What is high blood pressure (also called hypertension)?

Occasionally, high blood pressure can be traced to a specific disease condition in the kidneys or adrenal glands; this is referred to as secondary hypertension. However, 90-95% of hypertension cases cannot be linked to any specific disease. Such cases are called primary hypertension.

Nearly 1 out of every 3 American adults has high blood pressure; this is about 65 million people. Over half of Americans age 60 or older have high blood pressure, but this IS NOT a normal part of aging.

Many people assume that high blood pressure is related to high levels of stress, tension, and nervousness, however, a person can be very relaxed, easy-going and still have high blood pressure. While any type of stress can briefly raise blood pressure, it does not itself cause high blood pressure. Even so, people with high blood pressure should learn ways to control the stress in their lives.

Persons at increased risk for developing high blood pressure include:

• Those with a family history of high blood pressure
• People over age 35
• African-Americans
• Women over 55, men over 45
• Persons with diabetes or kidney disease
• Those who are inactive or overweight
• Heavy alcohol consumers
• Persons sensitive to sodium

What are the warning signs and symptoms of high blood pressure?

In most cases, people with high blood pressure do not have any symptoms (warning signs). The only real way to know if you have high blood pressure is to have your blood pressure checked by your doctor. High blood pressure can develop over time, so it should be checked at least once every 2 years.

How is high blood pressure detected?

High blood pressure is detected using a blood pressure monitoring device called a sphygmomanometer. Blood pressure can vary; so, if your doctor detects high blood pressure on one visit, he or she will usually take additional readings on separate occasions. You may also be asked by your doctor to purchase a home blood pressure monitoring device.

The two measurements that determine your blood pressure are:

1. Systolic: The systolic number represents the pressure against the arterial walls immediately after the heart pumps. This is the top number in the reading. For example, if your blood pressure is 120/80 (described as 120 over 80), the systolic measurement is 120.

2. Diastolic: The diastolic number represents the pressure against the arterial walls when your heart is resting between heart beats. This is the bottom number in the reading. Using the same example, if your blood pressure is 120 over 80, the diastolic measurement is 80.

A normal adult blood pressure measurement is below 120 over 80. Readings consistently at or above 140/90 are considered high, and requires a visit with a physician.

What are the treatment options for high blood pressure?

The first line of treatment for high blood pressure is lifestyle changes. Your doctor will discuss with you a variety of ways to control and/or lower your blood pressure. As with all cardiovascular risk factors, lifestyle changes are a good way to reduce your chances of developing cardiovascular disease. To reduce blood pressure in particular, it is necessary to:

• Exercise regularly – relaxes blood vessels and lowers resting heart rate thereby lowering blood pressure

• Stop smoking – smoking increases blood pressure and heart rate

• Eat a well-balanced diet low in salt, fat and cholesterol – the DASH diet can prevent and treat high blood pressure

• Manage stress levels – stress can cause blood vessels to narrow, slowing blood flow and increasing blood pressure

• Control weight – A small weight loss of 10-15 pounds can reduce blood pressure

• Reduce or avoid caffeine and other stimulants

In some cases, lifestyle changes are not enough to control high blood pressure. In this situation, your doctor may discuss medications and/or procedures that can help to reduce your blood pressure.

Medications

• Beta Adrenergic Receptive Blockers (Beta blockers) help control the heart beat and decrease oxygen demand, lower blood pressure, and protect against heart attack and heart failure

• Diuretics remove excess fluid from the body. Excess fluid in the body can cause high blood pressure.

• Calcium channel blockers decrease heart contractility and enlarge arteries, which can lower blood pressure

• Angiotensin Converting Enzyme (ACE) Inhibitors enlarge blood vessels to increase blood flow, prevent or delay arteriosclerosis (plaque in the arteries), help strengthen the heart muscle and lower blood pressure

• Angiotensin II Receptor Blockers widen blood vessels to increase blood flow

• Central Nervous System (CNS) Active Agents reduce nerve activity. Nerve activity may in some cases cause blood pressure to rise

6/16/2008