Hypertension

By Barbara Hales, M.D.
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healthcare, hospital and medicine concept - doctor and patient measuring blood pressure.

In order to understand hypertension or high blood pressure, it is important to know what blood pressure actually is.

Blood pressure is the force of blood pushing against the walls from within arteries.  This pressure changes throughout the day as blood is transported from your heart to other body organs.

It is measured with two numbers:

  1. Systolic blood pressure- arterial pressure when the heart beats (the top number)
  2. Diastolic blood pressure- arterial pressure between heart beats (the bottom number).

Normal blood pressure is considered less than 120/80 mm hg. Higher numbers are considered hypertension. 

Updated guidelines are reported as:

Normal- systolic less than 120 mm hg, diastolic less than 80 mm hg

At Risk- systolic 120-129 mm hg, diastolic more than 80 mm hg

Hypertension- systolic 130 mm hg or higher, diastolic 80 mm hg or higher

Causes of hypertension

While the exact cause of hypertension may not be diagnosed in an individual, there are many risk factors including:

  1. Age– Hypertension occurs more frequently in older age. Over 77% of men and 75% of women over the age of 65 have been found to have high blood pressure.
  2. Gender– Hypertension occurs more in men than women
  3. Diabetes and High Cholesterol– Chronically elevated cholesterol and blood sugar, predispose individuals to hypertension as they age.

In addition to the mentioned risks, The American Heart Association has established a guide for hypertension causes, which include:

  1. Heredity- A familial tendency and genes in DNA makeup causes it.
  2. Sedentary Lifestyle– lack of exercise and activity increase your chances
  3. Weight- Obesity and being overweight tend to have hypertension with as much as 40% of the high blood pressure cases.
  4. Diet- too much sodium (from salt). Avoid more than 1500 mg of salt/day.

Long term overindulging in salt increases risk of stroke and heart disease.

Not eating enough potassium. Consume 3500mg-5000 mg/day in foods.

  1. Alcohol– drinking alcohol excessively increases blood pressure and cholesterol levels.
  2. Drugs– Side effects of certain medications are linked.
  3. Hormones- Imbalances as in thyroid or aldosterone hormone levels can lead to hypertension.
  4. Renal Function– Kidney failure or decrease in function can lead to fluid retention and hypertension.
  5. Sleep Apnea– By decreasing oxygen and normal breathing patterns, hypertension can develop.
  6. Smoking– Tobacco over a period of time can constrict blood vessels leading to high blood pressure.

Symptoms of Hypertension

Hypertension is often known as the “silent killer” because it typically has no warning signs or symptoms.

As the blood pressure rises into a dangerous level, one may experience:

  • Dizziness, Lightheadedness
  • Redness of the Face and lower parts of extremities
  • Chest pain
  • Difficulty breathing

Decreasing Risk of Hypertension

Developing healthy lifestyle habits like establishing an exercise routine and maintaining a healthy balanced diet (with a weight loss plan to address any overweight issues), plays a keen role in diminishing high blood pressure. 

Lifestyle changes for hypertension management include:

  • Smoking cessation
  • Limit alcohol consumption
  • Healthy diet with weight loss, if overweight
  • Limit salt (sodium) intake
  • Eat foods with potassium
  • Stress management

Stress Management:

  • Meditation- Releasing stress can be attained using breathing exercises, mantra-based repeating a statement, phrase and uplifting thoughts, or imagining pleasant imagery.
  • Relaxation– Approaches that help with relaxation and thereby control hypertension are: Aromatherapy, Massage therapy, Biofeedback and Acupressure.
  • Acupuncture– A process of inserting small needles into specific points in the skin, acupuncture restores harmony, changes energy flow and decreases pain.

Cure for Hypertension

Hypertension cannot be cured but it can be controlled.  This is done by maintaining healthy lifestyle choices and reviewing all medications so that drugs can be changed if side effects have been shown to be associated with high blood pressure.

Sources:

PK, Carey RM, Aronow, WS, Casey DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelinesexternal iconJ Am Coll Cardiol. 2018;71(19):e127–e248.

  1. National High Blood Pressure Education Program. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure pdf icon[PDF – 223K]external icon. Bethesda, MD: National Heart, Lung, and Blood Institute; 2003.