Do you know what your blood pressure is? If not, you should! High blood pressure, also known as hypertension, is the number one risk factor for death and debilitation from a stroke. Longstanding hypertension can also damage the heart muscle, causing a condition known as congestive heart failure, in which the heart's ability to squeeze and pump blood throughout the body is impaired. When this occurs, fluid can back up into the lungs, legs and throughout the body, leading to shortness of breath, weakness and potential renal failure. High blood pressure can also contribute to the development of coronary artery disease, causing the arteries that supply blood to the heart muscle to become clogged. Coronary artery disease, in the form of a "heart attack" is a leading cause of death in the United States.

Systolic blood pressure, the top number of the blood pressure reading, indicates the amount of force exerted explosively against the blood vessel walls each time the heart contracts and pumps out blood. Diastolic blood pressure, the bottom number of the reading, indicates the amount of pressure constantly present in the arteries when the heart is at rest and is filling with blood in preparation for the next contraction. The old standard for the upper end of a "normal" blood pressure reading was 140/90. That number has recently been revised, and at this time medical experts recommend the "normal" blood pressure should be kept at or below 120/70.

Because of these potentially serious health risks associated with hypertension, it's a good idea for everyone to be aware of what their own blood pressure reading normally is. Hypertension doesn't announce its presence with a fever, stomach pain or bleeding, which is why it is often referred to as the "silent killer". Even seemingly healthy people can have high blood pressure, and not know it. Certainly individuals who do have identifiable risk factors for hypertension - like smoking, obesity, poor diet, excess sodium consumption, growing older (oops ... that's all of us!) should be aware that they are at risk for experiencing the consequences of chronic hypertension. The only way to find out for sure, however, is to have it checked. Unfortunately, many people only have their blood pressure taken when they are sitting in the doctor's office in a skimpy gown, anxiously waiting for the exam room door to open. Of course, under these conditions, whose blood pressure wouldn't be a little high? There is actually a term for this - it's called "white coat syndrome", because the anxiety experienced under these circumstances nearly always causes the blood pressure readings to be higher than they would in normal, more relaxed situations. The "white coat" blood pressure measurements may be inadequate to accurately assess what a person's typical blood pressure reading is.

Usually, blood pressure readings are lowest in the morning when a person is first getting out of bed. It is quite typical for there to be many variations in blood pressure throughout the day related to anxiety, stress, activity, eating, sleep and relaxation. More accurate than the occasional reading taken in the doctor's office, then, would be a regular measurement taken under similar circumstances, at the same time of day, in a relaxed environment.

Good news! Relaxed and more reliable blood pressure readings are now possible. There are quite a number of inexpensive blood pressure measuring devices available that are pretty easy to use at home.

Type #1: A digital monitor:Because the digital monitor is automatic, it is the most popular blood-pressure measuring device. The blood pressure measurement is easy to read, because the numbers are shown on a screen. Some electronic monitors even have a paper printout that gives you a record of the blood pressure reading.

The digital monitor is easier to use than the usual cuff and stethoscope system. It has a gauge and stethoscope in one unit, and the numbers are easy to read. It also has an error indicator, and deflation is automatic. Inflation of the cuff is either automatic or manual, depending on the model. This blood pressure monitoring device is good for hearing-impaired patients, since there is no need to listen to heart sounds through the stethoscope.

A disadvantage of the digital monitor is that the accuracy can be affected by body movements or an irregular heart rate. In addition, the monitor requires batteries. Some models are designed for use with the left arm only. This may make them hard for some patients to use. Finally, some digital monitors are expensive. They range in price from about $30 to over $100.

Type #2: A finger / wrist blood pressure monitor?Tests have shown that finger/wrist devices may not measure blood pressure as precisely as those devices that measure on the arm. The key to utilizing the results from these devices is to be very careful to follow the exact instructions for arm placement and positioning. Also, using the same device, with the same arm and body positioning, and measuring at the same time of the day will give consistent readings to use for comparison on a day to day basis. Many of these home models are priced less than $50.00. Important features to look for in a blood pressure monitorMake sure to get the proper cuff size. Blood pressure readings will be incorrect if your cuff is the wrong size, so ask your doctor, nurse or pharmacist to tell you the cuff size you need, based on the size of your arm. The numbers on the monitor must be easy for you to read. If you are using a stethoscope, you must be able to hear heart sounds through it.

Cost may be an important factor. Since home blood pressure units vary in price, you may have to shop around. The most expensive units might not be the best or the most accurate. Once you buy your monitor, take it to your doctor's office to be checked for accuracy. Be aware that proper care and storage are also necessary. Make sure the tubing is not twisted when the monitor is stored, and keep it away from heat. Periodically check the tubing for cracks and leaks. Ask your doctor or nurse to teach you how to use your blood pressure monitor correctly.

Taking daily measurements and keeping a record to present to the doctor at each visit will enable him/her to better evaluate your "normal" blood pressure and to determine appropriate treatment measures. The American Heart Association has developed a blood pressure tracker that I highly recommend. I urge each of you to log on, sign up and begin to utilize this tool. At your next visit, bring these results for your doctor to review. This will insure that your next doctor visit will be a less anxious "white coat" situation, and more to the point of meeting your health needs.

You may wonder why I have gone into such detail about hypertension. Both of my parents have high blood pressure. My own blood pressure tends to run on the high side. My wonderful sister, Susan had high blood pressure, and was on daily medication at the age of 37. She died at age 38, in part, because an aneurism in her brain that had probably been there for many years ruptured. That rupture, and her ultimate death may very well have been prevented if she had not been extremely overweight and if her blood pressure had not been so high.

It's one of my missions in life to help others become more healthy and to live a better life. Hypertension is one very big problem for a lot of people. The first step is to raise awareness and to develop an understanding of what the problem is. Now ...go to the American Heart Association blood pressure tracker, log on and begin to monitor your own blood pressure readings.