Blood pressure is that pressure which must be applied to an artery in order to stop the pulse. It may be roughly estimated by feeling the pulse at the wrist, or accurately measured using a SPHYGMOMANOMETER. It is dependent on the pumping force of the heart, together with the volume of blood, and on the elasticity of the blood vessels.
The blood pressure is described as having two parts, systolic and diastolic. Systolic pressure is the highest level reached, and occurs with each heartbeat; the pressure then falls to the lower diastolic level between beats. The systolic pressure is measured in millimetres of mercury (mm Hg) because that is how it was traditionally measured before the introduction of electronic devices. The average level is around 100 mm HG in children and 120 mm Hg in young adults, generally rising with age as the arteries get thicker and harder. Diastolic pressure in a healthy young adult is about 80 mm Hg, and a rise in diastolic pressure is often a surer indicator of HYPERTENSION than is a rise in systolic pressure; the latter is more sensitive to changes of body position and emotional mood. Hypertension has various causes, the most important of which are genetic predisposition and kidney disease (see KIDNEYS, DISEASES OF). In hypertensive persons, systolic pressure may be over 200 mm Hg. Abnormal hypertension is often accompanied by arterial disease (see ARTERIES, DISEASES OF) with an increased risk of strokes, heart attacks and heart failure (see HEART, DISEASES OF). Various ANTIHYPERTENSIVE drugs are available; these should be carefully evaluated, considering the patient's full clinical history, before use.
Low blood pressure or HYPOTENSION may result from major dilation of skin blood vessels for example, after a hot bath, in fevers or as a side-effect of medication, particularly that prescribed for high blood pressure and occurs also in severe acute disease (shock) or heart failure. The blood pressure generally falls on standing, leading in some to temporary postural hypotension – a particular problem for elderly people.