We hear about the dangers of high blood pressure nearly every day, and you likely know someone with this disease. High blood pressure, technically known as hypertension, often goes unnoticed, and if left unchecked, damages the blood vessels over time, makes the heart work harder than necessary, and can cause cardiac abnormalities. It’s no wonder health-care providers pay so much attention to it.
Blood pressure is the measurement of pressure generated in the arteries as blood flows from the heart and travels to the tissues. Blood pressure has two components, or numbers. The top number, the systolic blood pressure, refers to the pressure produced with a heartbeat, the pressure that sends blood flowing. The bottom number, the diastolic measure, represents the pressure in the artery as the heart relaxes. Blood pressure readings, recorded systolic over diastolic, resemble a fraction, 120/80 for instance.
High blood pressure is defined as elevated pressures as measured at least two times over several weeks in a healthy patient not taking blood pressure medications. Blood pressure varies greatly with stress or illness and should be measured in relaxed states if possible. A normal blood pressure has a top number less than 120 and a bottom number less than 80. With either number elevated, a person has high blood pressure or prehypertension (a new category introduced in medicine over the last couple of years).
In prehypertension, systolic readings range from 120 to 139 and diastolic go from 80 to 89. Individuals with prehypertension have an increased risk of progressing to hypertension. High blood pressure has two stages. Stage I hypertension is a systolic blood pressure of 140 to 159 or diastolic of 90 to 99, while stage II has a systolic measurement of greater than 160 or diastolic greater than 100.
Most people with hypertension show no signs of the disease. Occasionally, a patient with very high blood pressure might experience a headache, blurred vision, or stroke-like symptoms. In such cases, lowering blood pressure becomes a medical emergency. Healthcare providers usually discover high blood pressure when patients visit them for other reasons. When first diagnosed, a person with hypertension will often undergo some basic medical tests to rule out diseases that can cause hypertension; however, hypertension is usually the primary disease.
Treatment normally begins with lifestyle changes. People with high blood pressure need to watch their diets, exercise regularly, and shed pounds if overweight. Caffeine and alcohol can raise blood pressure and should be avoided. Salt should be limited to less than two grams a day. Most American diets, rich in food processed with salt, contain more than this limit, so a good first step is to stop using the salt shaker. Exercising on a regular basis causes blood pressure to go down by as much as 15 points in some people. Blood pressure falls by about a point for every 2.2 pounds of weight lost as well.
Many people with high blood pressure require medications. Your healthcare provider will individualize a medication plan to suit your situation. Most patients need more than one medication to control blood pressure, so do not be surprised if your doctor gives you more than one prescription.
High blood pressure is common and a silent disease for most. People with untreated high blood pressure may develop kidney failure, heart failure, stroke, and heart attacks. Get your blood pressure checked regularly and keep track of it on a wallet card. You risk everything by ignoring this silent killer.
Debra Buckler, DO, is a Freeman Health System physician specializing in geriatric and nursing home medicine. Additionally, she serves as Medical Director for Joplin Health and Rehabilitation Center and Co-medical director for National Health Care of Joplin.
