Hypertension or high blood pressure is dangerous because it can lead to strokes, heart attacks, heart failure or kidney disease.

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Blood pressure is the measurement of the pressure or force of blood pushing against blood vessel walls.  In hypertension (high blood pressure) the pressure against the blood vessel walls is consistently too high.  This diagnosis is often called the “silent killer” because you may not be aware that anything is wrong, but the damage is occurring within your body.

Your blood pressure reading has two numbers. The first is the systolic, which measures the pressure on the blood vessel walls when your heart beats. The second number is the diastolic, which measures the pressure on your blood vessels between beats when the heart is at rest. Normal blood pressure is classified as less than 120/80 mmHg, "pre-hypertension" as 120-139/80-89 mmHg, and "hypertension" as greater than 140/90 mmHg. All patients with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications. Treatment with medicine is recommended to lower blood pressure to less than 140/90 mmHg. For patients who have diabetes, or chronic kidney disease, the recommended blood pressure is less than 130/80 mmHg.

How did I get hypertension?

Hypertension can occur as the result of a combination of risk factors, both modifiable and non-modifiable, which may include the following:

  • Familial history of high blood pressure, cardiovascular disease or diabetes

  • Race, with it being more common in African Americans

  • Women who are pregnant or take birth control pills

  • People over the age of 35

  • Those who are overweight or obese

  • Sedentary lifestyle

  • Alcoholism

  • Poor diet consisting of foods high in fat or salt

  • Cigarette smoking

How is hypertension diagnosed?

Hypertension is diagnosed by your physician by using an inflatable arm cuff around your arm to measure your blood pressure reading using a pressure-measuring gauge. Your doctor will likely take two to three blood pressure readings with each at three or more separate appointments before making a diagnosis.  You may be asked to record your blood pressure at home and at work for several weeks to provide a more accurate picture of blood pressure changes. 

Your physician may also recommend additional testing to check for additional signs of heart disease, such as urinalysis, blood testing, lipid testing for cholesterol or an electrocardiogram. 

What are my treatment options for hypertension?

The goal of hypertension treatment is to lower harmful high blood pressures and protect important organs, such as the brain, heart and kidneys. Treatment for hypertension has been associated with reductions in stroke, heart attack and heart failure. Treatment involves a combination of lifestyle changes, drug therapy and routine follow up as described below:

Lifestyle changes are a critical step in preventing and treating hypertension and includes the following:

  • Losing weight if you are overweight or obese

  • Quitting smoking

  • Eating a healthy diet with more fruits and vegetables, low fat dairy, less saturated and total fat

  • Reducing the amount of salt in your diet

  • Getting regular aerobic exercise such as brisk walking for 30 minutes a day

  • Limiting alcohol consumption to 2 drinks a day for men and 1 drink per day for women

Drug therapy involves several classes of drugs to manage hypertension used alone or in combination, which includes the following:

  • ACE Inhibitors and ARBs: dilates (widens) the blood vessels to improve the amount of blood the heart pumps, which decreases the workload of your heart, decreasing blood pressure.

  • Diuretics- also known as “water pills” cause the kidneys to get rid of extra water and s

  • Beta Blockers- improves the hearts ability to relax, decreasing the production of harmful substances produced by the body in response to heart failure as well as slows the heart rate and decreases the blood pressure.

  • Calcium channel blockers- affect the movement of calcium in the cells of the heart and blood vessels.  This relaxes the blood vessels, increasing the supply of oxygen and blood to the heart, decreasing the workload of the heart, which in turn will decrease the blood pressure.

Follow up with your doctor is vital to closely monitor the effectiveness of drugs and therapy:

  • After starting antihypertensive drug therapy, the patient should see their doctor at least once a month or until blood pressure goals have been reaching.

  • The doctor should routinely check serum potassium if on diuretics as well as creatinine once or twice a year.

  • After the blood pressure goal has been reached, the patient should see a doctor every three to 6 months, depending on other diagnoses as well such as heart failure.

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