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High Blood Pressure

The Dangers of Hypertension

High blood pressure can damage your health in many ways. That's why it's so important to work with your doctor to develop a lifestyle and medication plan that is safe and effective.

If not controlled, high blood pressure can cause:

• Heart damage. High blood pressure causes the heart to work harder. Over time this can lead to congestive heart failure.

• Atherosclerosis. High blood pressure is one cause of initial damage to the inner walls of the arteries that leads to atherosclerosis or hardening of the arteries. This can lead to a heart attack.

• Kidney damage. Narrowing of the arteries caused by high blood pressure can cause kidneys to malfunction.

• Aneurysms. High blood pressure also weakens and stretches vessel walls. This can lead to balloon like projections called aneurysms which can burst when under pressure. This commonly occurs in the brain, eyes, kidneys or in larger blood vessels.

• Strokes. High blood pressure can lead to strokes by causing atherosclerosis of the arteries that feed blood to the brain causing an ischemic stroke.

It can also cause a rupture of blood vessels in the brain causing a brain hemorrhage.

Ischemic stroke and brain hemorrhage can produce permanent loss of speech, strength, mental functions and sensation, coma and death.

BLOOD PRESSURE EVALUATION

The following chart suggests when follow-up blood-pressure checks should be scheduled. Your doctor may recommend a different schedule depending on your risk factors, medical history and current health.

Blood Pressure Category	Systolic (mm Hg)	Diastolic (mm Hg)	Recommended Follow-up
Normal	Less than 120	Less than 80	Recheck in 2 years
Prehypertension	120 to 139	80 to 89	Recheck in 1 year
HIGH Stage 1 (mild)	140 to 159	90 to 99	Confirm within 2 months
Stage 2 (moderate)	160 to 190	100 to 110	Evaluate within 1 month
Stage 3 (severe)	180 or higher	110 or higher	Evaluate immediately

Understanding High Blood Pressure

High blood pressure, or hypertension, is a common, treatable medical condition.

Every time your heart beats, it pumps blood through arteries that transport blood from your heart to the rest of your body. When your blood is pumped through your arteries, it pushes against the arterial walls. The force of blood against the walls of the arteries is your blood pressure.

WHAT IS HIGH BLOOD PRESSURE?

High blood pressure is caused by arteriosclerosis (hardening of the arteries), thickening (hypertrophy) of the artery walls and contraction of the arterioles (smaller arteries). High blood pressure weakens arterial walls and increases the likelihood of further cardiovascular complications.

CAN I TELL IF I HAVE IT?

No, because high blood pressure has no symptoms you can see or feel. The only way to tell if your blood pressure is high is to have it checked; this process should be completed by your doctor or another health professional about once a year.

IS HIGH BLOOD PRESSURE DANGEROUS?

Yes. Untreated hypertension can result in serious illnesses such as coronary artery disease, stroke and kidney failure.

Any rise in blood pressure should be monitored and treated. Even borderline hypertension can damage heart and blood vessels and increase your risk of heart attack.

WHAT CAN I DO ABOUT IT?

Diet and lifestyle changes may be enough to control mildly elevated blood pressure. But if your blood pressure is moderate to high, your doctor may prescribe antihypertension medication and lifestyle changes.

Taking Your Medicine

Medications known as antihypertensives lower high blood pressure. Some, called diuretics, rid the body of excess fluids and sodium. Others, called beta blockers, reduce the heart rate and the heart's output of blood.

Another class of antihypertensives is called sympathetic nerve inhibitors. Sympathetic nerves go from the brain to all parts of the body, including the arteries. They can cause the arteries to constrict, raising blood pressure. This class of drugs reduces blood pressure by inhibiting these nerves from constricting blood vessels.

Yet another group of drugs is the vasodilators. These can cause the muscle in the walls of the blood vessels to relax, allowing the vessels to dilate.

Other classes of drugs used to treat high blood pressure are the angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers and the calcium channel blockers. The ACE inhibitors interfere with the body's production of angiotensin, a chemical that causes the arteries to constrict, and the angiotensin II receptor blockers block the effects of angiotensin. The calcium antagonists can reduce the heart rate and relax blood vessels.

People respond very differently to these medications so most patients must go through a trial period to find out which medications work best with the fewest side effects such as headaches, nausea, weakness, impotence or insomnia.

To gain the optimum benefits from your medication, follow these guidelines:

• Take all your medication as prescribed. Be sure you know whether it should be taken with food or on an empty stomach.

• Take your pills at the same time each day. Consider putting a check mark on your calendar after you've taken them.

• Refill your prescription before it runs out.

• Don't adjust your dosage without your doctor's approval.

• o Don't skip appointments to have your blood pressure checked.

Taking Control of Your High Blood Pressure

Almost anyone with high blood pressure can manage the condition. The disease responds to treatment in most cases, but the success of the treatment is up to you.

Taking charge of your condition by making lifestyle changes and/or taking antihypertension medication can help you feel better and live longer.

The risk factors for high blood pressure are divided into two categories ˜ those you can't control and those that can be controlled through lifestyle modification.

UNCONTROLLABLE RISK FACTORS

You can't control these risk factors for high blood pressure:

• Heredity ˜ Your chances of developing high blood pressure are increased if your parents or other close relatives had it.

• Gender ˜ Men are more likely to develop the condition than women until age 55; a woman's risk increases after menopause.

• Age ˜ High blood pressure occurs most often in men over age 35 and women over 45. And your risk increases with age.

• Race ˜ African-Americans develop high blood pressure more often than whites do.

LIFESTYLE ADJUSTMENTS

The more uncontrollable risk factors you have, the more important it is to make the right decisions regarding those risk factors you can control.

Consult your doctor about making lifestyle adjustments to eliminate these controllable risk factors:

• Stop smoking. Cigarette smoke inhalation stimulates your heart, making it beat faster. It also narrows your blood vessels, causing your blood pressure to rise dramatically.

• Keep your weight down. Cut your intake of foods high in fat and calories if you're 10 or more pounds overweight.

• Learn to cope with stress. Meditate, listen to stress-management tapes or do relaxation exercises daily. Stressed individuals often have high blood pressure.

• Exercise regularly. Regular aerobic exercise tones your heart, blood vessels and muscles and keeps your blood pressure low. Consult your doctor before beginning an exercise regimen if you have high blood pressure.

• Drink in moderation. Heavy, regular consumption of alcohol can increase blood pressure dramatically.

• Limit your salt intake. A diet too high in sodium may cause the body to retain water, which increases the volume of blood in circulation. This increases the pressure in the arteries.

The average adult needs 2,200 mg. of sodium per day, but many Americans consume 10 times that amount.

To reduce your sodium intake:

• Avoid high-salt foods such as soy sauce, potato chips, chicken broth, pickles, canned soups, bacon, ham and many convenience and frozen foods.

• Purchase no- or low-salt products whenever possible.

• Avoid adding salt at the table.

• Increase your intake of potassium, which helps flush sodium from the body. Good sources of potassium include: cantaloupe, cooked tomatoes, bananas, baked potatoes, strawberries and summer squash.

For More Information

The National Heart, Lung and Blood Institute, call 800-575-WELL or visit www.nhlbi.nih.gov.

The American Heart Association, call 800-AHA-USA1 or visit www.heart.org.
 

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