I Think I Have Borderline Blood Pressure: Now What?

Last reviewed: 28 Dec 2022

Medically Reviewed By: Dr Jay Shah

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If you suspect you have borderline (technically called high normal) blood pressure, it’s not too late. You’ve received valuable information that empowers you to take action to avoid developing high blood pressure and the potential health problems that come with it.

If your systolic blood pressure (the number you record when your heart is pumping blood into the arteries) falls between 130 and 139 and/or your diastolic blood pressure (the number you record while the heart is filling with blood between beats) is between at 85 to 89, you have ‘high normal’ blood pressure. If your systolic blood pressure reads between 140 and 159 and/or your diastolic blood pressure reads between 90 and 99, this is Grade 1 hypertension.

Below we discuss the consequences of high blood pressure and the importance of determining whether you’re actually at risk. We look at some of the issues with traditional devices and how using them to classify stages of blood pressure may be challenging. We also explain how you can monitor your blood pressure better with Aktiia’s technology and the steps you can take if your data suggests you have high normal blood pressure or another stage of hypertension.

Am I at risk?

High blood pressure, or ‘hypertension’ as is the medical term, is a ‘silent killer’ because there are no warning signs or symptoms. The disease can and often does appear for years, even decades prior to a person becoming aware of it, or receiving a diagnosis. That’s why it’s so crucial to monitor your blood pressure routinely, repeatedly and correctly.

High blood pressure leads to stiffer arteries, potentially lowering the flow of blood and oxygen to many organs. This can cause many problems, the most common of which are:

  • Stroke
  • Heart failure
  • Heart attacks
  • Kidney disease and failure
  • Eye issues and loss of vision
  • Aneurysms

According to European Society of Cardiology (ESC) and the European Society of Hypertension guidelines, blood pressure classification is as below:

Source: ESC/ESH Guidelines for the management of arterial hypertension, eshonline.org
Category Systolic (mmHg) Diastolic (mmHg)
Optimal Less than 120 and Less than 80
Normal 120 – 129 and/or 80 – 84
High normal 130 – 139 and/or 85 – 89
Grade 1 hypertension 140 – 159 and/or 90 – 99
Grade 2 hypertension 160 – 179 and/or 100 – 109
Grade 3 hypertension Higher than 180 and/or Higher than 110
Isolated systolic hypertension Higher than 140 and Lower than 90

Issues with traditional cuff-based blood pressure monitoring

Traditional upper arm cuff blood pressure monitors have been in mass production for over 50 years and have been a useful tool for monitoring blood pressure; however, there are some crucial underlying shortcomings of all cuff monitors. Chief among them is that all cuffs are designed, tested and validated for use in only one type of position and environment. To conduct an accurate cuff reading, by design, guidelines and regulation, the following must all be performed:

  1. You must sit and relax in a chair with your feet flat on the floor and back supported for at least 5 minutes.
  2. You cannot have caffeine, exercise, or smoke cigarettes for at least 30 min prior to measurement.
  3. You must have an empty bladder.
  4. You may not talk during the rest period or measurements.
  5. All clothing on the arm of the device must be removed.
  6. The arm must be supported at the level of the heart.
  7. Proper cuff size, position, and fit are crucial.
  8. The environment should be quiet.
  9. You should take at least two readings and average the numbers.

If it is not performed with this method, the accuracy of the measurement is questionable. Needless to say, this type of environment, position and setting is inconvenient and not reflective of most of our lives, and your blood pressure fluctuates dynamically throughout the day and night, irrespective of setting. So by their very nature and design, traditional cuff-based blood pressure measurements are not reflective of our blood pressure in our daily lives.

Furthermore, the risks of blood pressure are time-dependent, meaning that the damage to our organs from blood pressure occurs over time (months-years), not days, hours, or even minutes. Therefore, the measurement of blood pressure at a single point in time as is done by all cuff modalities, inherently is unable to demonstrate the true significance of blood pressure risk.

Measure your blood pressure more accurately and easily with continuous monitoring

Aktiia’s optical blood pressure monitoring technology is different to traditional blood pressure monitors. The Aktiia device analyses the pulsation of the arteries beneath the skin using an optical sensor and is undetectable to the person wearing it. It then analyses the ‘shape’ of the pulsation and extracts the information it contains to provide information on your blood pressure during the day and night — about 20 to 30 measurements daily — providing you with and your medical providers with a comprehensive picture of your blood pressure. To follow on the latest updates, sign up for our Newsletter:

The continual, passive and automated nature of the measurements means that Aktiia’s unique dataset gives you a comprehensive understanding of your blood pressure range over time and in positions, settings and environments of our daily lives. Most importantly, it provides a more accurate understanding of the potential future blood pressure-related health risks.

Changing your lifestyle

If Aktiia’s comprehensive data indicates you’re entering the early stages of hypertension, it’s not just a warning, but an opportunity to take action. There are steps you can take to lower your blood pressure naturally.

Take regular exercise
Plan five sessions of at least 30 minutes of exercise you can take each week. Find ways to incorporate physical activity into your day. Use the stairs instead of the lift, for instance.

Lose weight
Being overweight makes your heart work harder to pump blood around your body. Shedding as little as 10 pounds can lower your blood pressure significantly. Speak to your doctor about your diet.

Kick foods that are full of saturated fat, trans fats or cholesterol
If your diet is high in trans fats, such as snack foods or margarine; saturated fats, including meats and high-fat dairy products; or cholesterol, such as organ meats and, again, high-fat dairy products; this can cause obesity, heart disease and cancer. Lower your intake of these.

Eat more fruit and vegetables, fish and wholegrain foods
This is part of the DASH approach to dieting, a healthy eating plan designed to prevent high blood pressure. The diet is also low in sodium and high in calcium, magnesium, potassium and fibre.

Lower your salt intake
High sodium diets can increase blood pressure, whereas low sodium ones can lower it and can even ward off hypertension altogether. You should aim to keep intake below 2300 milligrams (mg) of salt per day. That’s around 1 teaspoon (tsp).

Only drink alcohol in moderation
Drinking too much alcohol can increase your blood pressure and render any medication you might be on for managing your blood pressure less effective. Avoid drinking more than 14 units of alcohol regularly. If you drink 14 units per week, spread them across three days or more.

Be careful with caffeine
Caffeine can raise blood pressure, but not everyone is sensitive to caffeine. If your blood pressure rises within 30 minutes of drinking a cup of caffeine, think about cutting down. Note that tea, coffee and some fizzy drinks such as cola are all high in caffeine.

Eliminate stress
Identify the different sources of stress in your life and work out how you can change your life to lower stress. Look for stress-reducing activities. Tai chi, yoga, meditation and deep breathing exercises are all options.

Stop smoking
After you smoke, the nicotine in the tobacco can raise your blood pressure as much as 10 points for up to an hour. Kick the habit and avoid being around people who smoke.

Learn more about Aktiia

You can learn more about the Aktiia blood pressure monitoring technology on the Aktiia App page of our website. We believe in transparency, which is why you can also access the research we’ve conducted that validates Aktiia’s accuracy on the Evidence section of our website.

Hypertension is a silent killer, but by monitoring your blood pressure with our technology, you can detect prehypertension, an indicator of potential future high blood pressure, early and act before it’s too late. If you have any questions about Aktiia, check out our FAQs section. If you still can’t quite find the answers you’re looking for, contact us and we’ll be in touch.


Sources:

Classification of office blood pressure and definitions of hypertension grade, page 1961, Oct 2018 – https://www.eshonline.org/esh-content-uploads/2018-10/Download.pdf

Borderline hypertension: When do you need treatment? Mar 2014 – https://www.health.harvard.edu/blood-pressure-borderline-hypertension-when-do-you-need-treatment

Prehypertension: Does it really matter? Mar 2007 – https://www.health.harvard.edu/heart-health-prehypertension-does-it-really-matter

Prehypertension: Are You at Risk? Feb 2021 – https://www.webmd.com/hypertension-high-blood-pressure/guide/prehypertension-are-you-at-risk

Measure Your Blood Pressure, Sep 2021 – https://www.cdc.gov/bloodpressure-measure.htm

How to choose a blood pressure monitor and measure your blood pressure at home, Jun 2021 – https://www.bhf.org.uk/informationsupport-heart-matters-magazine/medical/tests/blood-pressure-measuring-at-home

Everything You Need To Know About Wrist Blood Pressure Monitors For Seniors, Jun 2022 – https://www.forbes.com/health-healthy-aging/wrist-blood-pressure-monitor/

Nonvalidated Home Blood Pressure Devices Dominate the Online Marketplace in Australia, Jun 2020 – https://pubmed.ncbi.nlm.nih.gov-32275193/

NHS, Prevention, Oct 2019 – https://www.nhs.uk/conditions-high-blood-pressure-hypertension-prevention/

4 big ways BP measurement goes wrong, Jun 2019 – https://www.ama-assn.org/delivering-care-hypertension-4-big-ways-bp-measurement-goes-wrong-and-how-tackle-them

Aktiia Team Written by The Aktiia Team

Our mission is to help people live free from hypertension.

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