How Does Blood Pressure Work?

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Your heart is the master pump for all the blood in your body. With every heartbeat, your heart pushes your blood to all the vital parts of your body, such as muscles and bones, through a network of arteries, capillaries, and veins. As blood flows through the tube-like arteries, it presses up against the walls of the blood vessels with varying degrees of strength. The strength or weakness of this pressure is called your blood pressure (BP).

Each time your heart squeezes, moving your blood to its various destinations, your blood pressure goes up—this number is referred to by a blood pressure reading as systolic. Then, as the heart relaxes after each contraction, your blood pressure goes down; that is called the diastolic reading. Together, these two numbers are presented as a score, systolic over diastolic: Your doctor might tell you that your BP is “120 over 80.”

According to the American Heart Association (AHA), normal blood pressure should reflect systolic pressure between 90 and 120, over a diastolic pressure between 60 and 80. Your doctor may take this measurement with a fancy-named instrument called a sphygmomanometer—an inflatable rubber cuff attached to a manual air pump. When the doctor inflates the cuff at your arm with air, it temporarily cuts off blood flow, and when it releases, the blood starts flowing again, revealing those two key numbers.

Nowadays, though, doctors are recommended to use an automatic blood pressure cuff, which relies on a different method and seems to be more accurate. While the manual cuff relies on auscultation, in which the doctor listens for the correct pressures using a stethoscope/microphone, automatic blood pressure cuffs are usually oscillometric. When blood passes under the cuff, the arm increases in circumference ever so slightly. And by measuring the amplitude of the oscillations (hence oscillometric) at a continuous interval of pressures, blood pressure can be calculated in much the same way.

If you have high blood pressure, a.k.a. hypertension—approximately 130/80 or higher in a person of average health—your heart is working too hard to pump the blood through your body, which becomes dangerous. According to the AHA [PDF], elevated blood pressure is 120–129/less than 80; hypertension stage 1 is 130–139 (systolic) or 80–89 (diastolic); and hypertension stage 2 is 140 or higher (systolic) or 90 or higher (diastolic). If your blood pressure hits 180/120, you're in hypertensive crisis, and you should get help.

If you fall into the above categories, your doctor will recommend changes to diet and exercise and probably medication. High blood pressure is often a precursor to heart disease or a heart attack and can be a side effect of other diseases, such as diabetes. However, your blood pressure can temporarily rise due to stress, pregnancy, and even some common medications, including over-the-counter pain relievers and antidepressants. One high reading will not necessarily mean you have hypertension—but it’s good to keep vigilant.

Editor's note: This story was updated in July 2018 to reflect new blood pressure guidelines from the AHA.

Should You Take a Daily Aspirin to Prevent Heart Disease?

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For decades, physicians have recommended that older patients or those who have had a cardiac event like a heart attack take a low-dose aspirin daily. Acting as a blood thinner, aspirin can help prevent blood clots from forming and causing more cardiovascular issues.

This wisdom was examined in a new study published in the New England Journal of Medicine, which looked at more than 19,000 elderly people and found no measurable benefit to the practice for people aged 65 and over. Worse, aspirin may actually cause harm by increasing the risk of bleeding.

So, who should be taking aspirin as a preventative measure, and when?

The most recent study, which began in 2010 and followed subjects 65 and older with no prior cardiovascular disease taking either 100 milligrams of aspirin daily or a placebo, found that the risk of bleeding in the stomach or brain was increased in those taking aspirin (3.8 percent in the aspirin group versus 2.8 percent in the placebo group). The rate of disease-free survival among subjects was no higher among those taking aspirin compared to those on the placebo.

Aspirin has been shown to help some patient populations, however. For people who have already suffered a heart attack or stroke, aspirin can reduce the risk of a recurrence. According to the U.S. Preventative Services Task Force, adults aged 50 to 59 who have a 10 percent or greater chance of developing cardiovascular disease, typically as the result of lifestyle, genetic, and dietary factors, will likely benefit from a daily dose. As that patient population ages and risk of bleeding increases, it becomes a risk-to-benefit assessment. The task force found insufficient information for aspirin use to prevent cardiovascular disease in people under age 50.

The American Heart Association and the American Stroke Association both recommend aspirin to decrease cardiovascular events in patients with risk as low as 6 percent over a 10-year period. For adults with only average risk, no medical authority currently recommends the regimen.

As with any medical issue, it’s best to consult with your doctor about taking aspirin to prevent cardiovascular disease. Only your specific medical history can help determine whether it’s right for you. And if you're currently taking aspirin and have concerns based on the newest research, don't stop taking it until you've had a chance to discuss it with your provider.

[h/t NPR]

5 Ways to Express Your Gratitude (and Reap Its Benefits)

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Bad days happen to the best of us: The alarm doesn't go off, your kids are fussy, you get stuck in traffic, and as soon as you get to work, you spill coffee down the front of your favorite shirt. And then, to add insult to injury, you log onto Facebook and are greeted by the smiling face of your old college roommate, who is just so #blessed. Lucky her.

But is her life really better than yours? It turns out that being grateful for what you have—even if some days, what you have appears to be a disaster—is mostly an exercise in self-reflection. Here are some simple things you can incorporate into your daily routine in order to better appreciate the good things you have going in your life—and doing so, studies have found, can improve your physical and emotional health.

1. KEEP A GRATITUDE JOURNAL.

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The task is easy: Each week, take the time to write down and reflect on five things that you're grateful for. "These can be small things, but big things are fine, too," Jo-Ann Tsang, associate professor of psychology and neuroscience at Baylor University, says.

A 2003 study by researchers from the University of Miami and the University of California, Davis [PDF], found that students who recorded the things they're grateful for felt better about their lives, exercised more regularly, reported fewer physical problems, were more likely to make progress towards personal goals, and were more optimistic about their upcoming week than students who were tasked with writing down hassles or neutral life events.

For the greatest benefits, focus on people, rather than things, in your journaling, and go into detail about why you appreciate each item. Also, don't feel compelled to journal daily: According to the University of California, Berkeley's Greater Good blog, journaling once per week was found to be more beneficial than daily journaling.

2. DO A 30-DAY CHALLENGE.

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Committing to a full month of reflection not only boosts your gratitude awareness, but gives you the satisfaction of completing a goal. Lisa Ryan, gratitude expert and author of Express Gratitude, Experience Good, suggests writing down three to five things that you're grateful for each day for the next 30 days. As with gratitude journaling, this exercise works best if you're specific. Instead of writing that you're grateful for your husband, Ryan says, "you should write, 'I'm so thankful that Scott cooked a great dinner last night.'"

If you choose to write your list in the morning, you'll set a positive expectation for your day. Writing it in the evening will remind you of the good the day brought, even if it was a particularly hard day to get through. It will also help you fall asleep faster and sleep better, Ryan says.

3. HOST A GRATITUDE PARTY.

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If you're going through a hard time, write down the names of the people who have helped you in your life. Then, plan a party in their honor. Amy Newmark, author of Chicken Soup for the Soul: The Power of Gratitude, says, "You'll find that in planning your guest list, you'll start noticing how many people are there for you extending a helping hand every day. This will make you more grateful, and you'll feel less alone every day."

4. GAIN SOME PERSPECTIVE.

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Thinking about the alternatives can help you appreciate what you have, Newmark says. For example, are you stuck emptying the dishwasher again? Think about the fact that you have a warm, comfortable home filled with kitchen appliances. Are you running around in a frenzy, with no time for yourself? Think about how full your life is. "Would you rather not have these errands to do, these kids to drive around, this job that creates all this work?" Newmark asks.

5. SPREAD KINDNESS.

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The very fact that you have the ability to do something nice for someone else will make you feel more confident of your own situation, more aware of your own capabilities, and more grateful for the blessings in your own life. Keep a list of the good deeds you perform—it can be as simple as holding a door for someone or letting a mother with a crying child go ahead of you in line at the store, Newmark says.

And find the right "dosage" for you. For some people, doing five kind things on one day each week, rather than doing five good things throughout the week, showed more positive benefits. Others, however, get more of a boost from daily positive activity [PDF].

This story first ran in 2016.

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