High Blood Pressure Overview
High blood pressure (hypertension) is a serious condition that
affects one in three adults in the United States, according to the Centers for Disease Control
and Prevention (CDC). It’s called the “silent killer” because people often
have no symptoms, yet it can lead to some serious and sometimes even fatal conditions.
Your blood moves through your body at a certain rate. According
to the American Heart Association, a blood pressure reading of less than 120/80
mmHg is considered normal. When you have high blood pressure, your blood moves
through your arteries at a higher pressure, putting more pressure on the
delicate tissues and damaging your blood vessels. You are diagnosed with high blood
pressure (hypertension) if your blood pressure readings are consistently above
Causes of High Blood Pressure
For most cases of high blood pressure there is no known
cause. This is called primary hypertension. For others, certain medical
conditions like kidney or heart conditions can cause high blood pressure. This
is called secondary hypertension. Some medications like birth control pills or
over-the-counter cold medicines can cause high blood pressure as well. Blood
pressure may or may not return to normal upon discontinuation of the medication.
High Blood Pressure Risk Factors
There are many risk factors for high blood pressure. Some
factors you can’t change. Others are modifiable based on your lifestyle. Risk
factors you cannot change include:
- age: Older adults are at greater risk for high
- gender: Women over 65 are more likely to have
higher blood pressure, and men under age 45 are more likely to have high blood
pressure than women.
- race: African-Americans are more likely to have
high blood pressure.
- family history: If your direct family members
(parent or sibling) have high blood pressure, you are more at risk.
Factors that are modifiable include:
- being overweight
- not exercising enough
- eating an unhealthy diet
- consuming excess salt
- drinking alcohol
- sleep apnea
Diagnosing High Blood Pressure
Your doctor can diagnose if you have high blood pressure by
simply using a blood pressure monitor to measure your blood pressure. This
monitor records your systolic blood pressure (SBP), the top number, and your
diastolic blood pressure (DBP), the bottom number. There are a few types of
high blood pressure depending on severity. They are:
- prehypertension: 120/80 mmHg or higher
- stage 1 high blood pressure: 140/90 mmHg or
- stage 2 high blood pressure: 160/100 mmHg or
- hypertensive crisis (a life-threatening condition):
180/110 mmHg or higher
Your doctor will also review your health history and risk
factors and perform a physical exam to make a diagnosis.
High Blood Pressure Tests and Treatments
The test to determine if you have high blood pressure is
simple and non-invasive. Your doctor will measure your blood pressure using a
monitor with a cuff. Your doctor may do this several times over a few
appointments to get an accurate reading because your blood pressure can change
depending upon many factors, some as simple as your mood at the time the
measurement is taken. Your doctor may also order:
- blood tests
- urine tests
- electrocardiogram (ECG)
- chest X-ray
- computed tomography (CT) scan
- reducing the amount of salt in your diet
- exercising and losing weight
- beginning a smoking cessation plan
- trying to reduce stress with some relaxation
Treatment for high blood pressure varies from changing
lifestyle choices to using medications. If your increased blood pressure is not
severe your doctor will probably recommend lifestyle modifications first. These
- losing weight
- eating healthy
- reducing the amount of salt in your diet
If this doesn’t work or if you have a more serious high blood
pressure diagnosis, your doctor will probably prescribe medication. Drugs that
help lower high blood pressure include:
- beta blockers
- calcium channel blockers
- ACE inhibitors
Your doctor will monitor your
progress and may increase the dose or change and add medications until you find
the right one(s) that works for you. Your doctor will probably also have you
monitor your blood pressure at different times during the day so you can see
when it gets worse or better.
If you have a hypertensive crisis you will need to be
treated in the emergency room or intensive care unit, as this can be fatal.
Your heart and blood vessels will be monitored and you will probably be on
oxygen and receive medication to bring your blood pressure down to a safe
Doctors Who Treat High Blood Pressure
Your primary care doctor will treat most cases of high blood
pressure. You may require more appointments depending on your blood pressure levels.
If your doctor thinks you have other cardiac conditions (which are common
complications of chronic high blood pressure), you may be referred to a doctor
who specializes in heart problems (a cardiologist).
Complications of High Blood Pressure
High blood pressure is a silent killer because it can lead
to some very serious complications. High blood pressure can stretch out your
arteries and weaken them (an aneurysm). It can lead to an abnormal heart rhythm
(arrhythmia). It can also make you more likely to have a heart attack or heart
failure, kidney problems, or even a stroke.
High Blood Pressure Prevention
If you have a family history of high blood pressure, you
should work with your doctor on reducing your risks. You should also take the
- Eat a healthy low-sodium diet.
- Exercise regularly.
- Try to maintain a healthy weight.
- Quit smoking.
Be sure to take your medication for high blood pressure as
directed and monitor your blood pressure at home with a monitoring device. Talk
to your doctor if you have any concerns about high blood pressure.