What is Hypertension (High Blood Pressure)?

Hypertension is the medical term for high blood pressure. Blood pressure is the force of blood flow against the walls of the arteries.

Blood pressure measurements are read as two numbers. The highest number, called systolic pressure, represents the pressure in the artery when the heart beats. The lowest number, called diastolic pressure, represents the pressure when the heart is at rest. Normal blood pressure is in the range of 120/80. High blood pressure, or hypertension, is defined as systolic pressure greater than 140 and / or diastolic pressure greater than 90. Blood pressure varies throughout each day.

In most cases, the cause of hypertension is unknown. Genetic factors could be involved. In addition, the following conditions may cause hypertension: narrowing of the arteries, excess fluid in the blood, stronger heartbeats than normal, some medications, or disorders of the kidneys, nervous system, or endocrine system (hormones).

Over time, high blood pressure can damage organs and tissues. It also increases the risk of coronary heart disease, stroke, and congestive heart failure, and seems to contribute to hardening of the arteries.

Approximately 65 million adult Americans have high blood pressure, but approximately 30% of these people do not know it. Of these people with high blood pressure, approximately 25% are taking medications without having good control of their blood pressure, about 11% are not taking any medication, and only about 34% of people with hypertension are taking medications and have good control of your blood pressure.

Risk Factors for Hypertension

A risk factor is something that increases your chance of getting a disease or condition.

It is possible to develop hypertension with or without the risk factors listed below. However, the more risk factors you have, the greater your chance of developing hypertension. If you have numerous risk factors, ask your doctor what you can do to reduce your risk.

Risk factors for hypertension include:

Specific Lifestyle Factors

Consumption of alcohol – Drinking alcohol regularly and in large quantities increases blood pressure. This means taking more than one drink a day for women or two for men.

Dietary excess sodium – In susceptible people, a diet high in salt could contribute to high blood pressure.

Lack of exercise – Moderate to intense exercise, practiced regularly, improves cardiac function and promotes healthy arteries. If you are not used to exercising, check with your doctor before starting an exercise program.
Stress – The hormones released by your body when you are under stress can increase your blood pressure. This could aggravate high blood pressure in genetically susceptible people.

Medical Conditions

Obesity – Like all tissues, adipose tissue requires a rich blood supply. The heart has to work harder to supply blood to all body tissues in heavier people than in thinner people.

Other conditions associated with hypertension include:

• Diabetes
• Kidney Disease
• Hormone Disorders
• Porphyria
• Pregnancy Toxemia

Some Medications

Oral Contraceptives (Birth Control Pills) – Taking oral contraceptives may increase your risk of hypertension in some situations. You are more likely to develop high blood pressure while taking birth control pills if you:

• Have a family history of hypertension
• Have kidney disease
• Are overweight
• Have high blood pressure during pregnancy
• Other Medications – Some medications can increase your risk of hypertension and / or interfering with other medications you could take to lower your blood pressure. These include:
  • Steroids
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Decongestants
  • Weight loss pills
  • Antidepressants
  • Age

People 35 years of age and older are at increased risk of developing hypertension, although all people , even children, may have high blood pressure.

Sex

In general, men have a higher risk of hypertension than pre-menopausal women. However, after menopause, a woman's risk increases and is slightly higher than that of a man of the same age.

Genetic Factors

Having family members with high blood pressure increases their risk of developing the condition.

Race

Symptoms of Hypertension 

Hypertension tends to develop at an earlier age and is more severe in black people than in whites.

High blood pressure usually does not cause symptoms, and this is the reason why it remains undiagnosed if it is not checked. Your organs and tissues can be damaged by high blood pressure without sensing any symptoms.

Sometimes, if blood pressure reaches extreme levels, you may experience the following symptoms:

• Headache
• Blurred or double vision
• Abdominal pain
• Chest pain
• Shortness of breath
• Dizziness

Diagnosis of Hypertension

Frequently, high blood pressure is diagnosed during a visit with your doctor. Blood pressure is measured using a meter around your arm and a device called a sphygmomanometer. Your doctor may ask you to sit quietly for five minutes before checking your blood pressure.

If your blood pressure reading is high, you will probably be asked to return to repeat blood pressure checks. The diagnosis of high blood pressure could be made if you have three or more readings greater than 140/90.

Some people's blood pressure increases when they are in the doctor's office. If your doctor suspects that this may be happening, you may be asked to take some blood pressure readings at home. In some cases, he may recommend that you use an ambulatory blood pressure monitor. This device measures your blood pressure regularly throughout the day, while you carry out your activities. In general, it is used for 24 hours, even when sleeping.

Treatments for Hypertension

The goal of hypertension treatment is to reduce blood pressure to a range within normal, and keep it there while minimizing the adverse side effects of medical treatment. The main objective is to avoid and reduce the complications of hypertension. The control of hypertension involves changes in lifestyle and medications.

Specific treatments include the following:

• Changes in lifestyle
• Medications
• Alternative and complementary therapies

Review for Hypertension

The purpose of the review is early diagnosis and treatment. Screening tests are usually administered to people without symptoms present, but who may be at high risk for certain diseases or conditions.

Review Exams

Blood Pressure Review – A blood pressure reading measures the amount of pressure in the artery when the heart is pumping (the highest number) and at rest (the lowest number). This test is quick and painless. A blood pressure meter is placed around your arm. Air is pumped into the meter and released while a health professional listens with a stethoscope. The review for hypertension is easy and routine. Blood pressure checks can be done easily in your doctor's office by a nurse, in some pharmacies, or at home if you buy a blood pressure machine.

Revision Guidelines

The American Heart Association recommends checking your blood pressure regularly; It is usually done every time you see your doctor. Check your blood pressure at least every two years.
If the result is high, your doctor will probably check it again, since a result that shows high blood pressure does not necessarily mean you have hypertension. If your blood pressure is near the maximum normal range, or if you have a family history of high blood pressure or other risk factors, you are at risk for hypertension. Talk to your doctor about how often you should check your blood pressure.

Reducing Your Risk of Hypertension

To help reduce your risk of developing hypertension, follow these guidelines:

• If you are overweight, lose weight.
• Avoid heavy alcohol consumption.
• If you smoke, stop doing it.
• Eat a healthy heart diet, including:
• DASH Diet (Dietary Approaches to Stop Hypertension)
• Decrease salt intake.
• Exercise regularly.
• Control stress.

If You Are Overweight, Lose Weight

Losing as little as 10 pounds can help you lower your heart's workload and lower your blood pressure. Follow the food and exercise plans recommended by your doctor. To lose weight, consume fewer calories than you spend. To maintain a healthy weight, balance the number of calories you consume with the number of calories you spend.

Avoid Abundant Alcohol Consumption

Drinking too much alcohol increases blood pressure and can lead to other heart problems. However, moderate alcohol consumption is not associated with high blood pressure. Moderate alcohol consumption equals two drinks or less per day for men and one drink or less for women. Talk to your doctor if you need help to reduce your alcohol consumption, or to quit completely.

If You Smoke, Stop Doing It

Smoking can increase the amount of adipose material that builds up in your arteries and could contribute to high blood pressure results.

Eat a Healthy Heart Diet

A diet low in saturated fat, trans fat, and cholesterol, although rich in whole grains, fruits, and vegetables will help reduce blood pressure, cholesterol levels, and body weight; all of which leads to a healthier heart. Follow the meal plan recommended by your doctor, or ask for a referral with a registered dietitian.

A clinical study in progress, called Dietary Approaches to Stop Hypertension, has found that some healthy eating patterns can lower blood pressure. This is called the DASH diet. Results of the second phase of the DASH study conducted in 2000 (called DASH-Sodium) indicate that reducing salt is another effective way to lower blood pressure.

Exercise Regularly

Choose exercises that you enjoy and make them a regular part of your day. Strive to maintain an exercise program that keeps you in good physical condition and at a healthy weight. For many people, this includes walking or participating in another aerobic activity for 30 minutes a day. Exercise can also help you manage stress. Check with your doctor before beginning any exercise program.

Control Stress

Although stress does not cause hypertension, the hormones released by your body when you are under stress can increase your blood pressure. Take your time to relax, exercise, and practice relaxation techniques.

Talking to Your Doctor About Hypertension

You have a unique medical history. Therefore, it is essential that you talk with your doctor or health care professional about your personal risk factors and / or experience with hypertension. By speaking openly and regularly with your doctor, you can play an active role in your care.

General Tips for Gathering Information

Here are some tips that will make it easier for you to talk with your health care professional:

• Take someone else with you. It is helpful for another person to listen to what is said and think of questions to ask.
• Write your questions in advance, so you do not forget them.
• Write down the answers you get, and make sure you understand what you are listening to. Ask for clarification, if necessary.
• Do not be afraid to ask your questions or ask where you can find more information about what you are discussing. You have the right to know.

Specific Questions to Ask Your Healthcare Professional

About Hypertension

• What is my blood pressure?
• How high is my blood pressure?
• Do I have hypertension?
• Is my blood pressure high enough to require treatment?
• Does my blood pressure increase my risk of other conditions?

About Your Risk of Developing Hypertension

• Based on my medical history, lifestyle, and family history, am I at risk for high blood pressure?
• How can I prevent high blood pressure?

About Treatment Options

• What medications are available to help me?
• What are the benefits / side effects of these medications?
• Will these medications interact with other medications, over-the-counter products, or food or herbal supplements that I am already taking for other conditions?
• What time of day should I take my blood pressure medications?
• What should I do if I forget to take a dose?
• Is there any alternative or complementary therapy that I should consider?

About Changes in Lifestyle

• Should I exercise?
• What kind of exercise is better?
• How much exercise should I be doing?
• How do I start with an exercise program?
• Are there any dietary changes I should make? How do I carry them out?
• Can you channel me with a registered dietitian?
• Should I stop drinking alcohol?
• Where can I get help to stop smoking?
• I need to lose weight? If so, how much?
• Should I check my blood pressure at home? How do I carry it out?

About Your Treatment Objectives

• At what level do you want to maintain my blood pressure?
• How do I know if my blood pressure is staying within healthy limits?
• How often should a health professional check my blood pressure?