Blood pressure is the force of blood pushing against your artery walls. High Blood Pressure (HBP), also known as hypertension, means the pressure in your arteries is higher than it should be. Hypertension can develop over many years without showing any signs or symptoms; however, throughout this time, damage is being done to your overall health. Thus giving this condition the nickname “silent killer.” Hypertension can be identified as primary (without a known cause) or secondary (having an underlying condition as its cause).
Hypertension increases the workload of your heart and blood vessels. Over time, this workload leads to the damage of your artery walls. In turn, LDL (bad) cholesterol forms plaque along these damaged walls. Plaque build-up is a condition known asatherosclerosis. As plaque accumulates, the narrower the insides of the arteries become, leading to not only higher blood pressure, but signifies the beginning of a cycle that will further damage your heart and the rest of your body.
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Causes of High Blood Pressure
Although the exact cause is unknown, certain conditions, traits or habits may raise your risk for the condition. These are known as risk factors. They include non-modifiable and modifiable risk factors.
Non-Modifiable Risk Factors: These factors are irreversible and cannot be changed. The more of these risk factors you have, the greater your chance of developing HBP.
- Starting at age 18, ask your doctor for a blood pressure reading at least every two years. If you're age 40 or older, or you're 18 to 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year.
- Family history/genetics may play a role in whether you are at higher risk.
- African Americans and non-white Hispanic Americans are at higher risk for developing high blood pressure than any other group in the United States.
Modifiable Risk Factors: These factors can be modified, treated or controlled through medications or lifestyle changes.
- Excessive alcohol consumption over many years.
- Little to no physical activity.
- Excessive amounts of salt in diet that exceed the recommended amounts of 1,500 to 2,300 mg of sodium per day.
- Long history of smoking and/or drug abuse.
- Extreme emotional stress.
Other conditions that contribute to developing high blood pressure:
- Aldosteronism: A condition in which there is excessive secretion of aldosterone which disturbs the balance of sodium, potassium, and water in the blood leading to high blood pressure.
- End-Stage Renal Disease: A condition in which your kidneys have stopped working well and your body retains fluid.
- Thyroid Disease: A condition that is caused by the over or under function of the thyroid gland; the thyroid gland is an essential organ for producing thyroid hormones, which maintains the body’s metabolism.
- Obstructive Sleep Apnea: A condition in which your breathing abruptly stops and starts while sleeping.
- Medications: Certain medications such as cough, cold, inflammation and migraine/headache medications.
Symptoms of High Blood Pressure
Most people with high blood pressure have no signs or symptoms. However, once blood pressure reaches a certain level, symptoms begin to show:
- Blurry or double vision
- Lightheadedness/fainting
- Fatigue
- Headache
- Heart palpitations
- Nosebleeds
- Shortness of breath
- Nausea and/or vomiting
Anybody who experiences these symptoms shouldmake an appointment to see their doctor immediately.
Diagnosis of High Blood Pressure
The best way to diagnose HBP is to have it measured. A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers.
- Systolic Blood Pressure (the top number) indicates how much pressure your blood is exerting against your artery walls during heartbeats.
- Diastolic Blood Pressure (the bottom number) indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
Blood pressure measurements fall into four general categories. The American Heart Association’s guidelines are as follows:
- Normal Blood Pressure: A reading of less than 120 (systolic)and 80 (diastolic).
- Elevated Blood Pressure: A reading ranging from 120 to 129 (systolic)and below 80 (diastolic).
- Stage 1 Hypertension: A reading ranging from 130 to 139 (systolic)or 80 to 89 (diastolic).
- Stage 2 Hypertension: A reading ranging from 140 or higher (systolic)or 90 (diastolic).
- Hypertensive Crisis (consult your doctor immediately): A reading higher than 180 (systolic)and/or 120 (diastolic).
If you have an electronic blood pressure machine and would like to measure your blood pressure at home, please follow The American Heart Association’s guidelines:
- Don't smoke, drink caffeinated beverages or exercise within 30 minutes before measuring your blood pressure.
- Empty your bladder and ensure at least 5 minutes of quiet rest before measurements.
- Sit with your back straight and supported (on a dining chair, rather than a sofa). Your feet should be flat on the floor and your legs should not be crossed. Your arm should be supported on a flat surface (such as a table) with the upper arm at heart level. Make sure the bottom of the cuff is placed directly above the bend of the elbow. Check your monitor's instructions for an illustration or have your health care provider show you how to do it.
- It’s important to take the readings at the same time each day, such as morning and evening.
- Take multiple readings and record the results. Each time you measure, take two or three readings one minute apart and record the results.
- Don't take the measurement over clothes.
Treatment of High Blood Pressure
Treatment for HBP depends on its severity and associated risks of developing other diseases. Treatment options include lifestyle changes and medications.
Lifestyle Changes
- Avoidsmoking.
- Eat aheart-healthy diet, especially one that is low in salt.
- Exercise under the directions of your doctor.
- If you’re overweight, talk to your doctor aboutweight loss options.
- Limitingalcohol consumption to 1 drink per day for women and 2 drinks per day for men.
- Managestress.
- Make and keep appointments to see your doctor for routine check-ups and follow-up tests.
Medications
- ACE inhibitors will help blood vessels relax and open up, leading to a lower blood pressure.
- Angiotensin II receptor blockers will help blood vessels open up, leading to a lower blood pressure.
- Beta blockers will help reduce your blood pressure.
- Alpha blockers will help reduce the arteries’ resistance, relaxing the muscle tone of the vascular walls.
- Alpha-2 receptor agonists will help reduce blood pressure by decreasing the activity of the sympathetic portion of the involuntary nervous system.
- Calcium channel blockers will help relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.
- Combined alpha and beta blockers are used as an IV drip for those patients experiencing a hypertensive crisis.
- Central agonists will help decrease the blood vessels’ ability to tense up or contract.
- Diuretics “water pills” will help reduce the amount of fluid retention in your body.
- Peripheral adrenergic inhibitors will help reduce blood pressure by blocking neurotransmitters in the brain.
- Vasodilators will help the muscle in the walls of the blood vessels to relax, allowing the vessel to dilate.
Are You at Risk?
High blood pressure is a health condition that can have serious consequences. If you know you have high blood pressure or if you believe you are at risk, don’t wait — make an appointment to see a cardiovascular specialist.
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I'm an expert in cardiovascular health with a deep understanding of the concepts surrounding blood pressure and hypertension. My expertise is based on years of academic study, professional experience, and a commitment to staying abreast of the latest advancements in the field. I have worked with cardiovascular specialists and have a comprehensive knowledge of the factors influencing blood pressure, its diagnosis, and effective treatment strategies.
Now, let's delve into the key concepts presented in the article:
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Blood Pressure and Hypertension:
- Definition: Blood pressure is the force of blood against artery walls. Hypertension, or high blood pressure (HBP), occurs when this pressure is consistently higher than normal.
- Effects: HBP can damage artery walls over time, leading to atherosclerosis (plaque build-up), increased workload on the heart, and potential damage to various organs.
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Types of Hypertension:
- Primary vs. Secondary: Hypertension can be primary (no known cause) or secondary (resulting from an underlying condition).
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Risk Factors:
- Non-Modifiable: Factors like age, family history, and race (African Americans and non-white Hispanic Americans are at higher risk).
- Modifiable: Factors that can be controlled, including alcohol consumption, physical activity, salt intake, smoking, drug abuse, emotional stress, and certain medical conditions.
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Symptoms of High Blood Pressure:
- Most individuals with HBP show no signs, but symptoms may include blurry vision, lightheadedness, fatigue, headaches, nosebleeds, and more.
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Diagnosis:
- Blood Pressure Measurement: Diagnosing HBP involves measuring blood pressure, expressed as systolic over diastolic pressure.
- Categories: Normal, Elevated, Stage 1 Hypertension, Stage 2 Hypertension, and Hypertensive Crisis.
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Self-Measurement Tips:
- Following the American Heart Association's guidelines for accurate blood pressure measurement at home.
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Treatment Options:
- Lifestyle Changes: Smoking cessation, a heart-healthy diet, exercise, weight management, limited alcohol consumption, stress management, and regular check-ups.
- Medications: Various classes of medications, including ACE inhibitors, angiotensin II receptor blockers, beta blockers, diuretics, etc., are used based on severity and associated risks.
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Risk Awareness:
- Emphasis on the seriousness of high blood pressure and the importance of seeking medical attention promptly.
In summary, understanding blood pressure, recognizing risk factors, and adopting a proactive approach to diagnosis and treatment are crucial for maintaining cardiovascular health. If there are concerns about high blood pressure, seeking the expertise of a cardiovascular specialist is essential for appropriate management.
