High Blood Pressure

Definition

Hypertension is the term used to describe high blood pressure. Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. African Americans are 1.5 times as likely as non-Hispanic whites to have high blood pressure; although they are 40% more likely to have high blood pressure, they are 10% less likely than their non-Hispanic white counterparts to have their blood pressure under control.

The American Heart Association says blacks are more than three times as likely to die from heart disease caused by high blood pressure as whites.

Blood pressure readings are usually given as two numbers — for example, 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high.

The top number is called the systolic blood pressure, and the bottom number is called the diastolic blood pressure.

• Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most of the time.
• High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg or above most of the time.
• If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension.

If you have pre-hypertension, you are more likely to develop high blood pressure.

If you have heart or kidney problems, or if 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.

Alternative Names

High blood pressure (HBP) also is called hypertension (HI-per-TEN-shun).

When HBP has no known cause, it may be called essential hypertension, primary hypertension, or idiopathic (id-ee-o-PATH-ick) hypertension.

When another condition causes HBP, it’s sometimes called secondary high blood pressure or secondary hypertension. In some cases of HBP, only the systolic blood pressure number is high. This condition is called isolated systolic hypertension (ISH). Many older adults have this condition. ISH can cause as much harm as HBP in which both numbers are too high.

Causes

Many factors can affect blood pressure, including:

• How much water and salt you have in your body
• The condition of your kidneys, nervous system, or blood vessels
• The levels of different body hormones

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. High blood pressure increases your chance of having a stroke, heart attack, heart failure, kidney disease, and early death.

You have a higher risk of high blood pressure if you:

• Are African American
• Are obese
• Are often stressed or anxious
• Drink too much alcohol (more than one drink per day for women and more than two drinks per day for men)
• Eat too much salt in your diet
• Have a family history of high blood pressure
• Have diabetes
• Smoke

Most of the time, no cause of high blood pressure is found. This is called essential hypertension.

High blood pressure that is caused by another medical condition or medication is called secondary hypertension. Secondary hypertension may be due to:

• Chronic kidney disease
• Disorders of the adrenal gland (pheochromocytoma or Cushing syndrome)
• Pregnancy (see: preeclampsia)
• Medications such as birth control pills, diet pills, some cold medications, and migraine medications
• Narrowed artery that supplies blood to the kidney (renal artery stenosis)
• Hyperparathyroidism

Symptoms

High blood pressure (HBP) itself usually has no signs or symptoms. Rarely, headaches may occur. You can have HBP for years without knowing it. During this time, the condition can damage your heart, blood vessels, kidneys, and other parts of your body.

Some people only learn that they have HBP after the damage has caused problems, such as coronary heart disease, stroke, or kidney failure.

Knowing your blood pressure numbers is important, even when you’re feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your blood pressure is too high, you can take steps to lower it. Lowering your blood pressure will help reduce your risk for related health problems.

Exams and Tests

Your health care provider will check your blood pressure several times before diagnosing you with high blood pressure. It is normal for your blood pressure to be different depending on the time of day.

Blood pressure readings taken at home may be a better measure of your current blood pressure than those taken at your doctor’s office. Make sure you get a good quality, well-fitting home device. It should have the proper sized cuff and a digital readout. Practice with your health care provider or nurse to make sure you are taking your blood pressure correctly.

Your doctor will perform a physical exam to look for signs of heart disease, damage to the eyes, and other changes in your body.

Tests may be done to look for:

• High cholesterol levels
• Heart disease, such as an echocardiogram or electrocardiogram
• Kidney disease, such as a basic metabolic panel and urinalysis or ultrasound of the kidneys

Treatments

The goal of treatment is to reduce blood pressure so that you have a lower risk of complications. You and your health care provider should set a blood pressure goal for you.

If you have pre-hypertension, your health care provider will recommend lifestyle changes to bring your blood pressure down to a normal range. Medicines are rarely used for pre-hypertension.

You can do many things to help control your blood pressure, including:

• Eat a heart-healthy diet, including potassium and fiber, and drink plenty of water. See: High blood pressure and diet
• Exercise regularly — at least 30 minutes of aerobic exercise a day.
• If you smoke, quit — find a program that will help you stop.
• Limit how much alcohol you drink — one drink a day for women, two a day for men.
• 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 stress. You can also try meditation or yoga.
• Stay at a healthy body weight — find a weight-loss program to help you, if you need it.

Your health care provider can help you find programs for losing weight, stopping smoking, and exercising. You can also get a referral from your doctor to a dietitian, who can help you plan a diet that is healthy for you.

There are many different medicines that can be used to treat high blood pressure.

Often, a single blood pressure 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 medications prescribed to you. If you have side effects, your health care provider can substitute a different medication.

Possible Complications

When blood pressure is not well controlled, you are at risk for:

• Bleeding from the aorta, the large blood vessel that supplies blood to the abdomen, pelvis, and legs
• Chronic kidney disease
• Heart attack and heart failure
• Poor blood supply to the legs
• Stroke
• Problems with your vision

When to Contact a Medical Professional

If you have high blood pressure, you will have regular appointments with your doctor.

Even if you have not been diagnosed with high blood pressure, it is important to have your blood pressure checked during your yearly check-up, especially if someone in your family has or had high blood pressure.

Call your health care provider right away if home monitoring shows that your blood pressure is still high.

Preventions

If you don’t have high blood pressure (HBP), you can take steps to prevent it. Healthy lifestyle habits can help you maintain normal blood pressure.

• Follow a healthy diet. Limit the amount of sodium (salt) and alcohol that you consume. The National Heart, Lung, and Blood Institute’s DASH eating plan promotes healthy eating.
• Be physically active. Routine physical activity can lower HBP and reduce your risk for other health problems.
• Maintain a healthy weight. Staying at a healthy weight can help you control HBP and reduce your risk for other health problems.
• Quit smoking. Smoking can damage your blood vessels and raise your risk for HBP. Smoking also can worsen health problems related to HBP.
• Manage your stress and learn to cope with stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.

Many people who adopt these healthy lifestyle habits are able to prevent or delay HBP. The more lifestyle changes you make, the more likely you are to lower your blood pressure and avoid related health problems.

Natural Remedies

(BlackDoctor.org) — Beat hypertension—Lower your blood pressure with simple lifestyle changes to protect yourself from this hidden health problem. According to research or other evidence, the following self-care steps may be helpful:

What You Need To Know:

• Sidestep salt Avoid using too much table salt, limit salty fast foods, and read labels to find low-sodium foods in your grocery store
• Watch what you eat Choose a diet low in cholesterol and animal fat, and high in fruits, vegetables, whole grains, legumes, and low-fat milk products, with some nuts and seeds
• Maintain a healthy weight Lose excess weight and keep it off with a long-term program of exercise and healthier eating
• Try CoQ10 Taking 100 mg a day of this powerful antioxidant may have a significant impact on your blood pressure after one to several months
• Boost heart health with supplemental garlic 600 to 900 mg a day of a standardized garlic extract can improve heart and blood vessel health, and also has a mild blood pressure–lowering effect
• Take minerals Supplements of calcium (800 to 1,500 mg a day) and magnesium (350 to 500 mg a day) may be helpful

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full hypertension article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.