What is hypertension?
Hypertension is a medical term used to describe high blood pressure. To understand hypertension, one first has to understand blood pressure itself. The heart generates blood pressure when it pumps blood through your arteries. This creates a force against the arterial wall which is called blood pressure. When your blood pressure is measured, the health care professional will report two numbers (140/90 for example). The higher blood pressure number is called the systolic blood pressure and this occurs when the heart contracts. The lower blood pressure number is called the diastolic blood pressure and occurs when the heart relaxes.
What is normal blood pressure and what constitutes high blood pressure?
The latest guidelines define normal and elevated blood pressure as the following:
- Normal = <120/80 mmHg.
- Prehypertension = 120-139/80-89 mmHg.
- Hypertension, Stage 1 = 140-159/90-99 mmHg.
- Hypertension, Stage 2= >160/100
Why is hypertension dangerous?
High blood pressure causes your heart to work harder and over time it causes the heart muscle to thicken and become stiffer. Chronic blood pressure elevation can make your arteries harden quicker resulting in an even higher blood pressure. Uncontrolled blood pressure can cause a stroke, kidney failure, or a heart attack. Statistically, patients with uncontrolled blood pressure have three times the likelihood of developing coronary heart disease and a six fold probability of congestive heart failure. The stroke rate in patients with high blood pressure increases by seven times when compared to patients whose blood pressure is well treated.
What causes high blood pressure?
The cause of high blood pressure in most patients is unknown. This is the case in up to 90% of the time and is referred to as essential hypertension. Factors that predispose a patient to develop essential hypertension would include a family history of hypertension, race (African-American), age (over 35), sex (male), increased weight, stress, anxiety, excessive salt intake, and lack of exercise.
In a minority of patients, a specific cause of their high blood pressure is found. These patients are said to have secondary hypertension. Causes of secondary hypertension include the use of some medications including oral contraceptives, heavy alcohol consumption, blockages in the arteries bringing blood to the kidneys, and some tumors. The initial medical evaluation of a patient with high blood pressure generally includes screening the patient for these secondary causes. If this screening process is unremarkable, then the patient is diagnosed with essential hypertension.
Are you aware when your blood pressure is high?
In most cases, high blood pressure is not associated with symptoms and for that reason it can be very dangerous. Detection can only be made by having your blood pressure measured by a health care professional.
How is hypertension treated?
If your health care provider determines a cause for your hypertension (secondary hypertension), then treatment is directed against this cause. This should lead to significant improvement in your blood pressure.
If no cause is identified (essential hypertension), then lifestyle modifications may be effective in lowering your elevated blood pressure.
- Weight Loss can decrease systolic blood pressure 5-20 mmHg/22 lbs.
- Diets of low fats and high in fruits and vegetables can lessen the systolic pressure by 8-14 mmHg.
- Reduced salt intake can further decrement systolic blood pressure by 2-8 mmHg.
- Regular aerobic exercise reduces systolic blood pressure by 4-9 mmHg.
- Less alcohol consumption has the potential to further diminish the systolic blood pressure by 2-4 mmHg.
If the above measures are not successful, the medical therapy is then implemented under the care of your physician. These medications may include beta blockers, calcium channel blockers, diuretics and other medications used either alone or in combination.