Answers to your questions about high blood pressure

May 11, 2012

Gentleman getting his blood pressure measured

The facts about high blood pressure, or hypertension, may surprise you. According to the American Heart Association, about one in three American adults has it. That amounts to 75 million of us. Untreated, high blood pressure greatly raises the risk for heart disease and other serious conditions. Yet many of us tend to ignore it, because often, it presents no symptoms.

During golfing's Arnold Palmer Invitational this year, Palmer began having blood pressure problems. He had to be rushed to the hospital just hours before the end of his own event.

The incident kept him from presenting Tiger Woods with his first trophy since 2008. Fortunately, Palmer's outcome was good, but would you know if you were suffering like he was?

What is blood pressure?

Blood pressure is the force of blood against the walls of your arteries. It is recorded as two numbers.

The first number measures the force as your heart beats. This is called systolic pressure. The second number measures the force as your heart relaxes. This is called diastolic pressure.

A measurement of 120/80 mm Hg, for example, is read as "120 over 80." The systolic pressure is 120 mm Hg. The diastolic pressure is 80 mm Hg. The "mm Hg" stands for "millimeters of mercury."

When is blood pressure considered high?

Blood pressure measurements fall into four categories.

Normal blood pressure. Your blood pressure is normal if it's below 120/80 mm Hg. However, some doctors recommend 115/75 mm Hg as a better goal. Once it rises above 115/75 mm Hg, the risk of heart disease starts to increase.

Prehypertension. This is a condition in which blood pressure is above normal, but not yet high. Two things can show a person has prehypertension. They are a top number of 120 to 139 mm Hg, or a bottom number from 80 to 89 mm Hg. Prehypertension tends to get worse over time.

Stage 1 hypertension. This occurs when the top number is from 140 to 159 mm Hg, or the bottom number is from 90 to 99 Hg.

Stage 2 hypertension. This occurs with a top number of 160 mm Hg or higher, or a bottom number of 100 mm Hg or higher.

What are the risk factors for high blood pressure?

MayoClinic.com lists these risk factors for high blood pressure:

  • Age. The risk rises as you age. Through early middle age, it is more common in men. Women are more likely to develop it after menopause.
  • Race. It is more common among blacks. It often starts at an earlier age than it does among whites.
  • Family history.
  • Being overweight or obese. The more you weigh, the more blood you need to bring nutrients to your tissues. As the volume of blood goes up, so does the pressure against artery walls.
  • Not being physically active. Inactive people tend to have faster heart rates. That makes the force of blood against your arteries harder.
  • Using tobacco. Tobacco use immediately raises your blood pressure on a temporary basis. And the chemicals in tobacco can damage the lining of your artery walls.
  • Too much salt in your diet.
  • Too little potassium in your diet.
  • Too little vitamin D.
  • Drinking too much alcohol.
  • Stress. High levels of stress can lead to a temporary, but dramatic, rise in blood pressure.
  • Certain chronic conditions. They include high cholesterol, diabetes, kidney disease, and sleep apnea.

Sometimes, pregnancy contributes to high blood pressure as well.

What are the symptoms?

High blood pressure has been called a silent killer. That's because most people who have it have no symptoms. That can be true even when blood pressure reaches very high levels.

A few people with early-stage high blood pressure may have some symptoms. They may include headaches, dizzy spells or more nosebleeds than normal. But these signs don't usually occur until it reaches a severe stage. By the time these signs appear, high blood pressure may be life-threatening.

Because there are usually no symptoms, it's important to have blood pressure measured regularly.

Why is it so serious?

High blood pressure can hurt your heart and arteries by placing too much stress on them. It can also damage other organs. The American Heart Association describes how it harms various parts of your body.

Artery damage. When you have high blood pressure, the force of blood in your arteries is too high. It causes tiny tears in the artery walls, which turn into scar tissue. This scar tissue then traps bits of fat and other materials in the blood. Together they are called plaque. As plaque builds up, the arteries get narrow and harder. They can't send enough blood to the body's organs. The organs suffer because they don't get the oxygen and nutrients they need. When arteries are narrowed, there is also a bigger risk of blood clots. They can block the blood supply to other parts of the body.

Heart attack and heart failure. A heart attack is the result of a blocked blood supply to the heart. This can happen when arteries to the heart get a buildup of plaque. Sometimes plaque or a blood clot can close off an artery. The longer the artery stays blocked, the more the damage to the heart. HBP can also lead to heart failure. This means the heart can't supply a good flow of blood to the body.

Brain damage from stroke. High blood pressure damages arteries everywhere in the body. Weakened arteries in the brain put you at much higher risk of stroke. They create weak places that can rupture easily as well as areas that are more prone to blockage. Both of these problems can interrupt blood flow to brain cells. The result is a stroke.

Kidney damage. Kidneys are packed with arteries. So when high blood pressure hurts arteries, it hurts the kidneys as well. The kidneys filter blood. They rid it of waste and balance chemicals in the body. When arteries are damaged, the filters don't get the blood supply they need. So kidney function is limited. As more arteries become blocked, the kidneys may fail.

Vision loss. High blood pressure strains blood vessels in the eyes. That can damage your optic nerve and the retina of your eye. The longer it goes untreated, the higher the chance of permanent vision loss.

Erectile dysfunction, or ED. A healthy blood flow is necessary for an erection. Because high blood pressure damages arteries, it can impair blood flow and lead to ED.

How can you control HBP?

Changing your lifestyle can help. Here are some of the lifestyle changes recommended on MayoClinic.com. If you have high blood pressure, be sure to talk with your doctor about taking these steps:

  • Eat healthy foods such as fruits, vegetables, whole grains and low-fat dairy foods. Get plenty of potassium. Cut your intake of saturated fat and total fat.
  • Cut the salt in your diet. Try to keep your salt intake to 1,500 milligrams a day. One way is to put down the saltshaker. But be aware that there's already a lot of salt in many foods. Watch the salt content in processed foods, such as canned soups or frozen dinners.
  • Maintain a healthy weight. If you're overweight, losing even five pounds can lower your blood pressure.
  • Increase your physical activity. Try for at least 30 minutes of activity each day.
  • Limit your alcohol. Alcohol can raise your blood pressure even when you're healthy. If you choose to drink, do so in moderation. That means one drink a day for women and people older than 65, and two a day for men.
  • Don't smoke.
  • Manage stress. Practice healthy coping skills, such as muscle relaxation and deep breathing. Try to get plenty of sleep.
  • Monitor your blood pressure at home.

Many people need the help of medicines. Sometimes, lifestyle changes alone aren't enough to control high blood pressure. Your doctor may prescribe medicine, too, to keep it at a safer level.

There are many types of medicines available that work in different ways. Some relax blood vessels to make it easier for the blood to flow through. Some help your body get rid of excess salt and water. This reduces the volume of blood to help lower blood pressure.

Other medicines cause your heart to beat more slowly. Your doctor may prescribe a combination of medicines. Often, two or more together work better than just one.

If side effects or costs pose problems, don't stop taking your medicine. Ask your doctor about other options.

Myths vs. facts

A lot of things you may have heard about high blood pressure just aren't true. The American Heart Association warns you about these common, and dangerous, myths.

  • Myth: People with high blood pressure are nervous and sweaty. Their faces are flushed. I don't have that so I must not have it.
  • Fact: High blood pressure doesn't cause symptoms in most people. That's why it's called the silent killer. You can have it for years without knowing it. And all that time, it can be causing serious damage to your body.
  • Myth: I read that wine is good for my heart. That means I can drink as much as I want.
  • Fact: If you drink alcohol, including wine, do so only in moderation. Heavy and regular use of alcohol can raise blood pressure dramatically. I can also cause heart failure, lead to stroke and give you irregular heartbeats.
  • Myth: I use kosher or sea salt instead of table salt. They are low-sodium alternatives.
  • Fact: Chemically, kosher and sea salt are the same as table salt. They are not lower in sodium.
  • Myth: I was diagnosed with high blood pressure and I've been having lower readings. So I can stop taking my medication now.
  • Fact: It is a lifelong disease. Follow your doctor's advice carefully, even if it means taking medicine daily for the rest of your life.

By working with your doctor, you can reach your treatment goals and enjoy the benefits of better health.

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