Charlotte, NC
Swotantra Gautam, MD
Lumanti Manandhar, BPH
High blood pressure nearly affects 1 out of 2 adults in the United States. Hypertension is a medical condition where the blood flows through your body with too much force. This can cause damage to your blood vessels and increase your risk of severe health problems, such as heart disease and stroke. Early diagnosis and treatment are essential to control high blood pressure and reduce your risk of health problems.
Hypertension is often called the “silent killer” because it has no noticeable symptoms. Many people with hypertension do not know they have it because they do not feel sick. People with very high blood pressure may experience symptoms such as
Blurred vision
Dizziness or lightheadedness
Chest pain
Difficulty breathing/shortness of breath
Nausea
Bloody urine
There are many potential causes of hypertension; in some cases, the exact cause is unknown.
More than 90% of the time the cause is unknown. High blood pressure can be divided into two broad categories- Primary and Secondary high blood pressure.
What is Primary Hypertension?
Primary hypertension is high blood pressure most likely caused by environmental and genetic factors. It accounts for 90-95% of adult hypertension cases, It is strongly associated with risk factors like age (risk increases with advancing age), obesity, family history, race, diet (high salt diet), alcohol consumption (>8 drinks/week), physical inactivity.
What do you mean by secondary hypertension?
Secondary hypertension is high blood pressure that is caused by other medical conditions. In many cases, secondary hypertension may coexist with risk factors associated with primary hypertension.
The common cause of secondary hypertension includes.
● Oral contraceptives (particularly those with higher levels of estrogen)
● NSAIDs (chronic use of nonsteroidal anti-inflammatory agents)
● Decongestants
● Stimulants (amphetamine)
● Endocrine disorders (hypothyroidism, hyperthyroidism, Cushing’s syndrome)
● Sleep Apnea
Age: Your risk increases as you get older.
Family history: If your parents or siblings have hypertension, you are more likely to develop it.
Race: Some racial and ethnic groups, such as African Americans, are more likely than other groups to develop hypertension.
Lifestyle factors: Habits such as smoking, excessive alcohol consumption, and a sedentary lifestyle can increase the risk of hypertension.
Diet: A diet high in salt, and saturated fat can contribute to hypertension.
Obesity: Obesity or being overweight increases a person’s risk of developing hypertension.
Chronic conditions: Certain medical conditions, such as diabetes and kidney disease, can increase the risk of hypertension.
Stress: Hypertension can develop as a result of prolonged stress.
Your doctor will diagnose you with high blood pressure when your blood pressure readings consistently range from a systolic blood pressure of 130 mm of Hg and above or diastolic blood pressure of 80 mm Hg and above. If your blood pressure is consistently high, your healthcare provider may recommend additional tests to determine the cause and the best treatment course.
Some people with high blood pressure may have “white coat hypertension,” which means that their blood pressure is elevated when they are in a doctor’s office but normal when they are at home or at rest. In these cases, a healthcare provider may recommend monitoring blood pressure at home or using a portable blood pressure monitor to get a more accurate diagnosis.
Process of ambulatory measurement of blood pressure (measurement of blood pressure at home is more reliable than in hospital settings)
Things to avoid while checking blood pressure at home-
1. Buy an instrument with an appropriate cuff size by validating with a doctor beforehand
2. Check your blood pressure twice, first in the morning before taking medicine and then in the evening preferably at the same time each day.
3. Avoid food, caffeine, tobacco, and alcohol for 30 minutes before taking a measurement.
4. Sit quietly for 5 minutes on the chair before you take the reading.
5. Place the cuff on bare skin and not over clothing.
6. Arm should be positioned at the level of the heart, resting on the table or arm of the chair.
7. Do not repeat blood pressure measurement before 3 minutes on the same arm. Blood pressure chart: what your reading means.
Treatment for hypertension begins with lifestyle changes, such as following a healthy diet, exercising regularly, and limiting alcohol consumption. These changes can help to lower blood pressure and reduce the risk of related health problems. Your doctor will discuss this with you and can choose from numerous types of medications to manage high blood pressure:
● Diuretics: By helping the body to remove excess water, these medications can lower blood pressure.
● Beta-blockers: These medications lower blood pressure by reducing heart rate and relaxing blood arteries.
● ACE inhibitors: These medications relax blood vessels and lower blood pressure by inhibiting the production of an angiotensin II hormone.
● Calcium channel blockers: These medications relax blood vessels and lower blood pressure by blocking the movement of calcium into cells.
Correct knowledge and management strategies about hypertension can prevent you from hypertension. You can do the following things to lower your chances of developing hypertension or high blood pressure:
Adopting a healthy lifestyle: Eating a balanced diet, being active, and avoiding tobacco and excessive alcohol consumption.
Maintaining a healthy weight: Maintaining the weight that is appropriate for your height and body type by determining Body Mass Index (BMI) should be taken for this measure.
· Underweight: BMI less than 18.5
· Normal weight: BMI of 18.5 to 24.915
· Overweight: BMI of 25 to 29.9
· Obese: BMI of 30 or higher
3. Reducing stress: Engaging yourself in relaxation techniques or counseling can be helpful.
4. Limiting salt intake: A diet high in salt can contribute to hypertension.
5. Getting enough sleep
6. Monitoring blood pressure regularly: Checking your blood pressure regularly (twice a day) can help you identify any potential issues early on and take steps to address them.
7. Seeking medical attention if needed: If you are experiencing symptoms such as severe headache, chest pain, or difficulty breathing, you should seek medical attention immediately, as these could be signs of a more serious medical condition.
Several dietary changes can help to lower blood pressure and manage hypertension. These include:
● Consuming a diet high in nutrients and fiber: fruits, vegetables, and whole grains
● Limiting the intake of sodium in your diet(<1.5-2.3g/day)
● Eating less processed and packaged foods
● Eating more potassium-rich foods: bananas, sweet potatoes, avocados, and spinach.
● Limit alcohol intake (Alcohol consumption is limited to one drink per day for women and two drinks per day for men, and can change the systolic BP by 5mm of Hg)
● Choosing lean proteins: skinless chicken, turkey, and fish as they are low in saturated fat. Learn more about medicines for high blood pressure.
If you have had high blood pressure for a long time, you are at a higher risk for the following conditions.
Heart attack
Stroke
Vision loss
Sexual dysfunction
Kidney disease/ failure
● If you have sustained high blood pressure readings, it is necessary to see your doctor immediately. This is especially important if you have no previous diagnosis of hypertension and have not made any lifestyle changes that could be contributing to high blood pressure. Before visiting a doctor, a record of the BP chart (of at least a week) can be maintained and can be taken along with during the next appointment.
● If you have been taking medications for hypertension, it is important to see your doctor regularly to monitor your blood pressure and make any necessary adjustments to your treatment plan.
It is important to consult a doctor right away if you have any symptoms of hypertension. Additionally, it’s crucial to visit a doctor if you have other hypertension risk factors or a family history of the condition.
What are the potential complications of high blood pressure if left untreated?
What lifestyle changes can I make to help manage my blood pressure?
Are there any medications that can help lower my blood pressure? What are the possible side effects?
How often will I need to check my blood pressure?
Will I need to see a specialist, such as a cardiologist?
Is there a specific diet or exercise plan that you recommend for people with hypertension?
Can you recommend any resources or support groups for people with hypertension?
High blood pressure is only a problem for older people: While it is true that the risk of hypertension increases with age, anyone can develop high blood pressure, including young people and children.
2. High blood pressure has no symptoms: Although many people with hypertension are symptom-free, some may develop headaches, dizziness, and shortness of breath. Hence, it is essential to have regular blood pressure checks.
3. Only people who are overweight or obese develop high blood pressure: Excess weight is not the only factor for hypertension, other risk factors shouldn’t be overlooked.
4. You must continue taking blood pressure medicine for the rest of your life after you start: Although some hypertensive people may need to take medication for the rest of their lives, many people control their blood pressure by modifying their lifestyles.
5. High blood pressure is not a severe condition: Serious health issues might result from untreated high blood pressure, such as heart attack, stroke, kidney damage, and vision loss. Diagnosing and treating hypertension is vital to reduce the risk of these complications.
Understanding Blood Pressure Readings. (2023, January 24). www.heart.org. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings
