Blood pressure (BP) is a measure of the force of blood flowing through your blood vessels. This measure includes two numbers. The first number, your systolic blood pressure, reflects the pressure in your arteries when your heart beats. The second number, or diastolic blood pressure, measures the pressure in your arteries when your heart is resting between beats. High blood pressure (HBP) is considered 130/80 mm (millimeters of mercury) HG or higher. It’s natural for blood pressure to rise and fall during the day. When blood pressure is consistently high, it can cause health problems.
High blood pressure, also known as hypertension, refers to blood pressure that is consistently higher than recommended levels. The American Heart Association (AHA) considers a normal blood pressure as less than 120/80 mm HG. High blood pressure takes a toll on your internal organs and contributes to an increased risk for other health issues such as heart disease and stroke.
Hypertension is often referred to as the “silent killer” because you may have no symptoms, even though this condition is quietly causing damage inside your body. Regularly measuring your blood pressure is the only way to know for sure if you’re at risk.
Over time, high blood pressure takes a toll on your internal health, weakening important organs like your heart, brain, kidneys and eyes. In addition, high blood pressure can cause arteries to become blocked or burst, triggering a stroke. Having HBP, especially from midlife forward, has been linked to diminished brain function and even the onset of dementia as you age.
A combination of lifestyle changes plus medication can help you manage high blood pressure. Achieving a healthy blood pressure range can have numerous health benefits. Work with your primary care physician to develop a treatment plan that’s right for you.
Risk
Some risk factors for hypertension are within your control, but not all. Risk factors contributing to high blood pressure can include:
- A family history which includes high blood pressure (or related conditions such as heart disease and diabetes).
- Age – the risk of high blood pressure increases with age. About 9 out of 10 Americans will develop high blood pressure during their lifetime.
- Race or ethnicity – African Americans, Hispanics, Asians, Pacific Islanders, American Indians or Alaskan Natives are all at increased risk for high blood pressure.
- A poor diet, high sodium (salt) intake and over consumption of alcohol can increase blood pressure.
- Tobacco use increases your risk for HBP and smoking is known to damage the heart and blood vessels.
- Lack of physical activity or being overweight can contribute to high blood pressure.
Prevention
Managing blood pressure is a lifetime effort that involves addressing those risk factors that are within your control. In some cases, your physician will prescribe one or more medications to help you improve your blood pressure. The below lifestyle changes may prove beneficial:
- If you smoke, quit.
- The CDC offers free support to help you quit smoking, including coaching sessions, a customized “quit plan,” educational materials, plus referrals to local resources. Call 1-800-QUIT-NOW (1-800-784-8669).
- Maintain a healthy weight. If you are overweight, losing as little as five to ten pounds can measurably improve your blood pressure.
- The DASH diet (Dietary Approaches to Stop Hypertension) is widely recommended for management of high blood pressure.
- Increase your activity level.
- Try to receive seven to nine hours of sleep daily.
- Limit your alcohol consumption.
- According to the Centers for Disease Control and Prevention:
- Women should have no more than one drink per day
- Men should have no more than two drinks a day.
- Limit your sodium consumption. High salt intake can contribute to hypertension.
Diagnosis
Committing to an annual wellness visit with your primary care provider is an important component of managing high blood pressure and addressing risk factors.
How is blood pressure measured?
When you visit your healthcare provider, your blood pressure is often taken at the beginning of your appointment. If it’s high, your blood pressure may be taken later in the appointment to see if it changes over time.
Different types of devices can be used to obtain a blood pressure reading. In many clinics, this involves a wide cuff with Velcro fastening which is wrapped above your upper arm. The cuff is pumped and slowly released – either manually by the caregiver or automatically by a machine – to deliver your systolic and diastolic reading.
If your physician is concerned about your blood pressure, you may be advised to begin monitoring your BP at home. By keeping a record of how your pressure fluctuates during the day, your provider will have a better understanding of the treatment plan that’s right for you and what type of medication, if any, may be indicated.
Treatmeant
Once it’s confirmed you have hypertension, your physician will work with you to devise a care plan you can maintain. A good patient-provider partnership will help you achieve your goals. Based on your health, age and family history, a target BP will be established. It may require a combination of lifestyle changes and medication to bring your blood pressure within the desired range.
It can take time to find the proper medicine or combination of medicines that will help you reach your target. Your physician can educate you regarding the range of drugs under consideration, such as water pills (diuretics) which help remove sodium (salt) and water from the body, angiotensin-converting enzyme (ACE) inhibitors which help relax blood vessels, calcium channel blockers, alpha blockers, beta blockers and more.
Adhering to your medication is important. Depending on your treatment plan, suddenly stopping a medication can create a situation known as rebound hypertension. If you’re having trouble remembering to take your medications according to the instructions, discuss the reasons with your care provider. By communicating openly to address any challenges, you will have a better chance of devising a treatment you can follow – one that contributes to improved health and longevity.
Tips for maintaining medication adherence include:
- Obtain mail order prescriptions, if available.
- Ask your doctor for a 90-day prescription to help ensure supply.
- Check with your pharmacy about automatic refills.
- Use a pill box for daily medications. Refill it at the same time each week.
Sources:
https://dashdiet.org/
https://www.cdc.gov/bloodpressure/about.htm
https://jamanetwork.com/journals/jama/fullarticle/194679
https://www.heart.org/en/health-topics/high-blood-pressure
https://www.health.harvard.edu/staying-healthy/which-blood-pressure-number-is-important#:
https://www.fda.gov/drugs/special-features/why-you-need-take-your-medications-prescribed-or-instructed
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