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Sunday, May 19, 2013
High Blood Pressure
Median arterial pressure
. What is median arterial pressure? .What is the correct way to measure it? . What is the acceptable range for healthy men past 70 ? .How significant is it relative to the to the actual B/P readings?
The median blood pressure (MAP) is determined by multiplying the diastolic blood pressure (the lower number) by two, adding it to the systolic blood pressure (the upper number), and dividing the sum by three. For example, the median blood pressure of a person with a blood pressure of 140/90 is 140+180/3 = 107. Because the upper limit of normal for blood pressure is 140/90, the upper limit of normal for the median blood pressure is 107. The pulse pressure is the difference between systolic and diastolic blood pressure, in this case 140-90 = 50.
The median blood pressure is not often used in clinical practice. Recent data have shown that the pulse pressure has the best correlation with cardiovascular risk. However, for practical purposes, the best way to treat blood pressure is simply getting the systolic pressure to goal. According to current guidelines, the goals are 140 for otherwise healthy people, 130 for patients with diabetes and/or kidney disease.
Although blood pressure changes with age, the definition of the goal blood pressure stays the same for all adults: 140/90 if you are otherwise healthy, 130/80 if you have diabetes and/or kidney disease. However, optimal blood pressure is defined as less than 120/80. Individuals who have a blood pressure of 120-139/80-89 are considered "prehypertensive" and should be checked for other cardiovascular risk factors.
Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati