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The modern history of hypertension begins with the understanding of the cardiovascular system based on the work of physician William Harvey (1578–1657), who described the circulation of blood in his book De motu cordis. The English clergyman Stephen Hales made the first published measurement of blood pressure in 1733.
For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
Mean blood pressure rises from early adulthood, plateauing in mid-life, while pulse pressure rises quite markedly after the age of 40. Consequently, in many older people, systolic blood pressure often exceeds the normal adult range, [33] if the diastolic pressure is in the normal range this is termed isolated systolic hypertension.
For most adults, normal blood pressure at rest is within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg diastolic. [6] [7] For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg. [5] [6] [7] Different numbers apply to children. [14]
Guidelines on the choice of agents and how best to step up treatment for various subgroups in hypertension (high blood pressure) have changed over time and differ between countries. A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [ 1 ] )
A minimum systolic value can be roughly estimated by palpation, most often used in emergency situations, but should be used with caution. [10] It has been estimated that, using 50% percentiles, carotid, femoral and radial pulses are present in patients with a systolic blood pressure > 70 mmHg, carotid and femoral pulses alone in patients with systolic blood pressure of > 50 mmHg, and only a ...
The U.S. Dietary Guidelines for Americans recommend eating a diet of 2300 mg of sodium a day or lower, with a recommendation of 1500 mg/day in adults who have elevated blood pressure; the 1500 mg/day is the low sodium level tested in the DASH-Sodium study.
Using the results of the blood pressure test, the health care provider will diagnose prehypertension or high blood pressure if: For an adult, systolic or diastolic readings are consistently higher than 120/80 mmHg. A child's blood pressure numbers are outside average numbers for children of the same age, gender, and height. [40]
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