And what have we learned together evaluating our patient's blood pressure and the peripheral pulses? We really learned a lot. To begin with, our patient has both a systolic and a diastolic elevation of pressure and the peripheral pulses were essentially normal. Now, we are not, therefore, thinking of causes of isolated systolic hypertension, the elderly patient who might have arteriosclerosis. We are not thinking of patients with the wide pulse pressure, where the systolic is elevated and the diastolic may well be reduced, such as patients who have aortic regurgitation, patent ductus arteriosus and other causes of increase in diastolic runoff.
Our patient
The evaluation of our patient's blood pressure revealed significant systolic and diastolic hypertension. Because his peripheral pulses are symmetric, there is little support for proximal dissection of the aorta, a complication of hypertension. Because his femoral pulses are not delayed and leg blood pressure not diminished, there is little support for coarctation of the aorta, a secondary cause of hypertension.
Adult BP
The normal blood pressure in the adult is less than 120/80 mmHg, although no blood pressure is too low in asymptomatic individuals. Our patient's blood pressure shows significant elevation in both systolic and diastolic levels. Above 115/75 mmHg, the risk of cardiovascular disease doubles with each increment of 20/10 mmHg.
BP classification adults
This table shows the classification of blood pressure for adults from a recent consensus report. Hypertension is diagnosed when the systolic blood pressure is 140 mmHg or greater and/or the diastolic blood pressure is 90 mmHg or greater. The stages of hypertension correlate with the risk of complications.
Normal blood pressure for adults is less than 120 mmHg systolic and less than 80 mmHg diastolic and is associated with a lowest incidence of target organ damage.