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by Fucci MJ

High Blood Pressure

(Blood Pressure, High; Essential Hypertension; Idiopathic Hypertension; Primary Hypertension)

Definition

High blood pressure is abnormally high blood pressure with no known cause. Blood pressure measurements are read as two numbers:
  • Systolic pressure: higher number, normal reading is 120 millimeters of mercury (mmHg) or less
  • Diastolic pressure: lower number, normal reading is 80 mmHg or less
High blood pressure is defined as systolic pressure greater than 140 mmHg and/or diastolic pressure greater than 90 mmHg. You are considered prehypertensive if your systolic blood pressure is between 120-139 mmHg, or your diastolic pressure is between 80- 89 mmHg.
High blood pressure puts stress on the heart, lungs, brain, kidneys, and blood vessels. Over time, this condition can damage these organs and tissues.
Organs Impacted by High Blood Pressure
High blood pressure and organs
Copyright © Nucleus Medical Media, Inc.

Causes

The cause of primary hypertension is not known.

Risk Factors

High blood pressure is more common in men, postmenopausal women, older adults, and people of African American descent.
Factors that may increase your risk of high blood pressure include:
  • Overweight
  • Heavy drinking of alcohol
  • Smoking
  • Use of oral contraceptives (birth control pills)
  • Sedentary lifestyle
  • Family history
  • Kidney disease
  • Diabetes
  • High-fat, high-salt diet
  • Stress

Symptoms

High blood pressure usually does not cause symptoms. But, the condition can still damage your organs and tissues.
Occasionally, if blood pressure reaches extreme levels, you may have the following:
  • Headache
  • Blurry or double vision
  • Abdominal pain
  • Chest pain
  • Shortness of breath
  • Lightheadedness

Diagnosis

High blood pressure is often diagnosed during a doctor's visit. Blood pressure is measured using an arm cuff and a special device. If your reading is high, you will come back for repeat checks. If you have three visits with readings over 140/90 mmHG, you will be diagnosed with high blood pressure.
Your bodily fluids may be tested. This can be done with:
  • Blood tests
  • Urine tests
Images may be taken of your chest. This can be done with chest x-rays.
Your heart's activity may be measured. This can be done with an electrocardiogram (ECG, EKG).

Treatment

Lifestyle Changes

  • Maintain a healthy weight .
  • Begin a safe exercise program with the advice of your doctor.
  • If you smoke, talk to your doctor about ways toquit .
  • Eat a healthful diet , one that is low fat, low salt, and rich in fiber , fruits, and vegetables. Your doctor may recommend the DASH diet , which is designed to reduce blood pressure.
  • Drink alcohol in moderation. Moderate is two or fewer drinks per day for men and one or fewer drinks per day for women and older adults.
  • Manage stress .

Medications

Medications may include:
  • Diuretics
  • Beta blockers
  • Calcium channel blockers
  • Angiotensin receptor blockers
  • Aldosterone blockers
  • Alpha blockers
  • Alpha-beta blockers
  • Angiotensin converting enzyme inhibitors (ACE inhibitors)
  • Nervous system inhibitors
  • Vasodilators
Note: Untreated high blood pressure can lead to:
If you are diagnosed with high blood pressure, follow your doctor's instructions.

Prevention

To help reduce your risk of getting high blood pressure, take the following steps:
  • Eat a well-balanced diet. The DASH diet —rich in fruits, vegetables and low-fat dairy foods, and low in saturated fat, total fat, and cholesterol—may help keep your blood pressure in the healthy range.
  • Exercise regularly.
  • Maintain a healthy weight.
  • If you smoke, talk to your doctor about ways to quit .
  • Drink alcohol in moderation. Moderate is two or fewer drinks per day for men and one or fewer drinks per day for women and older adults.

RESOURCES

American Heart Association
http://www.americanheart.org
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Cardiovascular Society
http://www.ccs.ca
Heart and Stroke Foundation of Canada
http://www.heartandstroke.com

References

Chobanian AV. Clinical practice. Isolated systolic hypertension in the elderly. N Engl J Med. 2007;357:789-796.
Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. The JNC 7 report. JAMA. 2003;289:2560-2572.
High blood pressure or hypertension. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/High-Blood-Pressure-or-Hypertension%5FUCM%5F002020%5FSubHomePage.jsp. Accessed September 30, 2014.
Hypertension. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 26, 2014. Accessed September 30, 2014.
What is high blood pressure? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP%5FWhatIs.html. Updated August 2, 2012. Accessed September 30, 2014.
9/2/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Forman J, Stampfer M, Curhan G. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009;302(4):401-411.

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