• What Is Hypertension?
Guide To High Blood Pressure
|What Is Hypertension?
Hypertension is the medical term used to describe people who have consistently high blood pressure. As it is quite normal for blood pressure to rise in a single day and then return to normal the next, a diagnosis is only given if you have high measurements on 2 or more separate visits to your doctor. About one third of Americans are thought to have hypertension and many don’t know it. High blood pressure is sometimes referred to as a silent killer because it does not cause any symptoms, yet over time it can significantly increase a person's heart disease and stroke risk factors. Even then, most people who know they have the condition still do not manage to control their blood pressure well. However, the good news is that hypertension is easily diagnosed and highly treatable. And even better, it is preventable in the first place. For this reason, it is recommended that all healthy adults have their blood pressure tested every 2 years, and those diagnosed with the condition should buy a home blood pressure monitor to check their own reading regularly. The opposite of hypertension is hypotension which is low blood pressure.
See also: Why is high blood pressure dangerous?
The heart pumps blood through your arteries to deliver supplies of oxygen and nutrients around the body. As the blood moves through the arteries it pushes against the arterial walls. This force is measured as blood pressure. If the arteries are narrowed because of the build-up of fatty deposits (atherosclerosis, image) or the walls are less elastic due to a hardening of the arteries, then it takes more effort to pump blood through them. This causes pressure on the artery walls to rise. While most healthy people will experience high blood pressure occasionally - it is a normal response to exercise, stress, caffeine or certain medications - it then usually returns to normal. However, if blood pressure remains consistently high it ends up damaging the artery walls and the heart (because it has to pump harder).
Usually there are no symptoms of hypertension. Many people who are diagnosed are surprised to find they have the condition because they say they feel fine. Yet if you have undiagnosed high blood pressure for many years it could have been secretly damaging your arteries. This can lead to bleeding into the brain or bleeding in the retina of the eyes causing blindness. In other words, by the time the condition is discovered it could already have caused serious damage to the arteries which may manifest as a stroke, blindness, heart attack or kidney disease. It may also cause poor blood supply to the legs or heart failure.
Causes of high blood pressure: Most patients with high blood pressure have what is termed primary or essential hypertension. This means there is no obvious cause, although the person usually has risk factors which make it more likely they will develop high blood pressure (discussed below). Primary hypertension accounts for about 90 to 95 percent of cases. The remainder are categorized as secondary hypertension, which means it is a symptom of another disease, such as thyroidism, kidney disease or pregnancy (known as gestational hypertension). High blood pressure during pregnancy occurs in about 6 to 8 percent of all pregnancies, although it is more common in women who had hypertension or diabetes before they fell pregnant. High blood pressure is particularly dangerous in pregnant women because it can lead to preeclampsia, a life threatening condition, so it needs to be closely monitored. For more on this see, will pregnancy raise my blood pressure? and hypertension during pregnancy.
A doctor or nurse uses a blood pressure cuff and pressure gauge (technically called a sphygmomanometer) to measure blood pressure. The cuff is wrapped around the arm and is then pumped with air so that it squeezes the arm. The instrument works by measuring how high the blood pressure in the arm can raise a column of mercury in the pressure gauge. This is expressed in mm HG (millimeters of mercury). Two measurements will be taken - systolic (when the heart pumps) and diastolic (when it rests). If your blood pressure reading is high on the first visit to your doctor, he will ask you to return another day for a repeat reading. You may find it has returned to normal on the next visit. If not, your doctor may ask you to come back again in a few days. A hypertension diagnosis is only given after 2 or more visits where blood pressure levels have been consistently high. If you do receive a diagnosis you may be sent for heart disease testing to check for underlying damage.
Treatment for high blood pressure: People with prehypertension or those newly diagnosed with hypertension are now being advised to make lifestyle changes to lower their blood pressure. This is because the condition can often be controlled at this stage without resorting to blood pressure drugs. Advice usually involves losing weight, exercising regularly and following a low sodium diet such as the DASH Diet (Dietary Attempts to Stop Hypertension). This diet is high in veggies, fruit, grains and low fat dairy products. If lifestyle modifications do not lower your blood pressure then medications will be prescribed. Possible drugs include diuretics (water pills), calcium channel blockers, beta blockers, ACE inhibitors and angiotensin receptor blockers. In most instances medications will only control blood pressure, not cure it, so they may need to be taken for the rest of your life. If you do have hypertension, it important to be alert to the symptoms of stroke, the signs of coronary heart disease and heart attack symptoms.
There are several risk factors which can increase your chance of developing high blood pressure. These are:
Hypertension prevention: No matter how many risk factors you have, you can still reduce your chance of developing high blood pressure by:
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