High Blood Pressure:
Things People With Disability Need to Know

What is high blood pressure?

Blood pressure is the pressure of the blood against the arteries as the blood flows through the body. High blood pressure, also known as hypertension, increases the risk of cardiovascular disease such as heart attack, heart failure, and stroke. In Illinois, nearly half of adults with disability have high blood pressure, twice as many as those without disability. Most people do not know that they have high blood pressure because many times people with high blood pressure have no symptoms. Thus, it is important that everyone have their blood pressure checked regularly.

The table below shows normal blood pressure numbers for adults. It also shows which numbers put a person at greater risk for health problems. Blood pressure tends to go up and down, even in people who have normal blood pressure. Blood pressure that stays above normal most of the time puts a person at greater risk.

Categories for Blood Pressure Levels in Adults (in mmHg, or millimeters of mercury)

Source: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) , 2003

What are the risk factors for high blood pressure?

There are several factors that a person cannot change that increase the risk of high blood pressure. As a person gets older, blood pressure tends to increase. A higher percentage of men than women have high blood pressure until 45 years of age. From ages 45 to 64, the rate of high blood pressure in men and women is similar. After age 65, a much higher percentage of women have high blood pressure than men. A family history of high blood pressure can increase risk. Certain racial groups have a higher risk. For example, high blood pressure is more common and more severe in African Americans.

Lifestyle and personal habits, things that a person may be able to change, also can increase the risk for high blood pressure. For example:

• Smoking – Smoking can temporarily raise blood pressure and increase the risk of heart and blood vessel diseases.

• Diet – Eating too much salt can increase blood pressure. A diet high in cholesterol may cause narrowing of the blood vessels, which also can lead to high blood pressure.

• Obesity – People who are obese are more likely to develop high blood pressure. Data show that Illinois adults with disability are more likely to be obese (i.e., body mass index of 30 or higher) than their counterparts without disability. (Illinois Behavioral Risk Factor Surveillance System, 2008)

• Alcohol – Heavy and regular use of alcohol can increase blood pressure.

• Lack of exercise – Being physically inactive makes it easier to become overweight, which increases the chance of high blood pressure. Data show that Illinoisans with disability engage in exercise less often than Illinoisans without disability. (Illinois Behavioral Risk Factor Surveillance System, 2008)

What factors can affect blood pressure readings?

A blood pressure cuff is the most widely used method in monitoring your blood pressure. Measuring blood pressure correctly is important to ensure an accurate reading. Below are some things that can affect the blood pressure reading.

• Cuff size and placement -- The cuff needs to extend around at least 80 percent of the upper arm, and the width of the cuff needs to cover about 40 percent of the upper arm.

• Body position – Being seated, with back supported and feet flat on the floor, is critical. The arm should be supported and at about the same height as the heart.

• Inflation and deflation – Inflating the cuff too much or too little and/or deflating the cuff too fast can contribute to false readings.

• Physical activity – Performing physical activity right before taking blood pressure can increase the reading. Blood pressure should be measured after at least five minutes of rest.

• Caffeine or tobacco use – Using these products 30 minutes before a blood pressure measurement can cause an increased reading.

• Number of measurements –Taking two or three measurements should ensure more accurate readings. Allow at least a minute between each measurement.

Are there any special considerations in taking blood pressure for a person with disability?

• Persons who are deaf or hard of hearing – Automatic systems are available that take blood pressure readings without needing to hear the pulse.

• Persons who are blind or low vision – Manual blood pressure cuffs are available that have large digital read outs. Automatic blood pressure cuffs also are available that speak the reading once it is obtained.

• Persons with difficulty in using hand/arm – Automated systems inflate the cuff at the touch of a button, avoiding the need to manually pump the cuff. If a person has had a stroke or arm injury, measuring the blood pressure on the uninjured or unaffected side is important.

How is high blood pressure controlled?

Improving lifestyle, such as eating a low salt diet, exercising, quitting smoking and avoiding alcohol, is helpful in controlling blood pressure. In addition to lifestyle changes, medication is often needed to control Stage I and Stage II hypertension. It is important to follow up regularly with a health care provider.

For more information, a video is available that addresses blood pressure in greater detail. The half hour video can be viewed at the following link: www.idph.state.il.us/heartstroke under Health Care Professionals.

This information sheet is prepared by the Illinois Department of Public Health with a goal of promoting health and preventing secondary conditions among citizens with disabilities. Funding is provided by the U.S. Centers for Disease Control and Prevention through a cooperative agreement. To learn more about the Disability and Health Project or the Cardiovascular Health Program, call 217-782-3300 or TTY 800-547-0466.