HYPERTENSION

HYPERTENSION: High Blood Pressure

Overview

High blood pressure (hypertension) is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.

Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. A blood pressure reading is given in millimeters of mercury (mm Hg). It has two numbers.

• Top number (systolic pressure).The upper number measures the pressure in your arteries when your heart beats.
• Bottom number (diastolic pressure).The lower number measures the pressure in your arteries between beats.

You can have high blood pressure for years without any symptoms. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke. Fortunately, high blood pressure can be easily detected and you and your doctor will talk about a treatment plan to control it.

Symptoms

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.

A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms aren't specific and usually don't occur until high blood pressure has reached a severe or life-threatening stage.

When to see a doctor

You'll likely have your blood pressure taken as part of a routine doctor's appointment.

Ask your doctor for a blood pressure reading at least every two years starting at age 18. If you're age 40 or older, or you're 18 to 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year.

Causes

There are two types of high blood pressure.

Primary (essential) hypertension

For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called primary (essential) hypertension, tends to develop gradually over many years.

Secondary hypertension

Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

• Obstructive sleep apnea
• Kidney disease
• Adrenal gland tumors
• Thyroid problems
• Certain defects you're born with (congenital) in blood vessels
• Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs
• Illegal drugs, such as cocaine and amphetamines

Risk factors

High blood pressure has many risk factors, including:

• Age
• Race
• Family history
• Being overweight or obese
• Not being physically active
• Using tobacco
• Too much salt (sodium) in your diet
• Too little potassium in your diet.
• Drinking too much alcohol or caffeine
• Stress
• Certain chronic conditions. Including kidney disease, diabetes and sleep apnea.

Complications

• Heart attack or stroke.
• Aneurysm
• Heart failure
• Weakened and narrowed blood vessels in your kidneys
• Thickened, narrowed or torn blood vessels in the eyes.
• Metabolic syndrome
• Dementia

Blood pressure measurements fall into several categories:

• Normal blood pressure.Your blood pressure is normal if it's below 120/80 mm Hg.
• Elevated blood pressure.Elevated blood pressure is a systolic pressure ranging from 120 to 129 mm Hg and a diastolic pressure below (not above) 80 mm Hg. Elevated blood pressure tends to get worse over time unless steps are taken to control blood pressure. Elevated blood pressure may also be called prehypertension.
• Stage 1 hypertension.Stage 1 hypertension is a systolic pressure ranging from 130 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg.
• Stage 2 hypertension.More-severe hypertension, stage 2 hypertension is a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or higher.
• Hypertensive crisis.A blood pressure measurement higher than 180/120 mm Hg is an emergency situation that requires urgent medical care. If you get this result when you take your blood pressure at home, wait five minutes and retest. If your blood pressure is still this high, contact your doctor immediately. If you also have chest pain, vision problems, numbness or weakness, breathing difficulty, or any other signs and symptoms of a stroke or heart attack, call 911 or your local emergency medical number.

Diagnosis

Your doctor will get a blood pressure reading get an appointment. Your doctor may ask you to record your blood pressure at home to provide additional information and confirm if you have high blood pressure. Home monitoring is an important way to confirm if you have high blood pressure, to check if your blood pressure treatment is working or to diagnose worsening high blood pressure.

Tests

If you have high blood pressure, your doctor may recommend tests to confirm the diagnosis and check for underlying conditions that can cause hypertension.

• Lab tests
• Electrocardiogram (ECG or EKG).
• Echocardiogram

Treatment

Changing your lifestyle can help control and manage high blood pressure. Your doctor may recommend that you make lifestyle changes including:

• Eating a heart-healthy diet with less salt
• Getting regular physical activity
• Maintaining a healthy weight or losing weight if you're overweight or obese
• Limiting the amount of alcohol you drink

But sometimes lifestyle changes aren't enough. If diet and exercise don't help, your doctor may recommend medication to lower your blood pressure.

Medications

The type of medication your doctor prescribes for high blood pressure depends on your blood pressure measurements and overall health. Two or more blood pressure drugs often work better than one. Sometimes finding the most effective medication or combination of drugs is a matter of trial and error.

If you or a family member have blood pressure issues or you or a family members hasn’t had a blood pressure reading in a year the medical providers at Grayhawk Medical Group are here for an appointment to look at your blood pressure and or heart.

Author

Michael Nunez, M.D. Dr. Michael Nunez is a primary care physician who treats patients living in the Scottsdale, Arizona area. Dr. Nunez attended the University of Arizona where he earned both his Bachelor's degree as well as his doctorate. He received his Board Certification through the American Board of Family Medicine. The doctor is an Arizona native who takes pride in working with the people of his community. The doctor began practicing medicine in 1998. In 2001, he opened Grayhawk Medical Group, PLLC, to better serve the area residents. Dr. Nunez continues to expand his education so he can better serve his patients in all aspects of treatment.