Hypertension

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 28, 2016
StartDiseasesHypertension

A person is said to have hypertension when their blood pressure is increased and stays high throughout the day. Hypertension is also called high blood pressure. It is a serious condition that can lead to other heath problems, such as stroke, heart failure, kidney damage, and vision loss.

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Definition & Facts

Blood pressure is a measure of how forcefully the blood pushes up against arterial walls as it flows throughout the body. Blood pressure is measured using two numbers: systolic pressure (the first number in the blood pressure reading) and diastolic pressure (the second number).

For example, if a person has a systolic pressure of 130 and a diastolic pressure of 80, then his or her blood pressure would be read as 130/80. A good blood pressure reading is 120/80. A person is said to have hypertension if his or her systolic pressure is above 140 and his or her diastolic pressure is above 90.

Systolic blood pressure refers to blood pressure at the time of ventricular contraction (when the heart beats). Diastolic blood pressure refers to blood pressure in between heart beats.

Hypertension is somewhat common in the United States; approximately one third of adults in the U.S. (approximately 70 million) suffer from hypertension. People with a family history of hypertension have an increased risk of developing it. Hypertension is also more common among African-Americans than other demographics. Though hypertension is most common in adults, children may also develop it.

Symptoms & Complaints

People with hypertension don't typically display symptoms. In fact, some hypertensive people do not realize they have high blood pressure until they have their blood pressure measured by a healthcare professional.

Severely high blood pressure in the range of 180/110 is considered a medical emergency. When a person has extreme hypertension, they will experience symptoms such as blurred vision and headaches. Extremely high blood pressure is also called malignant hypertension, hypertensive crisis, or hypertensive emergency, and it requires immediate medical care.

Malignant hypertension may damage a person's eyesight, kidneys, heart, or brain. It can also cause heart attack, kidney failure, vision loss, and brain hemorrhage. Some symptoms of hypertensive crisis include headache, anxiety, nosebleeds, and shortness of breath.

Causes

Though medical experts do not know the exact cause of hypertension in all cases, most agree that certain behaviors are linked to developing it. Some factors that may lead to hypertension are:

Many of the above risk factors can be controlled with lifestyle changes. For example, eating a healthy diet rich in vegetables, fruit, whole grains, and low-fat dairy while limiting sodium intake can help reduce the risk of developing high blood pressure.

Regular exercise, particularly cardiovascular exercise, for 30 minutes several times per week can also improve cardiac functioning. Some of the best types of exercise for lowering blood pressure are walking, swimming, jogging, and cycling. 

Diagnosis & Tests

In order to diagnosis hypertension, healthcare professionals use a blood pressure cuff to measure the patient's diastolic and systolic pressure. Getting a blood pressure reading is fast and easy. The healthcare professional fastens the cuff around the patient's arm, tightens it around the arm, and then loosens the cuff. The blood pressure reading is quickly received and assessed by the healthcare professional.

Receiving a high blood pressure reading does not mean the patient has high blood pressure. For example, the patient could simply be experiencing a high level of stress at the time when the reading is recorded. For this reason, it is best for the patient to have their blood pressure monitored over time. This will give the healthcare professional an accurate idea of the patient's typical range of blood pressure readings.

A person who falls within the normal range for blood pressure should still get their blood pressure read at least once every two years.

If a person is diagnosed with hypertension, then they should have their blood pressure tested at least once per year. Depending on the severity of a person's high blood pressure, his or her doctor may require more frequent blood pressure screenings. A person with hypertension and other risk factors for stroke or heart attack might need to have their blood pressure read twice per year or even more, depending on their condition.

Treatment & Therapy

When a patient develops high blood pressure, their healthcare provider will usually suggest lifestyle changes. Overweight and obese patients are often instructed to lose weight. Exercise will also be recommended. Because smoking, eating too much salt, and drinking too much alcohol are all risk factors, doctors often suggest that patients quit smoking, limit alcohol intake, and eat a low-sodium diet.

Hypertension is often treated with antihypertensive drugs. Doctors generally prescribe a low dose medication at first. Then, depending on the patient's response to it, the dosage might be increased. Some patients require more than one medicine to control their blood pressure. People with extremely high blood pressure may need to take blood pressure meds for the remainder of their lives.

It is a good idea for those diagnosed as hypertensive to keep a blood pressure cuff at home to monitor their blood pressure. One should consult a healthcare provider about which types and brands of monitors work best. When a patient purchases a blood pressure monitoring system for their home, it is best to take that monitoring system to a healthcare provider to test its accuracy. 

Prevention & Prophylaxis

Healthcare professionals stress the importance of a healthy lifestyle. The following is a list of things people can do to prevent developing hypertension:

  • Exercise regularly
  • Do not smoke
  • Drink alcohol in moderation
  • Eat healthy foods, such as vegetables and fruit
  • Maintain a healthy weight
  • Eat a low-sodium diet

Because blood pressure increases when a person feels stress, stress management is another important part of managing and preventing high blood pressure. For patients with mild cases of hypertension, healthcare professionals might recommend relaxation techniques