Here are answers to your frequently asked questions about hypertension, commonly called high blood pressure.
1. What Causes High Blood Pressure?
2. What Is Systolic and Diastolic Blood Pressure?
The blood pressure reading is measured in millimeters of mercury (mmHg) and is written as systolic pressure, the force of the blood against the artery walls as your heart beats, over diastolic pressure, the blood pressure between heartbeats. For example, a blood pressure reading is written as 120/80 mmHg, or "120 over 80". The systolic pressure is 120 and the diastolic pressure is 80.
3. What Is a Normal Blood Pressure?
The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has classified blood pressure measurements into several categories:
- Normal blood pressure is systolic pressure less than 120 and diastolic pressure less than 80 mmHg.
- Elevated is systolic pressure of 120-129 and diastolic pressure less than 80 mmHg.
- Stage 1 Hypertension is systolic pressure of 130-139 or diastolic pressure of 80-89 mmHg.
- Stage 2 Hypertension is systolic pressure of 140 or greater or diastolic pressure of 90 or greater.
4. What Health Problems Are Associated With High Blood Pressure?
Several potentially serious health conditions are linked to high blood pressure, including:
- Atherosclerosis: a disease of the arteries caused by a buildup of plaque, or fatty material, on the inside walls of the blood vessels; hypertension contributes to this buildup by putting added stress and force on the artery walls.
- Heart Disease: Heart failure (the heart is not strong enough to pump blood adequately), ischemic heart disease (the heart tissue doesn't get enough blood and oxygen), and hypertensive hypertrophic cardiomyopathy (thickened, abnormally functioning heart muscle) are all associated with high blood pressure.
- Kidney Disease: Hypertension can damage the blood vessels and filters in the kidneys, so that the kidneys cannot excrete waste properly. Kidney disease can also cause high blood pressure, when electrolytes (including sodium) cannot be adequately secreted from the body.
- Stroke: Hypertension can lead to stroke, either by contributing to the process of atherosclerosis (which can lead to blockages and/or clots), or by weakening the blood vessel wall and causing it to rupture.
- Eye Disease: Hypertension can damage the very small blood vessels in the retina.
5. How Do I Know if I Have High Blood Pressure?
High blood pressure often doesn't have any symptoms, so you usually don't feel it. For that reason, hypertension is usually diagnosed by a health care professional during a routine checkup. If you have a close relative with hypertension, or other risk factors, it is especially important to pay attention to your blood pressure reading.
If your blood pressure is extremely high, you may have unusually strong headaches, chest pain, difficulty breathing, or poor exercise tolerance. If you have any of these symptoms, seek an evaluation promptly.
6. What Is the Treatment for High Blood Pressure
High blood pressure treatment usually involves making lifestyle changes and, if necessary, drug therapy.
Lifestyle changes for high blood pressure include:
- Losing weight
- Quitting smoking
- Eating a healthy diet, such as the DASH diet, which is high in fruits, vegetables, lean protein and whole grains and low in salt and fat
- Reducing the amount of salt in your diet
- Regular aerobic exercise (such as brisk walking)
- Limiting alcohol consumption
- Seeking treatment for sleep apnea
Commonly prescribed high blood pressure drugs include ACE inhibitors, angiotensin receptor blockers, diuretics, beta-blockers, calcium channel blockers, and alpha-blockers (alpha-adrenergic antagonists).
If you are over age 60, the goal of hypertension treatment is a systolic pressure of 150 and a diastolic pressure of 90. The goal of treatment is 140/90 for those under age 60. For people over 65, the goal bp is less than 130/85.
7. What Are the Side Effects of High Blood Pressure Drugs?
As is true with any medication, high blood pressure drugs have side effects. Among the most common are the following:
- Diuretics:headache, weakness, low potassium blood levels
- ACE inhibitors: dry and persistent cough, headache, diarrhea, high potassium blood levels
- Angiotensin receptor blockers:fatigue, dizziness or fainting, diarrhea, conjestion, high potassium blood levels
- Calcium channel blockers: dizziness, heart rhythm problems, ankle swelling, constipation
- Beta-blockers: dizziness or lightheadedness, decreased sexual ability, drowsiness, fatigue, low heart rate
- Alpha-blockers: dizziness, headache, pounding heartbeat, nausea, weakness, weight gain
8. What Type of Diet Should I Follow if I Have High Blood Pressure
A healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, is effective in helping to lower high blood pressure. The DASH diet calls for a certain number of daily servings from various food groups, including fruits, vegetables, and whole grains.
The following steps can also help:
- Eating more fruits, vegetables, and low-fat dairy foods
- Eating less of foods that are high in saturated fat and cholesterol, such as fried foods
- Eating more whole grain products, fish, poultry, and nuts
- Eating less red meat and sweets
- Eating foods that are high in magnesium, potassium, and calcium
- Eating foods with less sodium
9. When Should I Call My Doctor About High Blood Pressure?
If you are diagnosed with high blood pressure, it's important to see your doctor on a regular basis. They can answer your questions during these visits.
However, there may be other times when you may need to speak to your doctor. For instance:
- If you aren't responding to the prescribed treatment and your blood pressure is still high
- If you are having any side effects from the blood pressure medication; if this happens, your doctor may wish to adjust the dosage of the medication or put you on another medication.
10. Are There any Drugs that Cause High Blood Pressure?
Some drugs that you take for another condition may increase blood pressure. These include amphetamines, methylphenidate (Concerta, Metadate, Methylin, Ritalin), corticosteroids, hormones (including birth control pills), certain migraine medications, cyclosporine, and erythropoietin.
Don't stop taking any prescribed medication, including high blood pressure drugs, without talking to your doctor.