High
blood pressure is a common condition in which the force of the blood
against your artery walls is high enough that it may eventually cause
health problems, such as heart disease.You can have high blood pressure (hypertension) for years without any symptoms. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.
High blood pressure typically develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.
Symptoms
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.
Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don’t occur until high blood pressure has reached a severe — even life-threatening — stage
When to see a doctor
You’ll likely have your blood pressure taken as part of a routine doctor’s appointment.
Ask your doctor for a blood pressure reading at least every two years starting at age 18. He or she will likely recommend more frequent readings if you’ve already been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children age 3 and older will usually have their blood pressure measured as a part of their yearly checkups.
If you don’t regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free, but these machines can give you inaccurate results.
Causes
There are two types of high blood pressure.
1. Primary (essential) hypertension
For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years.
2. Secondary hypertension
Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:
Kidney problems
Adrenal gland tumors
Certain defects in blood vessels you’re born with (conprivate part)
Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs
Illegal drugs, such as cocaine and amphetamines
Blood Pressure Measurement
Blood pressure measurements fall into four general categories:
1. Normal blood pressure. Your blood pressure is normal if it’s below 120/80 mm Hg. However, some doctors recommend 115/75 mm Hg as a better goal. Once blood pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase.
2. Prehypertension. Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time.
3. Stage 1 hypertension. Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.
Both numbers in a blood pressure reading are important. But after age 50, the systolic reading is even more significant. Isolated systolic hypertension — when diastolic pressure is normal but systolic pressure is high — is the most common type of high blood pressure among people older than 50.
Medications to treat high blood pressure
1. Thiazide diuretics. Diuretics, sometimes called water pills, are medications that act on your kidneys to help your body eliminate sodium and water, reducing blood volume. Thiazide diuretics are often the first — but not the only — choice in high blood pressure medications. If you’re not taking a diuretic and your blood pressure remains high, talk to your doctor about adding one or replacing a drug you currently take with a diuretic.
2. Beta blockers. These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. When prescribed alone, beta blockers don’t work as well in blacks or in older adults — but they’re effective when combined with a thiazide diuretic.
3. Angiotensin-converting enzyme (ACE) inhibitors. These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.
Angiotensin II receptor blockers (ARBs). These medications help relax blood vessels by blocking the action — not the formation — of a natural chemical that narrows blood vessels.
4. Calcium channel blockers. These medications help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for blacks and older adults than do ACE inhibitors or beta blockers alone. A word of caution for grapefruit lovers, though. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Talk to your doctor or pharmacist if you’re concerned about interactions.
5. Renin inhibitors. Aliskiren (Tekturna) slows down the production of renin, an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Tekturna works by reducing the ability of renin to begin this process. Due to a risk of serious complications, including stroke, you shouldn’t take aliskiren with ACE inhibitors or ARBs.
Prevention
Lifestyle changes can help you control and prevent high blood pressure — even if you’re taking blood pressure medication. Here’s what you can do:
1. Eat healthy foods. Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and total fat.
2. Decrease the salt in your diet. A lower sodium level — 1,500 milligrams (mg) a day — is appropriate for people 51 years of age or older, and individuals of any age who are African-American or who have hypertension, diabetes or chronic kidney disease. Otherwise healthy people can aim for 2,300 mg a day or less. While you can reduce the amount of salt you eat by putting down the saltshaker, you should also pay attention to the amount of salt that’s in the processed foods you eat, such as canned soups or frozen dinners.
3. Maintain a healthy weight. If you’re overweight, losing even 5 pounds (2.3 kilograms) can lower your blood pressure.
4. Increase physical activity. Regular physical activity can help lower your blood pressure and keep your weight under control. Strive for at least 30 minutes of physical activity a day.
5. Limit alcohol. Even if you’re healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation — up to one drink a day for women and everyone older than age 65, and two drinks a day for men.
6. Don’t smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your doctor to help you quit.
7. Manage stress. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation and deep breathing. Getting plenty of sleep can help, too.
8. Monitor your blood pressure at home. Home blood pressure monitoring can help you keep closer tabs on your blood pressure, show if medication is working, and even alert you and your doctor to potential complications. If your blood pressure is under control, you may be able to make fewer visits to your doctor if you monitor your blood pressure at home.
9. Practice relaxation or slow, deep breathing. Practice taking deep, slow breaths to help relax. There are some devices available that can help guide your breathing for relaxation; however, it’s questionable whether these devices have a significant effect on lowering your blood pressure
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