Overview
High blood pressure, also known as hypertension, is a common condition where the force of blood pushing against the artery walls is consistently too high. This can cause the heart to work harder to pump blood. Blood pressure is measured in millimeters of mercury (mm Hg) and hypertension is generally defined as a reading of 130/80 mm Hg or higher. High blood pressure can be divided into four categories by the American College of Cardiology and the American Heart Association. Normal blood pressure is categorized as a reading of 120/80 mm Hg or lower, elevated blood pressure ranges from 120 to 129 mm Hg for the top number and below 80 mm Hg for the bottom number, Stage 1 hypertension has a top number between 130-139 mm Hg or a bottom number between 80-89 mm Hg, and Stage 2 hypertension has a top number of 140 mm Hg or higher or a bottom number of 90 mm Hg or higher. If blood pressure is higher than 180/120 mm Hg, it is considered a hypertensive emergency or crisis and requires immediate medical attention.
Understanding the disease
Risk Factors
The risk factors for developing high blood pressure are:
- Age: The risk increases with age, particularly after the age of 64 for women and before age 64 for men.
- Race: High blood pressure is more common among Black people, particularly at an earlier age.
- Family history: Having a parent or sibling with high blood pressure increases the risk.
- Obesity or being overweight: Excess weight causes changes in the blood vessels, kidneys, and other parts of the body, raising blood pressure.
- Lack of exercise: Inactivity leads to weight gain, higher heart rates, and increased blood pressure.
- Tobacco use or vaping: Smoking, chewing tobacco, or vaping immediately raises blood pressure and damages blood vessels.
- Too much salt: A high sodium intake causes the body to retain fluid, increasing blood pressure. Remember, controlling these risk factors through lifestyle changes and medication can help lower and manage blood pressure levels.
Development
High blood pressure can develop due to various factors, including chronic conditions like kidney disease and diabetes, lifestyle habits such as an unhealthy diet and lack of exercise, and medical conditions like sleep apnea, obesity, pregnancy, thyroid problems, hyperparathyroidism, coarctation of the aorta, adrenal gland tumors, congenital heart defects, and use of certain medications such as cough and cold medicines, pain relievers, birth control pills, and illegal drugs.
Assessment and Diagnosis
Triage
If you suspect high blood pressure, you should see a doctor for a blood pressure check at least every two years starting at age 18. If you're age 40 or older, or you're 18 to 39 with a high risk of high blood pressure, ask for a blood pressure check every year. If you have high blood pressure or other risk factors for heart disease, your care provider will likely recommend more-frequent readings. If you don't regularly see a care provider, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. Free blood pressure machines are also available in some stores and pharmacies, but the accuracy may depend on proper cuff size and machine use. It's important to have your blood pressure checked and discuss options for lowering your numbers with your doctor.
Diagnosis
To diagnose high blood pressure, your health care provider will examine you, ask questions about your medical history and any symptoms, and listen to your heart using a stethoscope. They will also check your blood pressure using a cuff, usually placed around your arm. A blood pressure reading has two numbers: the systolic pressure, which measures the pressure in the arteries when the heart beats, and the diastolic pressure, which measures the pressure when the heart is at rest. If there's a significant difference between the two readings, additional measurements should be taken. Blood tests and urine tests may also be performed to check for conditions that can cause or worsen high blood pressure.
Management and Treatment
Complications
Potential complications of high blood pressure include heart attack or stroke, aneurysm, heart failure, kidney problems, eye problems, and certain chronic conditions. High blood pressure can damage blood vessels and organs, increasing the risk of these complications. Uncontrolled high blood pressure can lead to a hypertensive emergency or crisis, which requires immediate medical attention. Despite lacking symptoms, high blood pressure can cause damage to arteries, aneurysm, and heart failure, among others. It is important to have regular blood pressure checks and maintain healthy lifestyle habits to prevent and treat high blood pressure.
Home Remedies
Here are some home remedies suggested for high blood pressure:
- Limit sodium intake: Reducing your consumption of salty foods and not adding salt to your meals can help lower blood pressure.
- Eat a low-sodium diet: Focus on consuming foods rich in potassium, magnesium, and calcium, such as fruits, vegetables, whole grains, and low-fat dairy products.
- Maintain a healthy weight: Losing weight, if necessary, can help lower blood pressure and improve overall health.
- Exercise regularly: Engage in regular physical activity, such as walking, swimming, or cycling, for at least 30 minutes most days of the week.
- Limit alcohol intake: Drink alcohol in moderation, if at all. For healthy adults, this means no more than one drink per day for women and two drinks per day for men.
- Manage stress: Practice relaxation techniques, such as deep breathing, yoga, or meditation, to help manage stress and lower blood pressure.
- Get enough sleep: Aim for 7-8 hours of quality sleep per night to help maintain healthy blood pressure levels.
- Consider natural remedies: Some people find relief in natural remedies like garlic, fish oil, or coenzyme Q10, but consult your doctor before incorporating these into your routine. Remember that these home remedies should be used in conjunction with, not as a substitute for, prescribed medications and regular medical check-ups. Consult your doctor before making any significant changes to your lifestyle or diet.
Treatment
Treatments for high blood pressure include lifestyle modifications, such as following a low-salt diet, exercising regularly, maintaining a healthy weight, and limiting alcohol use. In some cases, medications may be prescribed to help lower blood pressure. It is important to consult with a healthcare professional to discuss the best treatment options based on individual health conditions and needs.
Preparing for medical consultation
To prepare for an appointment for high blood pressure, follow these steps:
- Be aware of any pre-appointment restrictions: Ask your healthcare provider if there are any specific instructions you need to follow before your appointment, such as avoiding certain foods or activities.
- Wear a short-sleeved shirt: When attending the appointment, wear a short-sleeved shirt to make it easier for the healthcare provider to take your blood pressure.
- Avoid caffeine, exercise, and tobacco: For at least 30 minutes before the appointment, avoid caffeine, exercise, and tobacco to ensure an accurate blood pressure reading.
- Bring a list of medications: Bring a list of all medications, vitamins, and supplements you take, including dosages, to your appointment.
- Prepare a list of symptoms: Write down any symptoms you are experiencing, even if they seem unrelated to high blood pressure.
- Gather medical information: Note any family history of high blood pressure, high cholesterol, heart disease, stroke, kidney disease, or diabetes, as well as any major stresses or recent life changes.
- Take a family member or friend: If possible, bring a family member or friend along to help remember information discussed during the appointment.
- Prepare a list of questions: Compile a list of questions to ask your healthcare provider, such as the cause of your high blood pressure, necessary tests, and recommended lifestyle changes. Remember to be honest with your healthcare provider about your symptoms and medical history to receive the best possible care.