Understanding High Blood Pressure -- Diagnosis & Treatment
How Do I Know If I Have High Blood Pressure?
In order to diagnose high blood pressure, your health care provider will check your blood pressure with a blood pressure cuff. It's important to pay attention to both the higher (systolic) and the lower (diastolic) numbers in your blood pressure readings.
Persistently high systolic readings -- greater than 140 -- are dangerous, especially in adults over age 50. Although both numbers are felt to be important, systolic blood pressure is probably a better indicator of your risk for heart disease. For people under age 50, the diastolic number is a more important indicator of the risk for heart disease.
About one in three adults in the U.S. have high blood pressure. More than 90% of adults who survive into their 80s will develop elevated blood pressure, also called hypertension.
Although high blood pressure is common, it's not harmless. High blood pressure is a major cause of atherosclerosis, the artery-clogging process that leads to heart attacks and strokes. Blood pressure higher than 140/90 is seen in:
69% of people who have their first heart attack
77% of people who have their first...
Making lifestyle adjustments is key to maintaining normal blood pressure. In fact, most doctors will suggest lifestyle changes before prescribing drugs. Lifestyle changes are also the recommended treatment for pre-hypertension, a condition in which blood pressure readings are higher than 120/80, but below 140/90.
Quit smoking. This is perhaps the most important step a person can take to improve health.
Lose weight. Losing excess weight can help decrease your blood pressure. If you're overweight, work with your doctor to design a safe weight loss plan to get closer to your ideal weight.
Eat right. Studies show that a diet low in salt and fat and high in fruits and vegetables can significantly lower blood pressure. Also, make sure you get enough vitamins and minerals -- some studies show that having the recommended daily amounts of vitamin C, vitamin E, potassium, magnesium, and calcium can improve heart health. Your diet should also include low-fat dairy products.
Exercise. Regular aerobic activity, such as brisk walking on most days of the week, can lower blood pressure. Regularity of exercise is as important as intensity.
Limit alcohol. Women should drink no more than one alcoholic drink per day; men should limit intake to two drinks or fewer. "One drink" means one 5-ounce glass of wine, one 12-ounce beer, or one 11/2-ounce shot glass of hard liquor.
Reduce stress. Emotional factors play a role in blood pressure. Studies show that relaxation techniques such as meditation, yoga, or even therapy to help you cope with stress may reduce blood pressure.
Sometimes, high blood pressure requires drug therapy, either because of its severity or because it doesn't respond to lifestyle changes and self-help measures. Blood pressure medications do not cure hypertension but help keep blood pressure readings in a healthier range. They usually need to be taken for life. A number of drugs can be used alone or in combination to treat high blood pressure:
Diuretics, or "water pills," rid the body of salt and excess fluids.
Beta-blockers make the heart beat more slowly and with less force. These are particularly effective in people with heart disease.
Calcium-channel blockers reduce blood pressure by dilating blood vessels. Some of these drugs remain somewhat controversial. Some have been proven to decrease the risk of heart disease.
Angiotensin-converting enzyme (ACE) inhibitors block factors that cause blood vessels to constrict, which makes vessels dilate and thus reduces blood pressure. These drugs can decrease the risk of kidney disease, heart disease, and stroke, and are especially useful in people with heart disease or diabetes.
Angiotensin II receptor blockers (ARBs) are a newer type of blood pressure medicine, which work in a similar way to ACE inhibitors.
Alpha1-adrenergic blockers and centrally-acting agents lower blood pressure by relaxing and dilating arteries.
Alpha-beta blockers have the combined effects of relaxing arteries, slowing the heart beat, and reducing the force of the heart beat.
Centrally-acting agents prevent your brain from sending signals to your nervous system to increase your heart rate and narrow your blood vessels.
Vasodilators prevent arteries from narrowing by a direct action on the muscles in the walls of the arteries.
Warning: Do not stop taking prescribed medication until you have consulted your doctor; stopping abruptly can be harmful.
SOURCES: "Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressue," (JNC VII), JAMA Express, May 15, 2003. "Hypertension: Journal of the American Heart Association," Summer 2003. Elliot W., "Clinical Features and Management of Selected Hypertensive Emergencies," Journal of Clinical Malignant Phase Hypertension," The West Birmingham Malignant Hypertension Register. Journal of Human Hypertension, Jan. 2005. The American Heart Association.