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High Blood Pressure


High blood pressure, or hypertension, refers to the unhealthy amount of pressure pushing against the walls of the arteries. Pressure is needed to push blood throughout the body but high blood pressure may eventually cause health problems such as heart disease and stroke.


Hypertension is common, affecting nearly one in every two American adults. Most people do not feel elevated pressures. Because long-standing uncontrolled high blood pressure can increase the risk of serious health problems, it is important to be routinely screened and treated for hypertension.


What do blood pressure numbers mean?

Blood pressure is measured using two numbers:


The top number is called the systolic blood pressure. This is a measure of the pressure in the arteries when the heart squeezes or contracts. Less than 120 mmHg is considered normal for the top number.


The bottom number is called the diastolic blood pressure. This is a measure of the pressure in the arteries when the heart relaxes between contractions or beats. Less than 80 mmHg is considered normal for the bottom number.


Hypertension is grouped into two stages:

  • Stage 1: The top (systolic) number is 130 to 139 mmHg, or the bottom (diastolic) number is 80 to 89 mmHg

  • Stage 2: The top (systolic) number is at least 140 mmHg, or the bottom (diastolic) number is greater than 90 mmHg


What causes high blood pressure?

Most adults with high blood pressure have primary hypertension. The cause of primary hypertension is unknown and usually develops over many years.


Some people with high blood pressure have secondary hypertension, which means that there is an underlying cause, such as kidney or hormonal disorder, for the elevated pressures. 


Secondary hypertension can potentially be corrected once the underlying cause is treated.


Lifestyle and environmental factors affect our blood pressure. Eating highly processed, salty foods and having high levels of stress, for example, can increase our blood pressure.


What are the complications of high blood pressure?

Untreated high blood pressure increases strain on the heart and arteries. Over time, it can cause organ damage. High blood pressure increases the risk of heart failure, heart attack, stroke, and kidney failure.


What are treatment options for high blood pressure?

Treatment of hypertension usually begins with lifestyle changes. 


Recommended lifestyle changes include:

  • A healthy diet with limited salt and alcohol intake

  • Getting at least 30 minutes of exercise a day, 5 days a week

  • Keeping a healthy weight

  • Not smoking

  • Managing stress through relaxation methods


If the blood pressure remains consistently high, usually at or above 140/90, medication may be needed to normalize blood pressures.


The categories of medications commonly used to treat hypertension include:

  • Diuretics. Diuretics lower blood pressure mainly by causing the kidneys to excrete more sodium and water.

  • ACE inhibitors. These medications block production of the hormone (angiotensin II) that causes narrowing of blood vessels, thereby allowing the blood vessels to widen and lower blood pressure.

  • Angiotensin II receptor blockers. These medications block the effects of angiotensin II on the heart and blood vessels. Like ACE inhibitors they can widen blood vessels and lower blood pressure.

  • Calcium channel blockers. Calcium channel blockers cause muscle cells to relax and blood vessels to dilate. They reduce blood pressure as well as reduce the force and rate of the heartbeat.

  • Beta blockers. Beta blockers lower blood pressure by decreasing the rate and force at which the heart pumps blood.

  • Alpha blockers. Alpha blockers relax the smooth muscle in the walls of blood vessels, thereby allowing the vessels to widen and lower blood pressure.




References

https://www.cdc.gov/bloodpressure/about.htm

https://www.uptodate.com/contents/high-blood-pressure-treatment-in-adults-beyond-the-basics

https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure

https://www.nhlbi.nih.gov/health-topics/high-blood-pressure

https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure

https://familydoctor.org/condition/high-blood-pressure/