Blood pressure measures the force exerted by circulating blood against the walls of the arteries. This pressure is generated by the heart as it pumps blood throughout the body. Monitoring this force is important because consistently high pressure (hypertension) can damage arteries and organs over time. Since hypertension rarely presents with noticeable symptoms, regular measurement is a necessary part of routine health care.
Classifying Blood Pressure Readings
A systolic reading of 157 millimeters of mercury (\(\text{mm Hg}\)) is considered significantly elevated and places an individual squarely within the category of Stage 2 Hypertension. Current guidelines define Stage 2 Hypertension as a systolic pressure of \(140 \text{ mm Hg}\) or higher, or a diastolic pressure of \(90 \text{ mm Hg}\) or higher. This classification indicates a sustained level of pressure that poses a higher risk for serious health issues if not managed.
To put this reading into perspective, a normal blood pressure reading is defined as a systolic pressure below \(120 \text{ mm Hg}\) and a diastolic pressure below \(80 \text{ mm Hg}\). Readings between \(120 \text{ mm Hg}\) and \(129 \text{ mm Hg}\) systolic, with a diastolic pressure below \(80 \text{ mm Hg}\), are classified as Elevated. Stage 1 Hypertension is diagnosed when the systolic pressure is between \(130 \text{ mm Hg}\) and \(139 \text{ mm Hg}\), or the diastolic pressure is between \(80 \text{ mm Hg}\) and \(89 \text{ mm Hg}\).
A diagnosis of chronic hypertension is not based on a single measurement. Healthcare providers look for multiple high readings taken on separate occasions to confirm a persistent issue. A temporary reading of 157 can occur due to stress, caffeine intake, or physical exertion. However, such a high reading warrants prompt communication with a physician to establish a regular monitoring plan.
Understanding Systolic and Diastolic Pressure
A blood pressure reading is always given as two numbers, representing the pressure during two distinct phases of the heart’s cycle. The systolic pressure (the higher number) measures the maximum force exerted on the artery walls when the heart contracts and pushes blood out (systole). This contraction phase is when the pressure is at its peak.
The diastolic pressure (the lower number) reflects the pressure in the arteries when the heart is at rest between beats (diastole). This is when the heart fills with blood, and the pressure is at its lowest. While both numbers are important, the systolic pressure is often the primary focus for adults, especially those over age 50.
As people age, the arteries tend to stiffen, which often causes the systolic pressure to rise independently of the diastolic pressure. This condition is known as isolated systolic hypertension and is a significant risk factor for cardiovascular complications. For a reading like 157, the concern is primarily driven by the high systolic value, regardless of the diastolic number, because it indicates the intense force the heart must overcome with every beat.
When to Seek Immediate Medical Attention
While a reading of 157 requires medical follow-up, an extremely high reading can constitute a medical emergency. A Hypertensive Crisis is defined as a systolic reading of \(180 \text{ mm Hg}\) or higher, or a diastolic reading of \(120 \text{ mm Hg}\) or higher. It is important to distinguish between a hypertensive urgency and a hypertensive emergency, as the required response differs.
Hypertensive urgency occurs when blood pressure is at or above the \(180/120 \text{ mm Hg}\) threshold but is not accompanied by signs of acute organ damage. If you obtain such a reading at home without symptoms, you should retest after five minutes of rest, and if the reading remains high, contact your primary care provider immediately for advice. The goal in this situation is to gradually lower the pressure over several hours or days.
A hypertensive emergency involves the same severely elevated pressure, but it includes symptoms indicating acute damage to organs like the brain, heart, or kidneys. If your blood pressure is \(180/120 \text{ mm Hg}\) or higher and you experience any of these symptoms, call emergency services immediately. This requires rapid blood pressure reduction to prevent a stroke or other life-threatening event. Symptoms may include:
- Sudden, severe headache
- Chest pain
- Shortness of breath
- Numbness or weakness
- Blurred vision
- Confusion
Lifestyle Adjustments for Lowering Blood Pressure
Managing sustained high blood pressure involves consistent, long-term changes to daily habits that support cardiovascular health. Dietary adjustments are highly effective, with the Dietary Approaches to Stop Hypertension (DASH) eating plan being a primary recommendation. The DASH diet emphasizes consuming fruits, vegetables, whole grains, and low-fat dairy, which are rich in minerals like potassium, calcium, and magnesium that help regulate blood pressure.
A central focus of the DASH diet is reducing sodium intake, which directly affects fluid balance and blood volume. Limiting daily sodium to \(2,300 \text{ mg}\) is a standard goal, though a stricter target of \(1,500 \text{ mg}\) often yields greater blood pressure reduction. This means avoiding highly processed foods, which are often hidden sources of significant sodium.
Regular physical activity is another powerful tool, as it improves heart and vessel function. Aiming for at least 150 minutes of moderate-intensity aerobic exercise each week, such as brisk walking or cycling, can lower systolic pressure by several points. Even modest weight loss, such as a reduction of \(5\) to \(10\) pounds, can substantially impact blood pressure levels.
Incorporating stress management techniques can also contribute to lower readings by reducing the body’s release of stress hormones that constrict blood vessels. Practices like deep breathing, yoga, or ensuring seven to eight hours of quality sleep nightly help regulate the nervous system’s influence on blood pressure and improve vascular health.