High Blood Pressure

What is high blood pressure?

Blood pressure is a measurement this is determined by the amount of blood your heart pumps into your arteries—which carry blood to the rest of the body—and the amount of resistance to the blood flow in those arteries. If your arteries are narrow, the heart needs to pump more blood, which causes your blood pressure to rise.

High blood pressure, also known as hypertension, is a condition in which the force of the blood being pushed against the walls of your arteries is higher than normal. If your blood pressure stays elevated over time, it can damage the body and cause health problems such as:

  • coronary heart disease
  • enlarged heart
  • heart attack
  • heart failure
  • kidney disease or failure
  • peripheral vascular damage
  • stroke

Blood pressure is measured by two numbers, which represent different types of pressure:

  • systolic pressure, which indicates the pressure in the arteries when the heart beats and fills them with blood
  • diastolic pressure, which indicates blood pressure when the heart is at rest between beats

When written down, your blood pressure reading will appear with the systolic number on top or first, followed by a line or slash, and the diastolic number on the bottom or second (for example, 120/80). The number may be followed by “mmHg”, which means “millimeters of mercury” (120/80 mmHg). These are the units used to measure blood pressure. When your doctor tells you your blood pressure number, he or she will say it as your systolic number “over” your diastolic number (120 over 80).

Depending on your systolic and diastolic numbers, you will fall into one of four categories*:

  • Systolic 
    • Normal: Less than 120 
    • Prehypertension: 120 - 139 
    • Stage 1 Hypertension:140 - 159 
    • Stage 2 Hypertension: 160 and above
  • Diastolic 
    • Normal: Less than 80 
    • Prehypertension: 80 - 89 
    • Stage 1 Hypertension: 90 - 99 
    • Stage 2 Hypertension: 100 and above

*All readings are in millimeters of mercury (mmHg), the unit of measure for blood pressure

 The goal is to stay within the normal range because your risk of developing health problems becomes greater as the numbers rise. If you fall into the prehypertension range, it means you are on the path for developing hypertension unless you get your blood pressure under control. Stage 1 or 2 hypertension means you are at high risk of developing problems.

High blood pressure is common in the United States, affecting 1 in 3 adults. It tends to develop over many years, but it is easily detected and can be controlled with your doctor’s help.

What are the symptoms of high blood pressure?

People with high blood pressure typically have no symptoms. You can have it for years without even knowing. However, even though you may not feel any different, damage may already being done to your blood vessels and heart.

Sometimes people who are at an early stage of high pressure may experience some vague symptoms, such as headaches, dizziness, or an occasional nosebleed. But typically, these symptoms do not appear until a person’s blood pressure has reached dangerously high levels that can be life-threatening.

Because there usually are no symptoms, it’s important to see your doctor on a regular basis for a routine checkup and have your blood pressure taken at least once a year. You should be aware of your blood pressure numbers so that you can play an active role in helping your doctor control and manage your health.

How is high blood pressure diagnosed?

The first step in diagnosing high blood pressure is taking a blood pressure test at your doctor’s office or at a clinic. The test itself is simple and painless.

Before taking the test, you follow these steps to avoid causing a temporary rise in your blood pressure or affecting the test results:

  • do not drink coffee or smoke cigarettes in the 30 minutes before the test
  • use the rest room to clear your bladder before the test
  • sit for about 5 minutes before the test

When it’s time for the test, you will lie down or sit in a chair. Your doctor (or nurse) will then place a cuff around your arm. The cuff then inflates as a pressure-measuring gauge measures your blood pressure. The doctor may also use a stethoscope during the test. The test may be performed on both arms to see if there is any difference in the readings. If the doctor doesn’t share your readings with you, you should always ask what they are.

If your doctor suspects that you have high blood pressure, the test may be repeated two or three times during your visit, and you may be asked to schedule additional appointments for repeat testing.

High blood pressure is usually diagnosed when a patient has a blood pressure reading of 140/90 mmHg or higher over time. If a patient has diabetes or chronic kidney disease, high blood pressure is diagnosed with repeated readings of 130/80 mmHg or higher.

Additional testing

If repeat testing indicates that you have high blood pressure, your doctor will discuss your medical history with you and give you a physical exam. The doctor may also want you to have additional routine testing to determine whether your high blood pressure has affected any other parts of your body. These tests may include:

  • blood tests to check the levels of sodium, cholesterol, and potassium
  • blood urea nitrogen (BUN) test to evaluate how well your kidneys are working
  • cholesterol test, which shows the amount of cholesterol in your blood
  • electrocardiogram (EKG or ECG), which records the heart’s electrical activity and checks for irregular heart rhythms (arrhythmias); the test can show signs of damage due to coronary heart disease or signs of a current or previous heart attack
  • glucose blood test to check for signs of diabetes
  • urinalysis (urine test) to look for signs of kidney or liver disease

How is high blood pressure treated?

If you are diagnosed with high blood pressure, your doctor will probably treat you with a combination of lifestyle changes and medications. High blood pressure never really goes away, but controlling it is a lifelong commitment. If you follow your doctor’s recommendations, you can stop or delay problems caused by high blood pressure. This will help you live and stay active longer.

The goal of treatment for high blood pressure is to keep your blood pressure below certain numbers based on your age and/or any related conditions you may have. The target for:

  • adults under 60 years of age is below 140/90 mmHg
  • adults who have diabetes or chronic kidney disease is below 130/80 mmHg
  • adults 60 years of age or older is 150/90 mmHg

If you follow your doctor’s directions and get into your “normal” range, your high blood pressure is considered under control. However, you still need to follow lifestyle guidelines and prescribed medications that your doctor has recommended for you.

It is important to continue to visit your doctor for routine blood pressure testing. The doctor will tell you how often to schedule appointments, and may recommend that you learn how to take your own blood pressure at home.

Lifestyle changes

Some people who have high blood pressure may be able to control it by lifestyle changes alone, however, many people may also have to take medications to attain their target goal.

Making lifestyle changes can be a challenge. It may help to make one change at a time, then add others at your own pace. But it is important to follow all of the changes that your doctor recommends to achieve the best results in lowering your blood pressure.

Some of the lifestyle changes your doctor may recommend could include:

  • following a heart-healthy diet (such as foods that are low in fat, sodium, sugar, refined grains)
  • reaching and maintaining your recommended body weight
  • quitting smoking
  • limiting alcohol intake to no more than 2 drinks a day
  • learning to cope with and manage stress and controlling anger
  • becoming more physically active with activities such as walking, biking, or swimming; start slowly and build up to 30 to 45 minute sessions, three to five times a week—but also check with your doctor before starting any exercise program

If you doctor recommends that you also take medication, continue to maintain your new lifestyle program. The combination of the two will help give you the best results in controlling your blood pressure.

Medications

For people with high blood pressure, medications can be a safe and effective way of getting the condition under control. There are many medications available for treating high blood pressure; they are easy to take and side effects are few.

You may have to take a medication for the rest of your life, so your doctor will want to make sure that you are taking the most effective one for you. After you start taking it, the doctor will want to test your blood pressure again to see how it’s working. If you experience any side effects from your medication, tell your doctor. He or she may try adjusting the dosage or switch you to another medication. Never stop taking a medication without telling your doctor.

The following list shows the types of medications that are used to treat high blood pressure. Each type lowers blood pressure in a different way. Your doctor may prescribe more than one type of medication to control your condition. The different types of medications include:

  • ACE inhibitors, which widen blood vessels to lower blood pressure, improve blood flow, reduce the workload on the heart, and help lower the risk of heart failure
  • alpha-beta blockers, which reduce nerve impulses that tighten blood vessels, reduce the arteries’ resistance, relax the muscle tone of the vascular walls, and slow the heart down to lower blood pressure
  • alpha blockers, which reduce nerve impulses that tighten blood vessels, opening them up so that blood can flow more freely to lower blood pressure
  • angiotensin II receptor blockers to help relax blood vessels, which lowers blood pressure and makes it easier for the heart to pump blood
  • beta-blockers, which slow down the heart rate and reduce blood pressure
  • calcium channel blockers, which relax blood vessels and increase the supply of blood and oxygen to the heart, lowering blood pressure
  • diuretics, which remove excess fluids and sodium in the body, causing blood pressure to go down
  • nervous system inhibitors, which stop the brain from sending signals to the nervous system, allowing the heart to slow and blood vessels to relax for greater blood flow and lower blood presure
  • vasodilators (nitrates) to relax or widen blood vessels to allow more blood flow to the heart, reduce strain on the heart, and lower blood pressure

Advanced Cardiovascular Care at Jeanes Hospital

If you or your doctor suspect you may have high blood pressure, the highly-experienced cardiologists at the Temple Heart & Vascular Institute at Jeanes Hospital are ready to assist in the diagnosis and treatment of your condition in our state-of-the-art facility at Jeanes Hospital.

The Temple cardiologists at Jeanes Hospital evaluate hundreds of patients every year, managing a wide range of serious cardiovascular conditions. After careful evaluation, they can develop and oversee a treatment plan tailored to meet your specific needs.

We offer a level and quality of care that you would expect to find downtown or in another city. Yet, it’s available right here, in your own community.

To schedule an appointment with a cardiologist at the Temple Heart & Vascular Institute at Jeanes Hospital, click here or call 215-728-CARE (2273).

Jeanes Recognized as Distinguished Hospital for Clinical Excellence by Healthgrades
Jeanes Hospital Blood Drive
Help save lives by donating blood on January 24. read more»
The Orthopaedic Center at Jeanes Presents: Total Joint Replacement Classes
Upcoming 2017 Class Schedule read more»