High Blood Pressure

High blood pressure, also called hypertension can damage your arteries, heart, and kidneys, and lead to atherosclerosis and stroke.

Hypertension is often referred to as the ‘silent killer’ because it does not show any visible signs until it reaches dangerously high levels. If left untreated, this condition can lead to considerable organ damage but can be prevented with the right treatment. Hypertension is a serious medical condition in which the pressure applied by flowing blood on the walls of arteries is too strong. Your blood pressure measurement consists of two numbers: systolic and diastolic.

Systolic measurement

Systolic measurement is the pressure of blood against your artery walls when the heart has just finished pumping (contracting). The top number, or systolic measurement, of a blood pressure reading.

Diastolic measurement

Diastolic measurement is the pressure of blood against your artery walls between heartbeats when the heart is relaxed and filling with blood. The second value in a blood pressure reading

Level

Systolic

Diastolic

 

High blood pressure is:

140 or above

90 or above

 

Prehypertension is:

120 to 139

80 to 89

 

Normal adult (age 18 or older) blood pressure is:

119 or below

79 or below

According to new, more stringent high blood pressure guidelines from the Seventh Report of the Joint National Committee (JNC 7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, millions of people with previously considered borderline high (130 to 139/85 to 89 mm Hg) or normal (120/80) blood pressure now fall into the “prehypertension” range.

Because new studies show the risk of heart disease and stroke begins to increase at lower blood pressures than previously believed, health experts lowered the acceptable normal range to promote more aggressive and earlier treatment of high blood pressure.

Symptoms of High Blood Pressure

Usually, you will not feel any warning signs or high blood pressure symptoms, and you will not know you have it until a health professional takes a reading. Hypertension develops slowly and can cause serious organ damage, usually without any symptoms.

If you develop severe high blood pressure, you may have headaches, visual disturbances, nausea, and vomiting.

Hypertension Causes

It is not always easy for a doctor to determine the root cause of hypertension, Factors such as obesity, heavy alcohol consumption, genetic predisposition to high blood pressure, high salt intake and advancing age can all contribute to raising one’s blood pressure. In addition to sedentary habits, stress and less than sufficient potassium or calcium in your diet, insulin resistance can also lead to elevated blood pressure.

How is High Blood Pressure Diagnosed?

During routine doctor visits, many individuals come to realize that they have high blood pressure. To confirm that you have high blood pressure, your blood pressure must reach or exceed 140/90 mm Hg on three or more separate occasions. It is usually measured in intervals of 1-2 weeks. Except in very severe cases, the diagnosis is not based on a single measurement.

If there is a reason to suspect that the blood pressure measurements taken in the doctor’s office do not represent your accurate blood pressure (if, for example, you have white-coat hypertension), you may need to check your blood pressure away from the doctor’s office. Your blood pressure can rise more than 20 mm Hg systolic and 10 mm Hg diastolic from white-coat hypertension. Even routine activities, such as attending a meeting, can raise your blood pressure by that amount. Other factors that can raise your blood pressure include commuting to work, exposure to cold, and drinking large amounts of alcohol.

Your doctor may have you check your blood pressure at home 3 times a day and keep a record of the readings. Or you may need to wear an automated blood pressure cuff that periodically inflates and takes blood pressure measurements during the day. This is called ambulatory blood pressure monitoring.

High Blood Pressure Treatment

If you fall into the prehypertension range (120-139/80-89 mm Hg), your doctor will likely recommend lifestyle modifications, including losing excess weight, exercising, limiting alcohol, cutting back on salt, quitting smoking, and following the Dietary Approaches to Stop Hypertension (DASH) diet. The DASH eating plan is a low-fat and low-saturated-fat diet that emphasizes eating more fruits, vegetables, whole grains, and low-fat dairy foods.

If you have high blood pressure (140-159/90-99 mm Hg) and you do not have any organ damage or other risk factors for heart disease (uncomplicated high blood pressure), your doctor may suggest lifestyle changes and/or medicines to help manage it. Most people with high blood pressure will need two or more medications, including a thiazide-type diuretic, to lower their blood pressure to below 140/90 mm Hg, the goal for people with uncomplicated hypertension. If you have other conditions, such as diabetes, heart failure, or chronic kidney disease, your goal blood pressure is lower: 130/80 mm Hg.

If your blood pressure is 160-179/100-109 mm Hg or higher, you and your doctor may need to try various combinations of medications to find what works best for you. You will also need to make aggressive lifestyle changes.

Overall, your treatment will depend upon how high your blood pressure is, whether you have other medical conditions, such as diabetes, and whether any organs have already been damaged. Your risk of developing other diseases, especially heart disease, will be another important factor your doctor will consider.