Hypertension (High Blood Pressure)

Useful links:

What is high blood pressure?

Arteries are small tube-like structures that carry blood from your heart to the rest of your body. High blood pressure (also called hypertension) occurs when your blood moves through your arteries at a higher pressure than normal.

What does the blood pressure reading mean?

Blood pressure is really two measurements, separated by a slash when written, such as 120/80. You may also hear someone say a blood pressure is "120 over 80."

The first number is the systolic blood pressure. This is the peak blood pressure when your heart is squeezing blood out. The second number is the diastolic blood pressure. It's the pressure when your heart is filling with blood--relaxing between beats.

A normal blood pressure is less than 120/80. High blood pressure is 140/90 or higher. If your blood pressure is between 120/80 and 140/90, you have what is called "prehypertension," which means that if you don’t take important steps, your blood pressure can turn into high blood pressure.

How is high blood pressure diagnosed?

Blood pressure is measured by placing a blood pressure cuff around your arm, inflating the cuff and listening for the flow of blood. There are some automated cuffs which can do the same thing at home. Your primary health care provider will measure your blood pressure at more than one visit to see if you have high blood pressure.

How often should I have my blood pressure checked?

Women’s Health Connection recommends that it be checked annually as part of your preventative exam. If we find a high reading, we repeat it. If it’s still high, we recommend keeping a blood pressure diary for a few weeks. If it is consistently high, we recommend lifestyle and sometimes medications to prevent long term serious consequences.

What problems does high blood pressure cause?

Both high blood pressure and prehypertension damage your blood vessels. This in turn raises your risk of stroke, kidney failure, heart disease and heart attack.

What symptoms does high blood pressure cause?

Usually none. This is why it's so important to have your blood pressure checked regularly.

How is it treated?

Treatment begins with changes you can make to your lifestyle to help lower your blood pressure and reduce your risk of heart disease (see below). If these changes don't work, you may also need to take medicine.

Even if you need to take medicine, making some changes in your lifestyle can help reduce the amount of medicine you must take.

Lifestyle changes

  • Don't smoke cigarettes or use any tobacco product.
  • Lose weight if you're overweight.
  • Exercise regularly.
  • Eat a healthy diet that includes lots of fruits and vegetables and is low in fat.
  • Limit your sodium, alcohol and caffeine intake.
  • Try relaxation techniques.

How do tobacco products affect blood pressure?

The nicotine in cigarettes and other tobacco products causes your blood vessels to constrict and your heart to beat faster, which temporarily raises your blood pressure. It also makes your blood more concentrated and difficult for your heart to pump. If you quit smoking or using other tobacco products, you can significantly lower your risk of heart disease and heart attack, as well as help lower your blood pressure.

What about losing weight and exercising?

If you're overweight, losing weight usually helps lower blood pressure. Regular exercise is a good way to lose weight. It also seems to lower high blood pressure by itself.

Do I need to limit my salt intake?

Not everyone is affected by sodium, but sodium can increase blood pressure in some people. Most Americans with healthy blood pressure should limit the sodium in their diet to 2,300 mg per day. African Americans, older Americans and people with high blood pressure should limit the sodium in their diet to 1,500 mg per day. Your primary health care provider may tell you to limit your sodium even more.

Don't add salt to your food. Check food labels for sodium. While some foods obviously have a lot of sodium, such as potato chips, you may not realize how much sodium is in food like bread, canned vegetables, soups and cheese. Also be aware that some medicines contain sodium.

Do I need to quit drinking alcohol altogether?

In some people, alcohol causes blood pressure to rise quite a lot. In other people, it doesn't. If you drink alcohol, limit it to no more than 1 drink per day for women or 2 drinks per day for men. One drink is a can of beer, a glass of wine (4-5 oz.), or 1 shot (jigger) of liquor. If your blood pressure increases with alcohol, it's best not to drink any alcohol.

Does stress affect my blood pressure?

Stress may affect blood pressure. To help combat the effects of stress, try relaxation techniques such as Tai Chi, meditation, yoga, massage, or other techniques you find helpful. Try to do them on a regular basis.

What about medicine?

Many different types of medicine can be used to treat high blood pressure These are called antihypertensive medicines.

The goal of treatment is to reduce your blood pressure to normal levels with medicine that's easy to take and has few, if any, side effects. This goal can almost always be met.

If your blood pressure can only be controlled with medicine, you'll need to take the medicine for the rest of your life. You may need to take more than one medicine to help control your blood pressure. Don't stop taking the medicine without talking with your physician or you may increase your risk of having a stroke or heart attack.

Types of antihypertensive medications

  • Diuretics: These drugs help your body get rid of extra sodium and fluid so that your blood vessels don't have to hold so much fluid.
  • Beta-blockers: These drugs block the effects of adrenaline. (They also block beta-lipolysis of the fat cells, so may not be the best choice if you are overweight.)
  • Alpha-blockers: These drugs help your blood vessels stay open.
  • ACE inhibitors: These drugs prevent your blood vessels from constricting by reducing how much angiotensin II your body makes. Angiotensin II is a chemical that constricts blood vessels (makes them more narrow).
  • ARBs: These drugs work by blocking the effect of angiotensin II on cells
  • Calcium channel blockers: These drugs help prevent your blood vessels from constricting by blocking calcium from entering your cells.
  • Combinations: These drugs combine two medicines, like an ACE inhibitor or a beta-blocker plus a diuretic.

What are the possible side effects of hypertension medicine?

Different drugs have different side effects for different people. Side effects of antihypertensive drugs can include feeling dizzy when you stand up after lying down or sitting, lowered levels of potassium in your blood, problems sleeping, drowsiness, dry mouth, headaches, bloating, constipation and depression. In men, some antihypertensive drugs can cause problems with having an erection.

Talk to your primary care provider about any changes you notice. If one medicine doesn't work for you or causes side effects, you have other options. Let your provider help find the right medicine for you.