High Blood Pressure (Hypertension)

What is high blood pressure (hypertension)?

Hypertension, also known as high blood pressure, is a condition where the force of the blood against the artery wall is too strong. High blood pressure damages cells in your arteries by making the lining thinner. As a result, blood struggles to pass through your vessels smoothly. 

Two factors determine blood pressure. You may have noticed that the blood pressure monitor that wraps around your arm displays a reading that contains a top number and another on the bottom. The number at the top measures the pressure in the arteries every time the heart pumps, and the bottom number measures the pressure in the arteries between beats. 

Having uncontrolled high blood pressure can put you at risk for many other health conditions. However, it can be tricky to realize you have hypertension unless your blood pressure is high for an extended amount of time. Often, there are no noticeable symptoms other than high blood pressure readings. Hypertension tends to worsen with age and is essential to promptly treat as it can eventually cause other health concerns if left unmanaged.

Pathophysiology and Risk Factors

The amount of pressure with which your blood flows through your body is determined by how much blood your heart pumps with each stroke (beat) and how much resistance the blood encounters as it flows through your vessels. People with high blood pressure usually pump a normal amount of blood per beat but, for some reason, their blood vessels provide more resistance for the blood flow than usual. 

In many cases, hypertension has no known cause ("essential hypertension"). However, the following factors are known to place you at an increased risk of developing this condition:  

  • Diabetes - Approximately 6 out of 10 patients with diabetes also struggle with high blood pressure. High sugar content in the blood can make it more viscous and difficult for your heart to pump.
  • Poor diet - Too much salt leads to dehydration, which causes less blood volume so that your heart cannot pump as efficiently.
  • Lack of exercise - A sedentary lifestyle can lead to overall poor cardiac health.
  • High cholesterol - Too much cholesterol will cause the formation of plaques in your blood vessels. These narrow and harden your vessels, making it more difficult for blood to flow through them.
  • Genetics - Hypertension and cardiac disease can have a familial component.
  • Excessive alcohol consumption - This can lead to dehydration and less blood volume, so your heart has to work harder.
  • Age - The risk of hypertension increases as you age, with women being more likely to develop it by the age of 65 than men.
  • Consuming tobacco - Nicotine causes your heart to beat faster and your blood vessels to narrow, increasing blood pressure.
  • Stress - This can increase your heart rate leading to high blood pressure. It can also contribute to poor diet, lack of exercise, and alcohol and tobacco use.
  • Other medical conditions such as kidney disease and sleep apnea affect other body systems that interplay with the circulatory system. 

Signs and Symptoms of Hypertension

It is important to note that hypertension only has symptoms when the blood pressure is extremely high. Ignoring these signs can lead to a hypertension crisis, which can be fatal. If you are experiencing any of the following, you should seek medical care immediately:

  • Severe headaches
  • Nosebleeds
  • Confusion
  • Vision disturbances
  • Irregular heartbeat
  • Chest pain
  • Blood in your urine

If you have a history of high blood pressure readings, speak with one of our online doctors now to preserve your health and avoid long-term complications.

Diagnosis

When talking with your doctor about your blood pressure, they will usually begin by measuring it using an arm cuff. If readings from previous visits are available, they may also look at these to see any trends in your pressure over time. They may also ask you questions about your lifestyle and any symptoms you are experiencing.

If your reading is within the normal limits (less than or equal to 120/80 mm Hg), your physician will most likely recheck it the next time you're at the office. If your reading is high, it will fall into one of the following stages

Stage

Systolic Reading (top number)        

Diastolic Reading (bottom number)   

Elevated

120-129 mm Hg

<80 mm Hg

Stage 1

130-139 mm Hg

80-89 mm Hg

Stage 2

>140 mm Hg

>90 mm Hg

Hypertensive Crisis      

>180 mm Hg

>120 mm Hg

If your doctor needs more information to make a diagnosis, you may need ambulatory monitoring, where your blood pressure is read repeatedly over 24 hours to give a better understanding of your true blood pressure throughout the day. Lab tests may also be ordered, including urine analysis.

Your doctor may also refer you to a cardiologist for an electrocardiogram (ECG or EKG) to measure the electrical activity and health of your heart. An echocardiogram, which uses sound waves to image the heart, can also be performed to check for signs of cardiac disease that may be a cause or result of hypertension.

Treatment

If you have high blood pressure, you must work with your doctor to address the contributing factors and lower your reading. If your hypertension is not much above the target range, your physician may recommend trying lifestyle modifications to see if you can lower your blood pressure naturally. 

Eating a healthy diet and incorporating exercise can positively impact your overall cardiac health. Quitting or limiting alcohol and tobacco consumption can also be extremely helpful. You can also try techniques like journaling and mindfulness to relieve your stress. Finally, checking your blood pressure with an at-home monitor can help you keep track of your pressures and progress.

If lifestyle changes are not sufficient to bring your hypertension under control, medication can help. There are several medications that your doctor may want to explore. Keep in mind that finding a drug to which your body and hypertension respond well can be a trial and error process. Common medications used to treat hypertension are: 

  • Diuretics (also known as water pills)
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers (ARBs)
  • Calcium channel blockers (CCBs)
  • Beta-blockers (BBs)

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Prognosis

Hypertension can have serious complications such as heart disease, kidney failure, and many other chronic conditions if left untreated. Managing your blood pressure is a life-long commitment, especially once you're diagnosed with hypertension. 

Making healthy lifestyle changes can make a big difference in your heart health and overall well-being. In addition to adhering to any medical treatment prescribed by your doctor, this can keep your high blood pressure under control. Appropriate management can minimize the negative effects of high blood pressure. Talk to one of our online doctors now to learn how we can help you control your blood pressure and live healthily!

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