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High blood pressure (HBP), or hypertension, is often referred to as a "silent killer" because many people are often unaware that they have it. According to the American Heart Association, one in three U.S. adults has high blood pressure. Studies have shown that HPB is linked to artery damage and an increased risk for heart disease and stroke; it is the most common of all cardiovascular diseases. The good news is that HPB is fairly easy to detect and once diagnosed can usually be controlled.
What is Blood Pressure?
Blood pressure is a measurement of the force of blood against the inner walls of the arteries. "Blood pressure is naturally controlled by the brain and nervous system which regulate blood vessel constriction and dilation," says Kristine Batten M.D., cardiologist and medical director of the Women's Heart Program for John Muir Health. "This occurs on a moment-to-moment basis. Therefore the blood pressure is a constantly changing number reflecting the pressure within the arteries." The higher your blood pressure, the harder your heart must work.
HPB is considered a key risk factor for heart attack and stroke, as well as kidney and heart failure. And when compounded with obesity, smoking, high cholesterol levels or diabetes, the risk factor for heart attack and stroke is even higher.
How is Blood Pressure Tested?
Blood pressure is measured with a sphygmomanometer. A cuff is wrapped around the upper arm and then inflated, which compresses the large artery in the arm and stops the blood flow momentarily. Air in the cuff is released, and the tester listens with a stethoscope. The first number recorded is the blood pressure at its peak, during a beat. The second number reflects the blood when it is at its lowest pressure, in between beats. The numbers are measured in millimeters of mercury (mm Hg).
"120/80 or lower is considered a normal blood pressure," says Dr. Batten. "140/90 is a high blood pressure requiring medication." A blood pressure reading that falls between these two numbers is known as pre-hypertension. Pre-hypertensive patients require careful monitoring and lifestyle changes such as exercise, weight loss and decreased salt intake. For certain individuals, such as those with diabetes or kidney disease, a blood pressure over 130/80 is considered high.
What Causes High Blood Pressure?
According to the American Heart Association, 90 to 95 percent of HPB cases have unknown causes, although many factors can contribute:
Controllable Risk Factors: obesity, high salt intake, heavy alcohol use, sedentary lifestyle and stress. Uncontrollable Risk Factors: heredity, age and race. African Americans tend to develop hypertension at an earlier age and more often.
Medical research also suggests that taking birth control pills is linked with HBP in some women. "The combination of birth control pills and cigarette smoking may also be especially dangerous in some women," says Dr. Batten.
How is High Blood Pressure Treated?
There are a variety of medications that can help lower your blood pressure. In the 1950s diuretics were proven successful in reducing stroke and heart attack. Today, beta blockers that were popular in the 70's are still used to combat HPB. In fact, some of these drugs have been found to benefit not only HPB but also to reverse heart failure.
With so many drugs available, it may take trial and error to find the best choice for a patient. That is why regular follow-up with a physician is important.
What Can I do?
There are important lifestyle changes that can improve your blood pressure measurement. They include adopting a low-fat and low-salt diet, quitting smoking and getting more exercise. Relaxation techniques like yoga and even owning a pet have shown to help.
Home monitoring, that is checking your own blood pressure, for HBP is also gaining increased popularity by health care professionals. This works well for patients who are nervous when they visit the doctor's office and may exhibit "white coat" hypertension. In recent years, there has been an increase in the availability of easy-to-use, accurate, and inexpensive digital blood pressure devices. Most patients with a blood pressure issue can help their doctors to decide if HBP medication needs to be started, or if the dosage needs to be changed, based on frequent home blood pressure readings.
In order to get a consistent and accurate home blood pressure reading, discuss your situation with your doctor and observe the following:
- Your blood pressure device needs to be checked for accuracy, so bring it with you to your doctor visit.
- Follow proper technique as described by your doctor.
- Take your BP regularly (e.g. daily or 3 times/ week).
- Keep a log of your BP readings and bring it with you to your doctor visit.
- It is important to sample your BP at different times of the day.
"Controlling your blood pressure is the first step toward preventing heart disease and stroke," adds Dr. Batten.
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