It is imperative to monitor blood pressure regularly to treat it effectively," Dr. Aman says.

So, back to the original question, 130/70 is OK in an otherwise healthy person in the sense that you don't need ASAP medical intervention. It may be managed using lifestyle tweaks. Still, it should be checked on a regular basis. Also, keep in mind that the recommendations from the American Heart Association state that BP should not be higher than 120/80 for those at risk for coronary artery disease or who already have it (angina, history of a heart attack). Speak with your doctor about the best course for your specific situation.

Up next, learn the 25 best food for high blood pressure

Expert Sources

I'm 47 And Constantly Suffer With Constipation And Diarrhoea, I've Tried Everything And Don't Know What To Do

IT'S no secret that your diet plays a big role in your overall health.

Whether you are trying to lose weight, protect your memory or boost your heart health, it's vital to watch what you eat.

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Dr Zoe helps a reader who has been suffering from constipation and diarrhoeaCredit: Olivia West

A study last week showed people who adopt "the Mind diet" had a lower risk of cognitive decline over ten years.

It's a combination of the Mediterranean and Dash diet, which is designed to lower blood pressure.

The Mind approach recommends you eat five servings of nuts, one serving of oily fish, two portions of lean poultry, four of beans and two of berries per week.

Each day, you should aim for three servings of whole grains, such as quinoa, brown rice or oats, and at least two servings of veg.

Adopting a healthier diet can be challenging, but the evidence does suggest the Mind diet might be worth a try.

Meanwhile, here's a selection of what readers have asked me this week . . . 

FEAR I'M MENOPAUSAL

Q: I'M almost 55 and the only period I have had since January was a very heavy one last month.

I seem to be experiencing all the usual menopause symptoms apart from the hot sweats.

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I suffer from chronic aches and pains and, last night, while having sex, I experienced a painful burning feeling.

Do you think these symptoms are hormone-related?

Video explains the signs and symptoms of menopause

I have asked my doctor about HRT (hormone replacement therapy) but he seems reluctant to prescribe it as I'm not having the sweats.

Any advice would be much appreciated.

 A: You are describing classical symptoms of the menopause or, strictly speaking, perimenopause as you are still having some periods.

Not everyone has hot sweats.

We all experience a different array of symptoms during the menopause transition and some are lucky to experience none at all.

I wanted to make sure this question was included in the column as I hear versions of your story all the time.

Your GP or practice nurse SHOULD have a conversation with you about your symptoms and explore the options for managing them, which should include the various forms of HRT.

It may be necessary to rule out some of the other potential causes.

Abnormal thyroid function is an example of something that can cause changes to periods and other symptoms, but it can be checked for with blood tests if your clinician deems it to be necessary.

One thing I would say is that the topic of menopause does require its own protected appointment.

Tip of the week

AT this time of year the combination of sunny days and cooler temperatures make it the perfect time to get some outdoor exercise.

Why not make the most of it by going a long hike or cycle with the family or a friend this weekend?

Being in nature has been shown to improve mental wellbeing and stress levels.

I'm not saying that you did this, but sometimes women will mention it in passing at the end of a consultation.

This is often because they feel a little bit embarrassed or uncertain, but this makes it impossible for your GP to then deal with the topic properly.

So be upfront that the reason you are there is to discuss menopause.

It's a good idea to speak to reception to ask their advice on which doctor or nurse would be best to see.

And if you have to wait a bit longer for an appointment with that person, it will be worth it.

In the meantime, keep a log of your symptoms and visit Women's Health Concern and Menopause Matters websites for more information.

WHY'S MUM GETTING BALD PATCHES? 

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A reader asks why their mum is experiencing bald patchesCredit: Getty

Q: MY mum's hair is normally nice and thick, but it's now starting to thin out, leaving some bald patches.

She is 68 years old and she has tried Plantur 39 hair tonic for a couple of months, but it hasn't really done anything to help.

Please can you suggest anything she can try?

She is on aspirin, atorvastatin, bisoprolol and takes folic acid.

 A: Unfortunately, some hair loss is inevitable with ageing.

That said, you have mentioned bald patches and typically, with age-related hair loss, we'd see a thinning out rather than bald patches.

Aspirin can cause hair loss, but it's fairly unusual.

You don't mention how long your mum has been on her medication, but it might be worth seeing if there is a correlation between the length of time she's been prescribed a drug and when the hair loss started.

According to studies, around one per cent of people report hair loss when prescribed statins such as atorvastatin, so it's unlikely to be that – but there's a slim chance.

Your mum is also on folic acid, which is prescribed for B9 deficiencies.B9 and other nutritional deficiencies, in themselves, can cause hair loss, so it could be that now your mum is on folic acid, the thinning and the bald patches will lessen.

Hormonal changes can also result in the thinning of hair.

Female pattern hair loss (which is linked to hormones) is caused by our genetics.

And it tends to follow a particular pattern which is different to the one that we see in men.

It typically involves thinning of the hair over the crown and a widening of the central parting.

It tends to start at a younger age than your mum, though, with the first signs usually noticeable before the age of 40.

Whatever the cause, it's definitely worth your mum seeing a GP.

Q: WHEN I was a baby, I had trouble going for a poo. My mum had to use suppositories to make me go.

I am now 47 years old and, over the years, things seem to have got worse and I am suffering with diarrhoea and constipation.

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Another reader is having trouble with diarrhoea and constipationCredit: Getty

I have been to the doctors to have tests for blockages, Crohn's disease and bowel cancer, and they have come back negative.

But I still experience constipation and diarrhoea every three or four weeks.

I eat as much veg as I can and also plenty of beans and lentils.

So far I have tried medications like Fybogel, Senna and Lactulose, but nothing seems to work.

I go for walks as much as I can.

I have tried making a plan of what is upsetting my stomach and I have tried the FODMAP diet, but that doesn't work either.

I don't know what else to do. Is there anything that you can suggest?

A: You have already done a lot of the things I'd normally suggest for someone presenting with the issues you've got.

You have clearly researched it well and have been thorough in doing what you can to try to help yourself.

You've had medical tests too, which have ruled out the serious conditions that it would be highly important to diagnose and treat.

The fact that your problem has been present since you were a baby would indicate that your bowel has always, and may always, struggle to function well.

But I hear you when you say that these symptoms are causing you suffering, and therefore I don't think you should just have to accept it, unless every avenue to help you has been explored.

If you have ruled out putting a label on what you have in the context of disease, it's likely that it's IBS-M, which is irritable bowel syndrome with mixed bowel habits.

There aren't any specific medications for IBS-M, but there are medications to treat the symptoms, available both over the counter and on prescription.

Moving forwards, a dietician may be able to guide you further or, failing that, a psychological approach may help. Cognitive behavioural therapy for IBS is clinically proven to improve symptoms in two thirds of patients.

CARING READERS' TIPS TO HELP EASE WOMAN'S ITCHY RED SKIN

EVERY so often, a reader's health problem really resonates.

Earlier this month, a 65-year-old woman wrote to Dr Zoe seeking help for a skin condition that was causing red and itchy outbreaks on her face.

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A reader has recommended La Roche-Posay Invisible Fluid factor 50 for problem skinCredit: Supplied

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Boots' No.7 Protect and Perfect Intense factor 50 face cream has also been recommendedCredit: Supplied

She said she had spent hundreds of pounds on various creams, cleansers and moisturisers, but seemed to suffer a reaction to everything.

Dr Zoe replied: "It sounds from your description as though it could potentially be eczema or rosacea."

After learning of the woman's plight, two other readers shared their experiences and advice, having been in similar situations themselves.

Fiona wrote: "I, too, suffered from this and, no matter what I used product wise, my face would be itchy and red. It started in my early 40s. I tried all the creams for rosacea.

"However, after extensive research, I am now using a brand called MooGoo, which was originally designed for babies with eczema.

"I no longer have the itchiness or red face.

"I also noticed that if I used SPF on my face, it would irritate my skin, so I use MooGoo cream then Boots' No.7 Protect and Perfect Intense factor 50 face cream.

"I will never again buy any other cream. These two brands really saved my skin.

"It's also worth checking your shampoo and conditioner. If that seeps onto your face, it could cause redness, too.

"I switched brands and now use Garnier Ultimate Blends. I really hope this helps."

Meanwhile, a second reader, Sharon, wrote: "I am 54 and, in 2019, I started experiencing problems with my skin – but only on my face.

"I also had a problem with one of the glands in my eye.

"My GP initially treated me for seborrheic dermatitis.

"However, after seeing an NHS dermatologist, they diagnosed me with pustular rosacea and ocular rosacea.

"Like the woman who wrote in, I spent hundreds of pounds trying different skincare products.

"In 2021, I eventually found a range by a company called Image Skincare UK.

"It has been a game-changer for me. I was able to stop using the prescribed medication and my skin has remained under control and stable ever since then.

"I also use La Roche-Posay Invisible Fluid factor 50 all year round. Image Skincare products are a bit pricer than the high street, but last me months.

"The improvement to my skin is worth every penny. I also discovered Boots are really good at offering refunds if a product has been used and a customer has reacted to it.

"I really hope the woman in question finds what works for her."

Women Warned Two Common Health Issues Could Cause Facial Hair

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There are several reasons this could happen (Image: Getty)

Many women experience hair growth on their chin and upper lip, and if it is dark, thick, and coarse, it can be a source of embarrassment, leading many to pluck these hairs frequently and feeling self-concious. But what causes excess facial hair in women?

Excess facial hair in women can have several causes. One of the main reasons is elevated levels of male hormones in the body, according to  LloydsPharmacy Online Doctor UK. The NHS identifies this condition as Hirsutism, characterised by the growth of thick, dark hair on the face, neck, chest, abdomen, lower back, buttocks or thighs. The health service urges: "See a GP if it's a problem for you. It might be caused by a medical condition that can be treated."

Hormone imbalance

Androgens, like testosterone, are typically recognised as male hormones. Testosterone contributes to the deepening of men's voices and the production of sperm. Although all women produce some testosterone, elevated levels can intensify sexual drive, interfere with menstrual cycles, and cause an increase in facial and body hair.

PCOS

LloydsPharmacy Online Doctor UK. Explain: "One of the main causes of high levels of male sex hormones in premenopausal women is Polycystic Ovary Syndrome (PCOS), a common condition which causes cysts to grow around the edge of the ovaries (the organs which produce eggs and sex hormones). As well as excess hair growth, women with PCOS may put on weight and have irregular periods and acne."

Instead of higher levels of male sex hormones, some premenopausal women experience increased sensitivity to them, leading to things like more facial hair and on their bodies. Excess hair growth in postmenopausal women is typically due to a hormonal imbalance caused by the menopause. As the body adjusts its hormone levels, there may be an unusually high level of testosterone remaining.

Could there be other causes of excessive facial hair?

In a small number of cases, excess facial hair may be caused by:

medicines, such as minoxidil which is taken for high blood pressure

congenital adrenal hyperplasia - a hereditary condition which affects the adrenal glands (which produce sex hormones)

Cushing's Syndrome or Acromegaly - rare hormonal disorders

being overweight or obese

a tumour affecting your hormone levels

How can I treat my excess facial hair?

There are a number of treatment options available, including:

shaving - this is quick and easy, but you may have to shave every day, and there may be unpleasant stubble in between shaves

waxing - this is effective if done regularly, but may be painful and cause redness

bleaching - this can make dark hair less noticeable in the short term

hair removal creams - Vaniqa is a cream which reduces hair growth by acting on enzymes in the hair follicle. It can provide a more long-term solution to excess facial hair growth than shaving, waxing or bleaching.

electrolysis - electricity is used to destroy hair cells and remove hair permanently. This may take many treatments over a long time, and can be painful and change your skin colour.

laser hair removal - powerful beams of light are used to destroy hair. It can last several months.

some types of the contraceptive pill

losing weight if you're overweight – this can help control hormone levels

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