Silent Killers: High Blood Pressure

woman-3187087_1920What is blood pressure?

  • Blood pressure is the measure of the pressure exerted on the walls of your arteries by your blood.
  • The top number, or systolic pressure, is the pressure within the artery when the heart is contracted.
  • The bottom number, or diastolic pressure, is the pressure within the artery when the heart is relaxed.

Why is it important?

  • The pressure within our arteries keeps blood flowing throughout our body to take oxygen rich blood to our brain, muscles, organs, and skin to keep us functioning.

At what point is a blood pressure too high?

  • Blood pressure goals have recently been lowered. The goal blood pressure is now less than 120/80 for most individuals.
  • Elevated blood pressure is 120-129/80.
  • Stage 1 hypertension is 130-139/80-89.
  • Stage 2 hypertension is >140/90.
  •  For patients 60 and older, the goal is not as low. We aim for a goal of 140/80.
  • Patients with other chronic medical issues, such as diabetes, heart disease, or chronic kidney disease may be treated more aggressively since they are at higher risk of cardiovascular events and organ damage.

How do I know I have high blood pressure?

  • Your physician will screen you for hypertension at your wellness exam or yearly physical. Many offices do yearly health fairs for their patients.
  • You can also go to a local store and buy your own monitor and monitor it at home.

What are the symptoms of high blood pressure?

  • Some will develop headaches and fatigue. Some patients explain to me that they “just feel off” or have a “funny feeling in their head”.
  • Some people have no symptoms at all.
  • Worrisome symptoms are chest pain, shortness of breath, blurry vision. You should seek immediate medical attention if you should ever experience these symptoms.

When should I get treatment?

  • In order to be diagnosed with hypertension, a physician needs two separate readings above goal and two separate visits.
  • Many physicians like to have their patient monitor blood pressures at home so that they may differentiate between true hypertension and “white coat syndrome”.

What is white coat syndrome?

  • The body’s response to stress will automatically increase your blood pressure. Some people find coming to a doctor’s visit very stressful, and in turn, their blood pressure will be elevated.
  • Some individuals will have this response even if they do not feel as if they are anxious about being at the doctor.
  • You cannot be diagnosed with white coat syndrome without having appropriate home blood pressure monitoring to prove that your pressures are normal away from the clinical setting.

Are there remedies besides medications?

  • Yes! Some patients with mild elevations in blood pressure can bring their pressures down to goal with diet adjustment, exercise, stress reduction, and weight loss.

What causes someone to have high blood pressure?

  • Lifestyle plays a role in developing hypertension.
    • Persistent stress
    • High salt diet
    • Sedentary lifestyle
    • Excessive alcohol use
  • Hypertension can be caused by genetics. Some of these patients will need some form of treatment for their blood pressure no matter how hard they work on lifestyle changes.
    • African-Americans have a greater risk of developing hypertension. It tends to be more severe, occurs earlier, and causes greater damage than in non-black patients.
  • Some medications can cause high blood pressure and should be used with caution in those with hypertension.
    • Oral contraceptives (birth control pills)
    • NSAIDs (nonsteroidal anti-inflammatory drugs), especially taken chronically
    • Certain antidepressants
    • Steroids
    • Certain decongestants
    • Certain weight loss medications
    • Stimulant ADHD medications
    • Illicit drugs, especially methamphetamine and cocaine
  • Certain medical conditions can also cause hypertension. Physicians often look for these secondary causes before diagnosing a patient with essential (primary) hypertension.
    • Obstrucive sleep apnea
    • Fibromuscular dysplasia
    • Primary kidney disease
    • Thyroid disorders
    • Other hormonal disorders (aldosterone, parathyroid hormone)
    • Polycythemia

What will happen to me if I don’t get my hypertension treated?

  • High blood pressure is a silent killer, as the title suggests. Untreated, it can cause many health issues including:
    •  increased risk of heart attack and heart failure
    •  kidney disease and eventually kidney failure
    •  worsening vision or blindness
    •  stroke
  • Hypertension is the most important modifiable risk factor for premature cardiovascular disease. It is now even more common than cigarette smoking!
  • Risk of having a complication increases as the blood pressure increases.

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