High Blood Pressure

What Is High Blood Pressure?

Blood pressure is the force created by the heart as it pumps blood throughout your body. If blood vessels are wide open, blood flows through easily. If the blood vessels are closed down, it's difficult for blood to flow through. That means the heart has to work harder to move the blood through the body by beating more forcefully. The stronger beats push the blood through the narrowed vessels harder, increasing the pressure on the blood vessel walls, resulting in higher than normal blood pressure. Your body typically can easily handle changes in blood pressure, but if it remains elevated over a long period of time, it can cause major damage in any number of organs.

Screening for High Blood Pressure

Most of the time, high blood pressure doesn't cause any symptoms. Furthermore, we usually don't know the underlying cause of it. In this case, it is called "Primary Hypertension." When we do know the cause, such as kidney problems, structural problems, and narrowing of the arteries, it's called "Secondary Hypertension."

To determine your blood pressure, your doctor will check the pressure on the artery walls when the heart pumps and when the heart rests between beats. The test is extremely easy to do and results in two different numbers. These make up your overall blood pressure reading.

What Do the Numbers Mean?

The first number, or the number on top, represents the "Systolic Pressure." This is the pressure inside the arteries when the left ventricle of the heart contracts, pushing blood through the arteries. The bottom number represents the "Diastolic Pressure." This number should be lower than the first. It represents the pressure inside the arteries when the heart is at rest between beats.

While these two numbers make up your overall blood pressure, only one of them needs to be high for you to have high blood pressure, or hypertension.

Here's what the numbers mean:

• If your reading is less than 120 over 80, you have normal blood pressure;
• If you have a reading of any number between 120 to 139 over 80 to 89, you have Pre-Hypertension;
• If you have a reading between 140 to 159 over 90 to 99, you have Stage One Hypertension;
• If you have a reading that is greater than 160 on top and 100 on the bottom, you have Stage Two Hypertension, the most severe form of high blood pressure.

Risks for High Blood Pressure

• Age. Your risk increases with age.
• Gender. More middle-aged men than women have high blood pressure.
• Family History. You are more likely to develop high blood pressure if someone else in your family has it.
• Race. African Americans are at higher risk than other groups.
• Lifestyle Choices. Poor diet and low activity can contribute to high blood pressure.

If left untreated, high blood pressure can cause damage in a number of organs, and increases the risk of serious conditions such as heart attack, heart failure, stroke, and kidney failure.

Preventing and Reducing High Blood Pressure

You should have your blood pressure checked every two years, but if you are at risk or already know you have hypertension, you need more frequent checks. If you are diagnosed with hypertension, there are steps you can take today to reverse high blood pressure.

Lifestyle Changes

• Eat a healthy diet. Limit salt and red meat, fats and sweets. One diet approach is called the DASH diet... this stands for Dietary Approaches to Stop Hypertension.
• Keep a healthy weight. Extra weight means more work for your heart and more pressure on your blood vessels. Losing as little as ten pounds can make a big difference.
• Exercise. A brisk 30 minute walk several times a week-or each day if you can-can help lower blood pressure.
• Don't smoke. Chemicals in cigarette smoke damage the lining of the blood vessels and make your heart pump harder. Damage to the vessel walls may affect how you react to changes in blood pressure.
• Limit alcohol and caffeine. We're not sure why these both increase blood pressure...but we know that they do. Reducing alcohol consumption to moderate levels can lower systolic blood pressure by two to four points, and it can lower diastolic pressure by two points.
• Manage stress. Stress can increase blood pressure on a temporary basis, but there are long term affects to chronic, uncontrolled stress.
• Get plenty of sleep. A well rested person is better able to manage stress, which is a big part of maintaining a healthy lifestyle and keeping blood pressure down.

Medications

There are a number of medications that are very successful in lowering blood pressure. You may have to take two or even three of them together. And you and your doctor may need patience in finding the right combination. Like all medications, blood pressure drugs can cause side effects and need to be carefully selected and fine-tuned.

• Diuretics. These are often the first type of medication prescribed. These are very effective, and work by pulling water and sodium from the blood, and thereby lower pressure. Diuretics typical cause more frequent urination because the water that gets pulled from the body needs to be expelled.
• Beta-blockers. These work by blocking the effects of certain substances in the body. Beta blockers relax the heart muscle, and reduce the force of the heart's contractions.
• ACE Inhibitors. Angiotensin-Converting Enzyme Inhibitors and Angiotensin II receptor blockers both work by relaxing, and thereby opening the blood vessels to ease pressure.
• Calcium Channel Blockers. These also relax the blood vessels and may even slow the heart rate. It's important to know that you shouldn't eat grapefruit or drink grapefruit juice if you use these medications. A chemical in the fruit interacts with many medications and can cause side effects.
• Alpha-blockers. These prevent the muscles around smaller arteries from contracting.
• Central Acting Agents. These work in the brain, stopping the signals that increase the heart rate and narrow arteries.
• Direct Vasodilators. These work right in the muscles of the arteries to keep the walls dilated and opened wide.

Lowering your blood pressure is one of the most effective things you can do to reduce your risk of heart attack, stroke and kidney failure.