High blood pressure

Overview

Half of all Americans have high blood pressure, also known as hypertension, and many are unaware of their condition. High blood pressure occurs when blood flows at higher-than-normal pressures through your arteries. Blood pressure is measured in two parts: systolic and diastolic. The pressure created by the ventricles as they pump blood out of the heart is known as systolic pressure. Diastolic pressure is the pressure in the heart between beats when it is filling with blood.

Your blood pressure fluctuates throughout the day as a result of your activities. A normal blood pressure for most adults is less than 120/80 mm Hg, which is written as your systolic pressure reading over your diastolic pressure reading — 120/80 mm Hg. When you have consistent systolic readings of 130 mm Hg or higher or diastolic readings of 80 mm Hg or higher, your blood pressure is considered high.

How your blood pressure and circulatory system work?

Your tissues and organs require the oxygenated blood that your circulatory system transports throughout the body in order to survive and function properly. When the heart beats, it generates pressure, which forces blood through a network of tube-shaped blood vessels called arteries, veins, and capillaries. This pressure, or blood pressure, is caused by two forces: The first force (systolic pressure) occurs as blood pumps out of the heart and into the circulatory system's arteries. The second force (diastolic pressure) is created when the heart stops beating.

What is a High blood Pressure?

Blood pressure refers to the measurement of the force or pressure exerted by blood against the walls of blood vessels. This pressure against the blood vessel walls is constantly too strong in people with high blood pressure (hypertension).

High blood pressure is known as the "silent killer". This is because you might not know that something is wrong with your body, but it is causing harm. Moreover, high blood pressure could be present for years without causing any symptoms. If the condition is uncontrolled, it elevates the risk of severe health issues such as heart disease or stroke. However, the good news is that high blood pressure is easily detectable.

How common is High Blood Pressure?

High blood pressure is a common condition; it is estimated that 18% of adult men and 13% of adult women have it but do not receive treatment. There is no single identifiable cause of an increase in blood pressure in 90-95% of cases. However, all available evidence indicates that lifestyle plays a significant role in blood pressure regulation.

Risk factors for high blood pressure include:

Age (the risk of developing high blood pressure increases with age. Half of people over 75 years have the condition.)
Poor diet
Lack of exercise
Being overweight
Excessive alcohol consumption.

Furthermore, for unknown reasons, people of Afro-Caribbean and South Asian origin (Indian, Pakistani, and Bangladeshi) are more likely than other ethnic groups to develop high blood pressure.

Causes of High Blood Pressure

Hypertension is divided into two categories, each with varying causes:

Primary hypertension

Essential hypertension is another name for primary hypertension, the most common form of high blood pressure. It progresses gradually and has no known cause. The mechanisms that cause blood pressure to rise gradually are still unknown to researchers. However, various combinations of aspects might be at play. They include the following;

1. Physical changes

When anything in the body changes, you might start having problems all over. One of these problems may be high blood pressure. Changes in the function of the kidney because of aging, for example, are thought to upset the body's normal salt and fluid balance. Your blood pressure can then rise as a result of this shift.

Genes

Some individuals are predisposed to high blood pressure due to their genetic makeup. This could be due to inherited genetic defects or gene mutations from one or both parents.

Environment

Hazardous lifestyle decisions, such as improper diet or lack of physical activities, may have a long-term impact on the body. Weight issues can occur due to such lifestyle decisions. Hypertension is more likely if you are overweight or obese.

Stress

High-stress levels can cause a rise in blood pressure for a short period. Stress-related behaviors like overeating, smoking, or consuming alcohol may cause blood pressure to rise even higher.

2. Secondary hypertension:

This type of high blood pressure usually develops rapidly and might be more intense compared to primary hypertension. Examples of the health conditions that might trigger secondary hypertension are;

Obstructive sleep apnea
Thyroid problems
Kidney disease
Congenital cardiac defects
Some medication side effects
Alcohol abuse and excessive consumption
Illegal drugs use
Adrenal gland disorders
Some endocrine growths or tumors

Signs and Symptoms of High Blood Pressure

High blood pressure is typically a silent illness. Most people do not have any signs or symptoms. It could even take years, if not decades, for the disease to progress to the point that symptoms are visible. Even so, such symptoms might be due to something else.

Nonetheless, severe high blood pressure can cause the following symptoms;

Shortness of breath
Headaches
Nose bleeding
Dizziness
Flushing
Chest pain
Changes in vision
Blood traces in the urine

These hypertension signs and symptoms need medical attention right away. Although they don't happen to every person with the condition, waiting for the symptom to show might be life-threatening.

Taking routine blood pressure tests is the easiest way to determine whether you have high blood pressure. At almost every visit, most physicians' offices normally take a blood pressure reading.

High Blood Pressure Diagnosis

Taking a person’s blood pressure reading is all it takes to diagnose hypertension. Blood pressure is usually checked as part of a regular visit to the doctor's office. Request a blood pressure reading if you don't get one during your next visit.

When the reading shows that your blood pressure is high, the doctor can order additional tests over a few days or weeks. A diagnosis of hypertension is rarely made based on a single reading. The doctor would like to see signs of a long-term issue. This is because your surroundings, including the stress you might experience at the provider's office, can contribute to high blood pressure. On the other hand, high blood pressure levels tend to fluctuate during the day.

In case your blood pressure is consistently high, the doctor will most likely order further testing to rule out any underlying issues. Some of the tests you may be subjected to include;

Urine examination
Other blood checks, including cholesterol monitoring
An electrocardiogram to measure the heart's electric activity (also known as EKG, or sometimes an ECG)
An ultrasound of the kidneys or the heart

These diagnostic tests will assist the physicians in identifying any secondary conditions that could be contributing to your high blood pressure. They will also examine the effects of increased blood pressure on your body organs. The doctor can start the hypertension treatment during this period. Remember that early care and management could help prevent long-term consequences and various high blood pressure complications.

Understanding the Hypertension Readings

There are two numbers that make up a high blood pressure reading. They include;

Systolic pressure:

This refers to the first, or the top, number. It measures the pressure in the arteries as the heartbeats and pumps blood out.

Diastolic pressure:

The second, or the bottom, number. It's a measurement of the pressure in the arteries between heartbeats.

Adult blood pressure readings are divided into five categories:

Normal or healthy blood pressure

Blood pressure should be below 120/80 millimeters of mercury (mm Hg) in order to be considered stable or healthy.

Elevated or high blood pressure

The diastolic number is below 80 mm Hg, while the systolic number ranges between 120 to 129 mm Hg. In most cases, the doctors do not use drugs to treat high blood pressure. Instead, they can advise you to make some lifestyle changes that will reduce the numbers.

Stage 1 hypertension occurs when blood pressure consistently ranges between 130 and 139 mm Hg systolic or 80 and 89 mm Hg diastolic. Doctors will likely prescribe lifestyle changes and may consider adding blood pressure medication at this stage of high blood pressure based on your risk of atherosclerotic cardiovascular disease (ASCVD), such as a heart attack or stroke.
Stage 2 hypertension occurs when blood pressure is consistently 140/90 mm Hg or higher. Doctors are likely to prescribe a combination of blood pressure medications and lifestyle changes at this stage of high blood pressure.
Hypertensive crisis: Systolic number is greater than 180 mm Hg, and the diastolic number is above 120 mm Hg. This level of blood pressure needs immediate medical attention. Whenever the blood pressure is this high, the symptoms, including chest pain, shortness of breath, headache, or vision changes should be treated in the emergency department.

A blood pressure cuff is used to take a reading. It is vital to have a properly fitting cuff for a correct, accurate reading. The readings from an ill-fitting cuff can be unreliable.

Which number is more important?

For people over 50, systolic blood pressure (the first number) is typically emphasized as a major risk factor for cardiovascular disease. Systolic blood pressure rises steadily with age in most people due to increased stiffness of large arteries, long-term plaque buildup, and an increased incidence of cardiac and vascular disease.

High blood pressure can be diagnosed using either an elevated systolic or an elevated diastolic blood pressure reading. According to recent research, every 20 mm Hg systolic or 10 mm Hg diastolic increase in blood pressure doubles the risk of death from ischemic heart disease and stroke in people aged 40 to 89.

High Blood Pressure Treatment Options

Various factors enable the physician to determine the most suitable high blood pressure cure and treatment option. Examples of such factors are the type of high blood pressure you have and the underlying causes or triggers.

If the physician diagnoses primary hypertension, he or she can recommend lowering your blood pressure by making some lifestyle changes. He or she can suggest medication if lifestyle changes are not enough or if they're no longer effective.

If the doctor finds any disorder that is contributing to your hypertension, treatment and care will be tailored to that condition. If a drug you are taking is making you have high blood pressure, the doctor can recommend other medications with different effects.

In spite of a cure for the underlying cause, hypertension can sometimes persist. The doctor can work with you to establish lifestyle changes and advise on drugs to help you lower the elevated blood pressure in this situation.

Keep in mind that high blood pressure remedies and treatment options are constantly changing. What was effective in the beginning could become obsolete with time. Due to this, your medical provider will keep on refining your treatment.

High Blood Pressure Medication

With blood pressure drugs, most patients undergo a trial-and-error process. You may have to experiment with different drugs before you finally find one. At times, it could be a blend of medications that are effective for you.

The following are some of the drugs that doctors use to treat high blood pressure:

Beta-blockers: These drugs cause the heart to beat more slowly with less energy. This decreases blood pressure by reducing the amount of blood being pumped via the arteries with every beat. It also prevents the body from producing some hormones that can increase blood pressure.
Angiotensin-converting enzyme (ACE) inhibitors: These drugs prevent the body from releasing angiotensin. This is a chemical that makes the blood vessels and artery walls narrow and tighten. ACE inhibitors, therefore, relax the blood vessels and lowers blood pressure.
Diuretics: Increased levels of sodium and too much fluid in the body can cause blood pressure to rise. Also known as water tablets, diuretics aid in the removal of excess sodium from the body by the kidneys. Additional fluid in the bloodstream travels into the urine as the sodium leaves; this helps reduce the blood pressure.

Other significant medications for hypertension include;

Angiotensin II receptor blockers (ARBs)
Calcium channel blockers
Alpha-2 agonists

What's the Impact of Having High Blood Pressure?

Hypertension, among other complications, can cause serious heart damage. Excessive pressure can harden arteries, reducing blood and oxygen flow to the heart. This increased blood pressure and decreased blood flow can result in:

Chest pain, also called angina.
Heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
Heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs.
Irregular heart beat which can lead to a sudden death.

Hypertension can also cause a stroke by bursting or blocking arteries that supply blood and oxygen to the brain. Furthermore, hypertension can damage the kidneys, eventually leading to kidney failure.

High Blood Pressure Prevention

A healthy lifestyle is an effective defense against high blood pressure and its harmful effects. These steps can help lower your risk of developing prehypertension or hypertension, as well as help lower your numbers if you already have prehypertension or hypertension.

Lose a little weight.

Excess weight, particularly abdominal fat, can raise blood pressure by increasing blood volume and altering the balance of pressure-regulating hormones. “ Even minor weight loss can make a significant difference.

Cut back on alcohol.

Reduce your alcohol consumption if you are a man who consumes more than two drinks per day or a woman who consumes more than one drink per day." While a small amount of alcohol may relax arteries, excessive amounts appear to have the opposite effect.

Move more.

Exercise and other forms of physical activity help to keep arteries flexible while also decreasing sympathetic nervous system activity, which can tighten blood vessels and raise blood pressure. According to the American Heart Association, if you already have high blood pressure, regular exercise can reduce it by 8 to 10 points.

Feed healthy blood pressure.

Calcium, magnesium, and potassium (found in low-fat and fat-free dairy products such as milk and yogurt, as well as produce and dried beans) aid in blood pressure regulation. Too little can cause your blood pressure to rise. High levels of sodium, which are found in many processed foods, can also cause your body to retain water (which increases blood volume) and even tighten small blood vessels. Saturated fat (found in meat, cheese, butter, full-fat dairy products, and many processed foods) has been linked to an increase in blood pressure.

Quit smoking.

Cigarette smoking causes artery damage and increases the risk of heart disease. While you're smoking, the chemicals in tobacco products raise your blood pressure.

Soothe stress.

It is unclear whether mind-body therapies have a long-term effect or reduce the risk of high blood pressure, but it is known that the body's stress response releases hormones that temporarily raise blood pressure. If you regularly practice a stress-relieving technique such as breathing exercises, progressive relaxation, or fitness activities, you will feel better and find it easier to make other healthy changes. Meditation, for example, has been shown to lower the risk of heart attacks and strokes in people with high blood pressure.

Conclusion

The force that blood puts on the arteries' walls as it passes through them is measured when the doctor is taking your blood pressure. Blood vessels may be severely damaged if blood pressure remains high for an extended period.

At times, hypertension does not cause any associated symptoms; hence it becomes difficult to detect. However, routine screening enables you to know if you require more preventive action and treatment.