High Blood Pressure
High blood pressure (hypertension) is a serious condition that affects one in three adults in the United States, according to the Centers for Disease Control and Prevention (CDC). It’s called the “silent killer” because people often have no symptoms, yet it can lead to some serious and sometimes even fatal conditions.
Your blood moves through your body at a certain rate. According to the American Heart Association, a blood pressure reading of less than 120/80 mmHg is considered normal. When you have high blood pressure, your blood moves through your arteries at a higher pressure, putting more pressure on the delicate tissues and damaging your blood vessels. You are diagnosed with high blood pressure (hypertension) if your blood pressure readings are consistently above 140/90 mmHg.
For most cases of high blood pressure there is no known cause. This is called primary hypertension. For others, certain medical conditions like kidney or heart conditions can cause high blood pressure. This is called secondary hypertension. Some medications like birth control pills or over-the-counter cold medicines can cause high blood pressure as well. Blood pressure may or may not return to normal upon discontinuation of the medication.
There are many risk factors for high blood pressure. Some factors you can’t change. Others are modifiable based on your lifestyle. Risk factors you cannot change include:
- age: Older adults are at greater risk for high blood pressure.
- gender: Women over 65 are more likely to have higher blood pressure, and men under age 45 are more likely to have high blood pressure than women.
- race: African-Americans are more likely to have high blood pressure.
- family history: If your direct family members (parent or sibling) have high blood pressure, you are more at risk.
Factors that are modifiable include:
- being overweight
- not exercising enough
- eating an unhealthy diet
- consuming excess salt
- drinking alcohol
- sleep apnea
Your doctor can diagnose if you have high blood pressure by simply using a blood pressure monitor to measure your blood pressure. This monitor records your systolic blood pressure (SBP), the top number, and your diastolic blood pressure (DBP), the bottom number. There are a few types of high blood pressure depending on severity.
- prehypertension: 120/80 mmHg or higher
- stage 1 high blood pressure: 140/90 mmHg or higher
- stage 2 high blood pressure: 160/100 mmHg or higher
- hypertensive crisis (a life-threatening condition): 180/110 mmHg or higher
Your doctor will also review your health history and risk factors and perform a physical exam to make a diagnosis.
The test to determine if you have high blood pressure is simple and non-invasive. Your doctor will measure your blood pressure using a monitor with a cuff. Your doctor may do this several times over a few appointments to get an accurate reading because your blood pressure can change depending upon many factors, some as simple as your mood at the time the measurement is taken. Your doctor may also order:
- blood tests
- urine tests
- electrocardiogram (ECG)
- chest X-ray
- computed tomography (CT) scan
- reducing the amount of salt in your diet
- exercising and losing weight
- beginning a smoking cessation plan
- trying to reduce stress with some relaxation techniques
Treatment for high blood pressure varies from changing lifestyle choices to using medications. If your increased blood pressure is not severe your doctor will probably recommend lifestyle modifications first. These include:
If this doesn’t work or if you have a more serious high blood pressure diagnosis, your doctor will probably prescribe medication. Drugs that help lower high blood pressure include:
- beta blockers
- calcium channel blockers
- ACE inhibitors
Your doctor will monitor your progress and may increase the dose or change and add medications until you find the right one(s) that works for you. Your doctor will probably also have you monitor your blood pressure at different times during the day so you can see when it gets worse or better.
If you have a hypertensive crisis you will need to be treated in the emergency room or intensive care unit, as this can be fatal. Your heart and blood vessels will be monitored and you will probably be on oxygen and receive medication to bring your blood pressure down to a safe level.
Your primary care doctor will treat most cases of high blood pressure. You may require more appointments depending on your blood pressure levels. If your doctor thinks you have other cardiac conditions (which are common complications of chronic high blood pressure), you may be referred to a doctor who specializes in heart problems (a cardiologist).
High blood pressure is a silent killer because it can lead to some very serious complications. High blood pressure can stretch out your arteries and weaken them (an aneurysm). It can lead to an abnormal heart rhythm (arrhythmia). It can also make you more likely to have a heart attack or heart failure, kidney problems, or even a stroke.
If you have a family history of high blood pressure, you should work with your doctor on reducing your risks. You should also take the following measures:
- Eat a healthy low-sodium diet.
- Exercise regularly.
- Try to maintain a healthy weight.
- Quit smoking.
Be sure to take your medication for high blood pressure as directed and monitor your blood pressure at home with a monitoring device. Talk to your doctor if you have any concerns about high blood pressure.
Written by: Tricia Kinman
Published on Oct 27, 2014
Medically reviewed on Oct 27, 2014 by Kenneth R. Hirsch, MD