High Blood Pressure – How High is Too High?


According to the Centers for Disease Control, 1 in 3 people in the US has High Blood Pressure (HBP), and about 20% of these people don’t know they have it. HBP is often called the “Silent Killer” because there are no symptoms and no warning signs, which is why it is even more important that people should check their blood pressure periodically and not just when they go to the doctor. HBP causes damage to the heart, blood vessels and kidneys and can lead to a stroke and other significant health events.

Let us look at some of the things that potentially can cause HBP:

  • AGE: The risk of developing HBP increases as individuals get older.
  • DIET: Too much sodium and saturated fat, as in fast food and processed food.
  • WEIGHT: Being overweight from either poor diet and/or lack of exercise.
  • HABITS: Smoking or too much alcohol consumption on a regular basis can cause HBP.
  • RACE/ETHNICITY: A higher percentage of African Americans have HBP compared to Caucasians.
  • FAMILY HISTORY: HBP can run in families, which could increase the risk of developing HBP.
  • DIABETES: About 60% of people with diabetes also have HBP.

Standard guidelines for Blood Pressure:

  • Normal: 120/80
  • Pre-Hypertension: 120-139/80-89
  • Stage 1 HBP: 140-159 / 90-99
  • Stage 2 HBP: 160+ / 100+

What can be done to control blood pressure? If blood pressure values are in the pre-hypertension range, an individual may be able to control it by changing his or her diet, cutting back on daily sodium intake, stopping smoking, and getting 20-30 minutes of exercise daily. A physician may prescribe medication to better control blood pressure, especially if someone presents with Stage 1 or Stage 2 HBP. If medication is prescribed, patients should be certain to keep taking their medication unless otherwise advised by the doctor. Statistics show that a large number of prescriptions for BP medication never get filled or re-filled.

Here at Job Ready Services, checking a client’s blood pressure is a part of every FCE and Post Offer Employment Test, and it is taken during a Fit for Duty test if the job requires it. Unfortunately, clients often have to be placed on hold because their blood pressure is over 160/100. The client then is given the option to re-check their blood pressure the following day or to take a form to their physician. Most people are surprised that their blood pressure is that high because they don’t have any symptoms, but they will sometimes reveal that they either have NOT taken their prescribed blood pressure medication or they have a history of high values but haven’t been to a doctor for it.

The post-offer employment testing process is administered by medical professionals who recognize a candidate or employee’s heart rate and blood pressure is an important part of protecting an employee in the workplace and at home. There are several horror stories from other WorkSTEPS providers of candidates who could not complete testing due to elevated blood pressure and were reported to have went to work for an employer who didn’t test just to hear they collapsed at work due to a heart attack or stroke. Even with physician clearance, we have had incidences of candidates who returned to test and experienced difficulty completing the testing safely, and EMS assistance was requested. Many times, candidates have returned to thank us for finding a potentially life threatening condition before it became an emergent situation.

Waiting for a candidate or employee to visit the doctor and start a medication regimen may seem like an imposition, but the avoidance of a possible heart attack, stroke, or death in the workplace is well worth the wait.

Additional information about High Blood Pressure and how to control and treat it can be found at:
Centers for Disease Control and Prevention: www.cdc.gov/bloodpressure
American Heart Association: www.heart.org