Overview of Hypertension
High or elevated blood pressure, also known as hypertension, is a common health problem worldwide. It is one of the most common complex genetic disorders. The risk of developing hypertension increases as we age. Hypertension is an independent and significant risk factor for cardiovascular disease, which includes heart attacks, strokes, congestive heart failure and even kidney failure. Accelerated atherosclerosis (hardening of the arteries) is an invariable companion of hypertension. The higher the blood pressure, the greater one’s risk.
Blood pressure is expressed as a systolic pressure (top number) over the diastolic pressure (bottom number) using mm of mercury. The systolic pressure is the peak blood pressure when your heart is pumping blood out. The diastolic pressure is the blood pressure when your heart muscle is relaxed and filling up with blood in between beats.
A normal blood pressure is less than or equal to 120/80 (but not lower than 90/60). Pre-hypertension is defined as a systolic pressure between 120 – 139 and a diastolic pressure between 80 – 89. Anything above 140/90 is hypertension. If you already have diabetes or kidney disease, less than 130/80 is the goal.
Though there are some specific causes of hypertension, with the majority of people who have hypertension, the cause is still unknown. This is termed essential hypertension.
Signs & Symptoms
There are usually no signs or symptoms, which is why it is sometimes known as the “silent killer”. With very high blood pressure readings, sometimes there can be headache.
Although our understanding of the pathophysiology of elevated blood pressure is increasing, the cause of hypertension is still largely unknown. Thus, the ability to prevent it or cure it is not possible at this time. However, lifestyle modifications listed below, may alter the timing of when a person develops essential hypertension and/or the severity of the problem.
Lifestyle modifications to include:
- Weight loss (even as little as a 10 – 20# wt. loss can significantly lower blood pressure) if you are overweight/obese
- Decrease salt intake (sodium)
- Decrease alcohol intake
- Increase physical activity
- Stress reduction
- Stop smoking
- Certain diets (e.g. DASH) that are high in fruits & vegetables and low fat dairy products may be as effective as monotherapy with one antihypertensive drug.
- Anti-hypertensive medications: There are many classes of anti-hypertensive drugs that one’s physician can prescribe. A patient may need more than one medication to lower his/her blood pressure.