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Hypertension (High Blood Pressure)

What is it?

Symptoms

Causes

Diagnosis

Treatment

Prevention

What is it?

Blood pressure is the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, also called hypertension, is dangerous because it makes the heart work harder to pump blood to the body and it contributes to hardening of the arteries or atherosclerosis and the development of heart failure

Symptoms

One of the most dangerous aspects of hypertension is that you may not know that you have it. There are generally no symptoms of high blood pressure, so you usually don't feel it. In fact, nearly one-third of people who have hypertension don't know it. The only way to find out if you have high blood pressure is to get your blood pressure checked on a regular basis. This is especially important if you have a close relative who has high blood pressure.

If your blood pressure is extremely high, there may be certain symptoms to look out for, including:

  • Severe headache
  • Fatigue or confusion
  • Vision problems
  • Chest pain
  • Difficulty breathing
  • Irregular heartbeat
  • Blood in the urineIf you have any of these symptoms, see a doctor immediately.

You could be having a hypertensive crisis that could lead to a heart attack or stroke.

Causes

The exact causes of hypertension are not known. Several factors and conditions may play a role in its development, including:

  • Smoking
  • Being overweight
  • Lack of physical activity
  • Too much salt in the diet
  • Too much alcohol consumption (no more than 1 to 2 drinks per day)
  • Stress
  • Older age
  • Genetics
  • Family history of high blood pressure
  • Chronic kidney disease
  • Adrenal and thyroid disorders
Who Is More Likely to Develop Hypertension?
  • People with family members who have high blood pressure.
  • People who smoke.
  • Women who are pregnant.
  • Women who take birth control pills.
  • People over the age of 35.
  • People who are overweight or obese.
  • People who are not active.
  • People who drink alcohol excessively.
  • People who eat too many fatty foods or foods with too much salt.

 

Diagnosis

You can determine your blood pressure by having it checked by a doctor, at a pharmacy or you can purchase a blood pressure monitor for your home.

Blood pressure is most often measured with a device known as a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve. and it is measured in two ways: systolic and diastolic.

  • Systolic blood pressure is the pressure during a heartbeat.
  • Diastolic blood pressure is the pressure between heartbeats.

Blood pressure is measured in millimeters of mercury (mm Hg) and is written systolic over diastolic (for example, 120/80 mm Hg, or "120 over 80"). According to the most recent guidelines, a normal blood pressure is less than 120/80 mm Hg. Prehypertension consists of blood pressure that is 120-139/80-89. Blood pressure that is 140/90 or greater is high blood pressure, or hypertension.

Blood pressure may increase or decrease, depending on your age, heart condition, emotions, activity, and the medications you take. One high reading does not mean you have the diagnosis of high blood pressure. It is necessary to measure your blood pressure at different times while resting comfortably for at least five minutes to find out your typical value.

In addition to measuring your blood pressure, your doctor will ask about your medical history (whether you've had heart problems before), assess your risk factors (whether you smoke, have high cholesterol, diabetes etc.), and talk about your family history (whether any members of your family have had high blood pressure or heart disease).

Your doctor will also conduct a physical examination. As part of this examination, he or she may use a stethoscope to listen to your heart for any abnormal sounds and your arteries for a bruit, a whooshing or swishing sound that may indicate that the artery may be partially blocked. Your doctor may also check the pulses in your arm and ankle to determine if they are weak or even absent.

Treatment

Treating hypertension involves lifestyle changes and drug therapy.

Lifestyle Changes

A critical step in preventing and treating hypertension is a healthy lifestyle. You can lower your blood pressure with the following lifestyle modifications:

  • Losing weight if you are overweight or obese.
  • Quitting smoking.
  • Eating a healthy diet, including eating more fruits, vegetables, and low fat dairy products, less saturated and total fat.
  • Reducing the amount of sodium in your diet to 2,300 milligrams (about 1 teaspoon of salt) a day or less.
  • Getting regular aerobic exercise (such as brisk walking at least 30 minutes a day, several days a week).
  • Limiting alcohol to two drinks a day for men, one drink a day for women.

In addition to lowering blood pressure, these measures enhance the effectiveness of antihypertensive medications.

Medications

There are several types of drugs used to treat hypertension, including:

  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers (ARBs)
  • Diuretics
  • Beta-blockers
  • Calcium channel blockers

Diuretics are usually recommended as the first line of therapy for most people who have hypertension. If one drug doesn't work or is disagreeable, other types of diuretics are available.

However, your doctor may start a medicine other than a diuretic as the first line of therapy if you have certain medical problems. For example, ACE inhibitors are often a good choice for a people with diabetes.

If your blood pressure is more than 20/10 mmHg higher than it should be, your doctor may consider starting you on two drugs.

Prevention

The following strategies may help to prevent high blood pressure and organ damage it may cause.

  • Eat a nutritious, low-fat diet.
  • Exercise regularly.
  • Decrease salt (sodium) intake: Read food labels so you know the salt content before you buy a product in the grocery store.
  • Maintain a healthy weight: If you are overweight or obese, try to lose weight.
  • Use alcohol in moderation, if at all.
  • Stop smoking.
  • Get your blood pressure checked periodically. Consider getting an accurate and easy-to-use home monitor.
  • Take your blood pressure medications as directed, even if you’re feeling fine.
  • Reduce stress and practice relaxation: Physical activity will help with this.
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