Overview Of High Blood Pressure (Hypertension)
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the term used to describe high blood pressure.
Untreated hypertension can lead to many medical problems. These include heart disease, stroke, kidney failure, eye problems, and other health issues.
Readings are given as two numbers. The top number is called systolic blood pressure. The bottom number is called diastolic blood pressure. For example, 120 over 80 (written as 120/80 mm Hg).
One or both of these numbers can be too high. (Note: These numbers apply to people who are not taking medicines for blood pressure and who are not ill.)
Normal blood pressure is when your levels are lower than 120/80 mm Hg most of the time.
High blood pressure (hypertension) is when one or both of your readings are higher than 130/80 mm Hg most of the time.
If the top reading is between 120 and 130 mm Hg, and the bottom reading is less than 80 mm Hg, it is called elevated blood pressure.
If you have heart or kidney problems, or you had a stroke, your doctor may want your blood pressure to be even lower than that of people who do not have these conditions.
Commonly Associated With
High blood pressure – adults
Causes Of High Blood Pressure (Hypertension)
Many factors can affect blood pressure, including:
- The amount of water and salt you have in your body
- The condition of your kidneys, nervous system, or blood vessels
- Your hormone levels
- You are more likely to be told your blood pressure is too high as you get older. This is because your blood vessels become stiffer as you age. When that happens, your blood pressure goes up. Hypertension increases your chance of having a stroke, heart attack, heart failure, kidney disease, or early death.
You have a higher risk of hypertension if you:
- Are African American
- Are obese
- Are often stressed or anxious
- Drink too much alcohol (more than 1 drink per day for women and more than 2 drinks per day for men)
- Eat too much salt
- Have a family history of high blood pressure
- Have diabetes
- Smoke
- Most of the time, no cause of hypertension is found. This is called essential hypertension.
High blood pressure that is caused by another medical condition or medicine you are taking is called secondary hypertension.
Secondary hypertension may be due to:
- Chronic kidney disease
- Disorders of the adrenal gland (such as pheochromocytoma or Cushing syndrome)
- Hyperparathyroidism
- Pregnancy or preeclampsia
- Medicines such as birth control pills, diet pills, some cold medicines, migraine medicines, corticosteroids, some antipsychotics, and certain medicines used to treat cancer
- Narrowed artery that supplies blood to the kidney (renal artery stenosis)
- Obstructive sleep apnea (OSA)
Symptoms Of High Blood Pressure (Hypertension)
Most of the time, there are no symptoms. For most people, hypertension is found when they visit their health care provider or have it checked elsewhere.
Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have this condition.
Malignant hypertension is a dangerous form of very high blood pressure. Symptoms may include:
- Severe headache
- Nausea and vomiting
- Confusion
- Vision changes
- Nosebleeds
Exams & Tests
Diagnosing hypertension early can help prevent heart disease, stroke, eye problems, and chronic kidney disease.
Your provider will measure your blood pressure many times before diagnosing you with hypertension. It is normal for your readings to be different based on the time of day.
All adults over the age of 18 should have their blood pressure checked every year. More frequent measurements may be needed for those with a history of high blood pressure readings or those with risk factors forhypertension.
Blood pressure readings taken at home may be a better measure of your current levels than those taken at your provider’s office.
Make sure you get a good quality, well-fitting home monitor. It should have a properly sized cuff and a digital readout.
Practice with your provider to make sure you are taking your blood pressure correctly.
You should be relaxed and seated for several minutes prior to taking a reading.
Bring your home monitor to your appointments so your provider can make sure it is working correctly.
Your provider will do a physical exam to look for signs of heart disease, damage to the eyes, and other changes in your body.
Tests may also be done to look for:
- High cholesterol level
- Heart disease, using tests such as an echocardiogram or electrocardiogram
- Kidney disease, using tests such as a basic metabolic panel and urinalysis or ultrasound of the kidneys
Treatment Of High Blood Pressure (Hypertension)
The goal of treatment is to reduce your blood pressure so that you have a lower risk of health problems caused by hypertension. You and your provider should set a goal for you.
Whenever thinking about the best treatment for high blood pressure, you and your provider must consider other factors such as:
- Your age
- The medicines you take
- Your risk of side effects from possible medications
- Other medical conditions you may have, such as a history of heart disease, stroke, kidney problems, or diabetes
- If your reading is between 120/80 and 130/80 mm Hg, you have elevated blood pressure.
Your provider will recommend lifestyle changes to bring your levels down to a normal range.
Medicines are rarely used at this stage.
If your blood pressure is higher than 130/80, but lower than 140/90 mm Hg, you have Stage 1 hypertension.
When thinking about the best treatment, you and your provider must consider:
- If you have no other diseases or risk factors, your provider may recommend lifestyle changes and repeat the measurements after a few months.
- If your levels remains above 130/80, but lower than 140/90 mm Hg, your provider may recommend medicines to treat hypertension.
- If you have other diseases or risk factors, your provider may be more likely to start medicines at the same time as lifestyle changes.
- If your blood pressure is higher than 140/90 mm Hg, you have Stage 2 hypertension. Your provider will most likely start you on medicines and recommend lifestyle changes.
- Before making a final diagnosis of either elevated blood pressure or hypertension, your provider should ask you to have your levels measured at home, at your pharmacy, or somewhere else besides their office or a hospital.
LIFESTYLE CHANGES
You can do many things to help control your blood pressure, including:
- Eat a heart-healthy diet, including potassium and fiber.
- Drink plenty of water.
- Get at least 40 minutes of moderate to vigorous aerobic exercise at least 3 to 4 days a week.
- If you smoke, quit.
- Limit how much alcohol you drink to 1 drink a day for women, and 2 a day for men or less.
- Limit the amount of sodium (salt) you eat. Aim for less than 1,500 mg per day.
- Reduce stress. Try to avoid things that cause you to stress, and try meditation or yoga to de-stress.
- Stay at healthy body weight. Your provider can help you find programs for losing weight, stopping smoking, and exercising.
You can also get a referral to a dietitian, who can help you plan a diet that is healthy for you.
How low your blood pressure should be and at what level you need to start treatment is individualized, based on your age and any medical problems you have.
MEDICINES FOR HYPERTENSION
Most of the time, your provider will try lifestyle changes first, and check your levels two or more times.
Medicines will likely be started if your blood pressure readings remain at or above these levels:
- Top number (systolic pressure) of 130 or more
- Bottom number (diastolic pressure) of 80 or more
- If you have diabetes, heart problems, or a history of a stroke, medicines may be started at a lower reading. The most commonly used targets for people with these medical problems are below 120 to 130/80 mm Hg.
There are many different medicines to treat hypertension.
Often, a single drug may not be enough to control your blood pressure, and you may need to take two or more drugs.
It is very important that you take the medicines prescribed to you.
If you have side effects, your doctor can substitute a different medicine.
