High Blood Pressure

High blood pressure, or hypertension, means that the pressure of blood against the artery walls is elevated. High blood pressure is the most common chronic adult illness in the United States. There is no cure for high blood pressure, but it can be controlled.

Blood pressure measurements are expressed using two numbers, one written over the other. The top number is the systolic blood pressure; it is the pressure of blood against the artery walls when the heart is contracting and pushing blood out. The lower number is the diastolic blood pressure; it is the pressure of blood against artery walls when the heart is resting and filling with blood between heartbeats.

High blood pressure is one of the three major controllable risk factors for heart and blood vessel diseases and stroke. The risk relates not only to how high your blood pressure is, but also to how long it has been raised.

Controlling your blood pressure can also reduce your risk for kidney disease. The sooner your blood pressure is controlled, the less you risk future problems.

Causes

High blood pressure occurs when the heart pumps blood with too much force, or when the blood vessels are too narrow because of cholesterol plaques (a condition called atherosclerosis) or too stiff from calcium (a condition called arteriosclerosis) to allow blood to flow as it should. It is normal for blood pressure to change during the day and in response to increased activity or stress, or even cold weather.

In the vast majority of people, the exact cause of high blood pressure is not known. A small number of people have secondary hypertension, which is high blood pressure caused by medication or another medical condition such as renal disease or atherosclerosis.

Certain risk factors make it more likely that you will develop hypertension. The older you are, the greater the chance that high blood pressure will develop. African Americans are more likely to have high blood pressure and to develop it at a younger age. High blood pressure also can be hereditary. These risk factors can’t be changed, but some lifestyle factors, such as being overweight, smoking, consuming too much salt, getting too little exercise or consuming too much alcohol, can be controlled.

Diagnosis

High blood pressure usually does not cause symptoms; the only way to know if you have it is to have your blood pressure checked. Having a high blood pressure measurement one time does not necessarily mean you have hypertension. Usually, three measurements that show high blood pressure on three occasions are needed to diagnose hypertension. Optimal blood pressure is less than 120/80. You have hypertension if your resting systolic pressure is consistently 140 or greater and/or your diastolic pressure is consistently 90 or greater. A systolic pressure of 120 to 139 and a diastolic pressure of 80 to 89 is considered pre-hypertension and means you are at risk for high blood pressure.    

Treatment

Treatment decisions are based on your blood pressure measurement, the presence or absence of heart or kidney damage, and the presence of other risk factors. Your doctor may give you medications right away or may have you try lifestyle changes such as regular exercise or change in diet for up to one year. Depending on your treatment plan and medications prescribed, your doctor will tell you how often to have your blood pressure checked.

Self-Care Steps for High Blood Pressure

Here are ways to reduce high blood pressure and cardiovascular risks:

• Lose weight. Being overweight increases your risk of developing high blood pressure. A weight loss of five to 10 pounds can lower and help control blood pressure. Weight loss can also decrease blood cholesterol, triglycerides and blood sugar levels. Weight loss is the most effective method for controlling hypertension without medication.

• Exercise regularly. For healthy adults, regular aerobic exercise -- walking, running, bicycling or swimming laps -- can prevent and reduce high blood pressure. More activity can also help reduce weight and stress. Try to get 30 to 60 minutes of aerobic exercise as many days of the week as possible.

• Control salt in your diet. Limit sodium to less than 2,300 mg a day by not adding salt to food, and limiting processed, convenience and fast foods.

• Limit alcohol. Drinking too much alcohol can raise blood pressure, add weight and make blood pressure control more difficult. Avoid alcohol or limit yourself to two drinks a day for men, and one drink a day for women. A drink is defined as 12 ounces of beer, 4 ounces of wine, or 1 ounce of 100-proof liquor.

• Increase potassium intake. A high intake of potassium may improve your blood pressure control. Not getting enough potassium may actually increase blood pressure. Many fruits and vegetables are good sources of potassium; try to eat at least five servings a day.

• Quit smoking. Smoking cigarettes does not cause chronic high blood pressure, but smoking is a major risk factor for cardiovascular disease.

• Eat less fat. A low-fat diet may lower blood cholesterol and the risk for coronary artery disease. Eating less fat will also aid in weight loss.

• Take your medications. If your doctor prescribes medication, take it as directed. Discuss any side effects or reactions you experience with your doctor. Do not stop taking medications without talking to your doctor.

• See your doctor regularly. After your blood pressure is controlled, you should continue to have it checked regularly. Usually, you will not have any symptoms to tell you if your blood pressure is elevated. See your doctor at least once a year to make sure your blood pressure is under control.

To confirm a hypertension diagnosis, your doctor will need blood pressure readings from three or more visits. The data below outlines blood pressure classifications and the different stages of hypertension.