Vital Signs

I am sure I am not the only one exhausted by the political ups, downs, turns, and about changes in the first fifteen weeks of 2019.

What better time to return to a non-political and practical question I got from my friend Michael: “Can you explain all the numbers I hear at my doctor’s office?”

Whenever he gets a check-up, the office nurse tells Michael what his Blood Pressure numbers are, but never what they mean. When he asks, he gets a circular answer along the lines of “the number is the pressure of your blood…”



The measurements include Pulse, Respiratory Rate, Body Temperature, and Blood Pressure. I will give a brief primer on all four- but will start with Michael’s question first.

Blood Pressure [BP]


  • The Second Number = Diastolic Pressure: This is the resting pressure of your blood on your arteries in between beats when your heart is filling.

Think of this as a closed system of hoses run by a pump (which it is). An obstruction in the peripheral line (such as atherosclerosis or plaque buildup) will cause both numbers to rise- there is more pressure needed to get the blood distributed, and the fluid exerts more pressure against the walls between beats.

Alternatively, if those numbers fall, it indicates either a leak in the system (hemorrhage) or the size of the “hose” has increased in volume (such as a sudden dilation of your vascular system in septic shock).

Determining what is a “good” blood pressure for you is a strategic conversation to have with your physician/primary provider, but here is a useful chart from the American Heart Association:

It is important to note that the chart (and associated webpage) was updated in December 2017 after a new definition of an elevated blood pressure was set at anything over 120/80.

The implication of this new limit is the number of Americans with high blood pressure went from 32% of the population to 46%. That could very likely include you.

I will let you discuss the implications of this change in the exam room with your own provider, but if you want to know more before your next office visit see these articles from Science News, NBC news, the New York Times, or Consumer Reports.

Pulse [or Heart Rate- HR]




Your pulse in your neck and feet have other clinical significance:

  • your provider might put a stethoscope to your neck to listen to your pulse (Carotid Artery) checking for sounds suggesting an incomplete flow (obstruction) of blood to your brain;
  • checking your pulse on the top of your feet (your pedal pulse) is an indicator that your blood is flowing without difficulty to the farthest reaches of your body.




Respirations [Respiratory Rate or RR]


But how much is too much- or not enough?




Body Temperature [BR]


First of all– it will depend on where the temperature is being taken:

  • Temporal Scanners (running over the forehead) also run lower than oral by .5 to a full degree- so a normal reading can be as low as 97.6 (again- check the manufacturer’s guide)



In Closing

Smart people get very intimidated in medical settings. It is common to pretend to understand what a health professional is saying even though you have no clue. Forgive yourself if this is true for you…

And then start asking questions.

Want to Know More?



