Normal Blood Pressure Range and How to Lower High BP: A Practical Guide

About one in three Indian adults has high blood pressure, according to the ICMR-INDIAB study, and many do not know it. High BP rarely causes symptoms, yet it is a leading cause of heart attack, stroke and kidney failure.

Blood pressure chart

Indian and European guidelines diagnose hypertension at 140/90 mmHg or higher on repeated readings. Some American guidelines use a lower cut-off of 130/80.

Is "normal BP by age" real?

BP tends to rise with age, but the target does not simply go up with your age. Most adults should aim for below 140/90, and many doctors aim for around 130/80 if you have diabetes, kidney disease or heart disease.

Symptoms of high BP

Usually none. Very high BP may cause headache, dizziness, blurred vision, chest pain or breathlessness. This is why regular checks matter: at least once a year from age 18.

How to check BP correctly at home

1. Avoid tea, coffee, smoking and exercise for 30 minutes before.
2. Sit quietly for 5 minutes with your back supported and feet flat.
3. Rest your arm at heart level and use the right cuff size.
4. Take 2 readings a minute apart and note the average.
5. Measure at the same times each day and share the log with your doctor.

Proven ways to lower BP

• Cut salt to under 5 g a day (about one teaspoon). Watch pickles, papad, namkeen, sauces and packaged foods.
• Eat more fruits, vegetables, dals and low-fat dairy (the DASH approach).
• Exercise for 150 minutes a week, such as brisk walking.
• Lose weight: every few kilos lost helps.
• Limit alcohol and stop tobacco.
• Sleep well and manage stress; yoga and breathing exercises can help.

Medicines for high BP

If lifestyle changes are not enough, your doctor may prescribe:

• Amlodipine (e.g. Amlong, Stamlo)
• Telmisartan (e.g. Telma) or losartan (e.g. Losar)
• Combinations such as Telma-AM and Telma-H
• Metoprolol for some patients with heart disease

BP medicines are usually long term. Do not stop them when your BP becomes normal: it is normal because of the medicine. Telmisartan and losartan must not be used in pregnancy.

Low BP

Low BP (below 90/60) is a concern only if it causes dizziness, fainting or tiredness. Drink enough fluids and see a doctor if symptoms persist.

When to see a doctor

See a general physician or cardiologist if your readings are repeatedly 140/90 or higher. Call 108 or 112 for BP above 180/120 with chest pain, breathlessness, weakness or confusion.

What do the two numbers mean?

The top number (systolic) is the pressure when your heart beats. The bottom number (diastolic) is the pressure when the heart rests between beats. Either number being high counts as high blood pressure.

Why high BP is called a silent killer

Over years, high pressure damages the walls of arteries. This can lead to:

• Stroke
• Heart attack and heart failure
• Kidney disease
• Eye damage and vision loss

Controlling BP greatly lowers these risks.

White-coat and masked hypertension

Some people have high readings only at the clinic (white-coat hypertension), while others are normal at the clinic but high at home (masked hypertension). Home monitoring or a 24-hour ambulatory BP test helps your doctor decide on treatment.

Tests your doctor may order

An ECG, kidney function test, urine test, lipid profile and blood sugar check for damage and other risk factors.

Indian kitchen tips to cut salt

• Add salt at the end of cooking and taste before adding more.
• Use lemon, herbs and spices such as jeera, ajwain, garlic and coriander for flavour.
• Limit pickles, papad, chutneys, namkeen and instant noodles.
• Read labels for sodium; packaged foods often contain much more than you expect.

High BP in pregnancy

High BP in pregnancy needs close monitoring, as it can lead to pre-eclampsia. Several common BP medicines, including telmisartan and losartan, must not be used in pregnancy. Pregnant women should have regular BP checks with their gynaecologist.

Myths and facts

• Myth: "I feel fine, so my BP must be normal." Fact: High BP usually has no symptoms.
• Myth: "BP medicine is addictive." Fact: It is not addictive; it is needed because the condition is long term.
• Myth: "Sea salt or rock salt is safe." Fact: All salts contain sodium and count towards your daily limit.