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High Blood Pressure
Basic Information

High Blood Pressure

High blood pressure, called hypertension by doctors, affects nearly one out of every three Americans. High blood pressure can cause a multitude of serious medical problems. The good news is that there are medications and lifestyle changes that are very effective at treating problems with blood pressure. Damage to the body slows down or stops when blood pressure is brought under control.

In order to understand hypertension, it is first necessary to understand what blood pressure is and how it occurs.

The body's tissues depend on nourishment from the blood in order to survive. Blood circulates to all body tissues through a network of blood vessels and organs known as the circulatory system. The blood is entirely contained by the circulatory system. It stays within the various vessels, arteries and organs (the lungs and heart) comprising the circulatory system and fills the space within that system pretty much completely.

Blood does not move through the circulat...


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What is high blood pressure?

  • High blood pressure, also called hypertension, affects nearly one out of every three Americans.
  • The body's tissues depend on nourishment from the blood in order to survive and blood circulates to all body tissues through a network of blood vessels and organs known as the circulatory system.
  • Blood is forced through the circulatory system by the heart.
  • The force of the heart's muscular contractions put pressure onto the blood, forcing it to flow through the blood vessels in a forward movement in a continual loop.
  • Blood pressure is the result of the force of the heart and the resistance of the vessel walls - coming together to push the blood through the body's circulatory system.
  • Blood pressure is not constant or flat; rather it is cyclical or wavy.
  • As the heart beats, it puts force on the blood, increasing the overall blood pressure and as the heart relaxes between beats, there is less force put onto the vessels and the blood pressure lowers.
  • The body's blood vessels are strong, elastic and designed to handle a variety of blood pressures, but it is important that the blood pressure never get too strong because the vessels themselves can be damaged with long term issues for the health of the tissues and organs that depend on those vessels.
  • When damage does occur, it generally happens slowly over time and not as any single 'blowout' event.

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What are normal and abnormal blood pressures?

  • Measurements of blood pressure have two components: one to capture the peak pressure during a heartbeat (systolic), and the other to capture the resting pressure during the space between heart beats (diastolic).
  • Blood pressure is measured in a unit called "millimeters of mercury".
  • The systolic blood pressure measurement is the higher of the two numbers and is written on top of the diastolic.
  • Blood pressure measurements can be classified into four categories depending on how they vary from what is most healthy. The categories are hypotensive, optimal, prehypertensive, and hypertensive.
  • Hypotensive, or lower than normal blood pressure, is mostly only of concern when patients are hospitalized or feeling faint upon standing up or passing out for unknown reasons.
  • For most purposes, blood pressure readings can be considered optimal, prehypertensive, or varying degrees of hypertensive.
  • Optimal blood pressure is 120 over 80 - meaning the systolic pressure is below 120 and the diastolic is below 80.
  • Prehypertension is diagnosed when the systolic is between 120 and 139 and the diastolic is between 80 and 89.
  • Mild Hypertension is when the systolic is between 140 and 159 and the diastolic is between 90 and 99.
  • Moderate to Severe Hypertension is when the systolic is above 160 and the diastolic is above 100.

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What are the symptoms of high blood pressure?

  • Hypertension is sometimes called the "silent killer" because for all the disease and destruction it can cause, it is surprisingly quiet and difficult for a person to identify.
  • You can have raging high blood pressure and not know it, as there are often no obvious symptoms that you would experience.
  • When hypertension does produce symptoms they tend to be subtle and non-specific symptoms such as headache, dizziness, or blurred vision.
  • Because of the absence of obvious symptoms associated with hypertension, regular visits to the doctor's office are essential.

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How is high blood pressure diagnosed?

  • Diagnosis of hypertension is made by a doctor with the aid of a blood pressure measurement device such as a blood pressure cuff and stethoscope.
  • Due to the dynamic, changeable nature of blood pressure, the doctor may take multiple readings to get an average blood pressure and to spread the readings out over time.
  • He or she may also take the readings under controlled circumstances (for instance, always sitting after having relaxed for 1 minute and before meals) so as to get the most accurate and comparable reading possible.
  • The diagnosis of hypertension is usually made over several visits.
  • If your blood pressure is mildly elevated, a doctor will likely re-check it within a couple of months.
  • If your blood pressure is moderately to severely elevated the doctor may re-evaluate it within a week or so, or may start treatment immediately.

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How is high blood pressure treated?

  • The following lifestyle changes are important for reducing hypertension:
    • Exercise - Experts recommend at least 30 minutes of moderate exercise (brisk walking or stationary bike) on most of, if not all, days of the week. Intense work-outs (such as shoveling snow or heavy lifting) and competitive contact sports may be dangerous for people with high blood pressure.
    • Modified Diet - using the DASH or Dietary Approaches to Stop Hypertension diet, people can lower their high blood pressure. This involves avoiding saturated fats, choosing whole grains, eating fresh fruits and vegetables every day, and eating nuts, seeds or beans every day. Eating potassium-rich foods, restricting salt, cutting down or abstaining from alcohol use, and avoiding caffeine can also help.
    • Lifestyle modifications can substantially reduce hypertension, but they can be difficult for most people to follow, and even when followed correctly may not completely eliminate hypertension.
  • Various medications will commonly also be prescribed to help control blood pressure.
  • Commonly known as 'water pills', diuretics work by adjusting the fluid levels within the body.
  • Angiotensin Converting Enzyme Inhibitors (commonly known at ACE inhibitors) are not only useful for people with high blood pressure but are also important for people with heart disease and diabetes. They work by blocking chemical signals that can increase blood pressure.
  • Angiotensin Receptor Blockers (ARB's) reduce the effects of the angiotensin chemical signal system in a different way than ACE Inhibitors, but may have similar results.
  • Beta-blockers have their effect by reducing the frequency of heart beats.
  • Vasodilators open up the blood vessels and are often used in combination with other medications.

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What is living with high blood pressure like?

  • A combination of medication and lifestyle changes can bring most cases of hypertension under control.
  • It is necessary to stop eating some tasty foods, to exercise more frequently than may be comfortable (at least at first), and to take medicines as prescribed day in and out - possibly for the rest of your life.
  • It can be difficult for people to truly accept and recognize the need for such changes when they do not feel particularly impacted by their illness and when there are no obvious symptoms.
  • Failure to maintain treatments and lifestyle changes will likely result in the slow but cumulative and progressive damage to the body's vital organs (the heart, kidney and brain in particular).
  • It can be very discouraging to be diagnosed with a chronic condition and can lead to feelings of depression and helplessness.
  • Finding support systems (church, clubs, community centers), as well as family and friends to talk with can help defuse this negative stress, as can seeking out counseling and medical treatments for depression (such as antidepressant medications).
  • Taking steps to insure your mental wellness and positive outlook make it easier for you to improve your physical health and make necessary lifestyle changes.

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