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Hypertension: High Blood Pressure

Blood Pressure CheckThe American Heart Association (AHA) says approximately half of American adults have hypertension. Many don't know it, though, because high blood pressure often produces no symptoms. But even if there are no symptoms, untreated high blood pressure can damage internal organs, so it's important to be aware of your risks.

What is blood pressure

Every time your heart beats, it pushes blood into your arteries, creating pressure in them. (Read about "The Heart & Cardiovascular System") This is what keeps blood moving through your body. (Read about "Vascular System") According to NHLBI, most of us have probably had our blood pressure measured at some point.

A blood pressure cuff is generally wrapped around your upper arm and inflated to stop the blood flow in your artery for a few seconds. A valve is opened and air is then released from the cuff so the blood can start flowing again. The pressure of your blood rushing through an artery is then measured.

The first pressure registered on the gauge is called the systolic blood pressure. This is the maximum pressure in the artery produced as the heart contracts and the blood begins to flow again.

The last pressure registered after more air is released from the cuff is the diastolic blood pressure. This is the lowest pressure that remains within the artery when the heart is at rest. The two readings are given, one (systolic) over the other (diastolic) in millimeters (mm) of mercury (Hg), such as 120/80 mmHg. According to AHA here are the categories for blood pressure measurements in adults:

Your systolic and diastolic numbers may not be in the same blood pressure category. In this case, the more severe category is the one you're in. For example, if your systolic number is 130 and your diastolic number is 75, your would still be considered to have stage 1 hypertension. According to National Heart, Lung, and Blood Institute (NHLBI), for persons middle aged and older, systolic pressure gives a better diagnosis of high blood pressure. For younger people, the diastolic blood pressure is an important hypertension number.

HBP numbers differ for children and teens. To find out whether a child has HBP, a doctor will compare the child's blood pressure numbers to average numbers for his or her age, height, and gender.

Although high blood pressure (also called hypertension) may not produce any symptoms you can feel, it still causes damage, which is why it's often called the "silent killer." Left untreated, high blood pressure can damage your blood vessels, as well as internal organs such as your heart or kidneys. (Read about "Enlarged Heart" "Blood Pressure and Kidney Disease") Having high blood pressure also means you have a higher risk of developing heart disease or having a stroke. (Read about "Coronary Heart Disease" "Stroke") In addition, NHLBI says studies show that even elevated blood pressure puts you at an increased risk of disease. The only way to find out if your blood pressure is too high is to have it measured by a healthcare professional.

Risk factors

According to the American Medical Association (AMA), we don't know exactly what causes high blood pressure, but there are certain things that can put you at a higher risk of having high blood pressure. Some you can control; others you can't. They include:

In addition, the American Heart Association (AHA) says that in certain sodium-sensitive people, using too much salt may contribute to high blood pressure. (Read about "Sodium") Certain medications can also raise blood pressure, according to AHA; therefore, anyone with high blood pressure should make sure they tell their doctor about any prescribed and/or over-the-counter medicines they're taking, such as steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), nasal decongestants and other cold remedies, diet pills, antidepressants, and monoamine oxidase inhibitors.

AHA recommends a blood pressure screening by a healthcare professional at least once every two years. If a screening reveals elevated blood pressure, your doctor will decide on the appropriate follow-up and treatment.

Treatment options

Sometimes, high blood pressure can be controlled through changes in lifestyle and diet, cutting back on salt or sodium for example, or losing weight. (Read about "Low Fat Food Tips") A special diet, called DASH for Dietary Approaches to Stop Hypertension, was developed by NHLBI. Basically, the DASH diet is low in saturated fat, cholesterol and total fat and emphasizes fruits, vegetables and low fat dairy foods. The DASH diet is also low in red meat, sweets and sugar-containing drinks. It is rich in potassium, calcium, magnesium, fiber and protein. (Read about "Vitamins & Minerals" "Calcium") NHLBI says this special diet has been found to lower blood pressure, especially when people also reduce their sodium intake. (Read about "Dietary Guidelines") Exercise is often suggested for people with high blood pressure. (Read about "Exercise and Your Heart") Be sure to check with your doctor before beginning any exercise program.

Your doctor may decide, however, that (along with diet and lifestyle changes) medication is needed as well. There are a number of different types or classes of medications to control hypertension. According to NHLBI, they include:

One thing antihypertensives have in common is that they may have side effects. They may also interact with other medications you take, both prescription and over-the-counter. (Read about "Drug Interaction Precautions" "Herbal Precautions") Therefore, it's important for your doctor and pharmacist to be aware of any other medications you may be using.

AHA says different people respond in different ways to these medications. Therefore, most patients must go through a trial period to find out which medications work best with the least number of side effects. When taking medication, any side effects should be reported to your doctor, but patients should not decide to stop taking the medicine without their doctor's advice. (Read about "Medicine Safety")

Pulmonary hypertension

LungsThere is another type of hypertension called pulmonary hypertension (PH). (Read about "Pulmonary Hypertension") It affects the lungs and the pulmonary artery. Pulmonary hypertension happens when the blood pressure in the pulmonary artery rises far above normal levels. The pulmonary artery is the blood vessel carrying oxygen-poor blood from the right ventricle, one of the pumping chambers of the heart, to the lungs. (Read about "Vascular System") In the lungs, the blood picks up oxygen and then flows to the left side of the heart, where it is pumped by the left ventricle to the rest of the body through the aorta.

Normal mean pulmonary-artery pressure is approximately 14 mm Hg at rest. In the PH patient, the mean blood pressure in the pulmonary artery is greater than 25 mm Hg at rest and 30 mm Hg during exercise. This abnormally high pressure (pulmonary hypertension) is associated with changes in the small blood vessels in the lungs, resulting in an increased resistance to blood flowing through the vessels. This increased resistance, in turn, places a strain on the right ventricle, which now has to work harder than usual against the resistance to move adequate amounts of blood through the lungs.

Related Information:

    Cardiovascular Tests

    Blood Donation Guidelines

    Quit Smoking



    Food Labels

    Glossary of Stroke Terms

    Glossary of Heart Terms

    Glossary of Respiratory Terms

    Walking for Health

All Concept Communications material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.

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