Hypertension

High blood pressure is a common condition in which the blood in your arteries reaches a high enough pressure that it may start damaging tiny delicate arteries which then causes damage in organs throughout your body.

It is difficult to talk about “high” blood pressure when many of us don’t understand normal blood pressure. Normal blood pressure starts in the heart. The heart is connected by branching arteries to every organ in the body! How much blood the heart pumps, as well as what force with which the heart pumps, gives the blood a certain speed and a certain pressure within the arteries. The blood in the arteries is pulsatile because it is higher when the heart is pumping more blood into the system (systolic pressure – or top number) and lower when heart rests between beats (diastolic pressure – or bottom number). This is why your blood pressure has two numbers. High blood pressure, or hypertension, is simply too high of a pressure in either one or both of those numbers. The heart may pump too hard or too fast, or the blood vessels may not stretch enough to accommodate such high pressures. Either way, hypertension causes damage and illness by injuring the inside of the blood vessels.

Symptoms

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don’t occur until high blood pressure has reached a severe — even life-threatening — stage. You’ll likely have your blood pressure taken as part of a routine doctor’s appointment. Ask your doctor for a blood pressure reading at least every two years starting at age 20. He or she will likely recommend more frequent readings if you’ve already been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children age 3 and older will usually have their blood pressure measured as a part of their yearly checkups. If you don’t regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free, but these machines can give you inaccurate results.

Cause

Primary (essential) hypertension

For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years.

Secondary hypertension

High blood pressure caused by an underlying condition tends to appear suddenly and cause higher blood pressure than primary hypertension. Various conditions and medications can lead to secondary hypertension, including: kidney problems, adrenal gland tumors, certain defects in blood vessels you’re born with (congenital), certain medications (birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs), Illegal drugs (cocaine and amphetamines).

Prevention

There are many lifestyle changes that can help control and even prevent hypertension. These measures are important even if you are already taking blood pressure medication.

Diet

  • Eat healthy: decrease salt and fat intake
  • Try the DASH diet
  • Get plenty of potassium
  • Eat less saturated fat and total fat. This can also help you lose weight and decrease cholesterol.
  • Decrease the salt in your diet
  • Maintain a healthy weight
  • Increase physical activity
  • Limit alcohol
  • Don’t smoke
  • Monitor your blood pressure at home

Treatment

Treatment is based on what stage you are as well as if you have certain chronic conditions, like diabetes, high cholesterol, heart disease, or kidney failure.

  • Normal blood pressure – < 120/80
  • Prehypertension – 120/80 up to 139/89
  • True high blood pressure – 140/90 or higher

Medication Information

Thiazide diuretics

Diuretics, sometimes called “water pills,” are medications that act on your kidneys to help your body eliminate sodium and water, reducing the amount of fluid in your body.

Beta blockers

These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force, which lowers blood pressure and protects the heart from further damage.

Angiotensin-converting enzyme (ACE) inhibitors

These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.

Angiotensin II receptor blockers

These medications help relax blood vessels by blocking the action — not the formation — of a natural chemical that narrows blood vessels.

Calcium channel blockers

These medications help relax the muscles of your blood vessels. Some may slow your heart rate. Calcium channel blockers may work better for African-Americans and older adults than do ACE inhibitors or beta blockers alone.

Alpha blockers

These medications reduce nerve signals to blood vessels, reducing the effects of natural chemicals that narrow blood vessels, causing blood vessels to be more open, thus reducing blood pressure.

Alpha-beta blockers

In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels.

No matter what medication your doctor prescribes to treat your high blood pressure, you’ll need to make lifestyle changes to lower your blood pressure.

*If your blood pressure remains stubbornly high despite taking at least three different types of high blood pressure drugs, you may have resistant hypertension. People who have controlled high blood pressure but are taking four different types of medications at the same time to achieve that control also are considered to have resistant hypertension. Your doctor can evaluate whether the medications and doses you are taking for your high blood pressure are appropriate.