An in-depth report on the causes, diagnosis, treatment, and prevention of high blood pressure.
Blood Pressure Measurements
Normal blood pressure readings are below 120/80 mm Hg.
High blood pressure (hypertension) is generally considered to be a blood pressure reading greater than or equal to 140 mm Hg (systolic) or greater than or equal to 90 mm Hg (diastolic).
Blood pressure readings in the prehypertension category (120 -139 systolic or 80 - 89 diastolic) indicate an increased risk for developing hypertension.
A blood pressure reading of 139/89 mm Hg or below should be the minimum goal for everyone. People with heart disease, peripheral artery disease, diabetes, or chronic kidney disease should strive for 130/80 or less. Blood pressure goals are being reexamined for African-Americans and for people with diabetes and chronic kidney disease.
Blood Pressure Screening Guidelines
- Current guidelines from the U.S. Preventive Services Task Force recommend that all adults age 18 years and older have their blood pressure measured.
- People with high blood pressure should be screened for diabetes. The U.S. Preventive Services Task Force recommends that all patients with blood readings of 135/80 mm Hg or higher be screened for type 2 diabetes. (The American Diabetes Association recommends screening for patients with blood pressure greater than 140/90.)
Home Blood Pressure Monitoring
Most patients with high blood pressure will benefit from monitoring their blood pressure at home on a regular basis. Home monitoring can help show if blood pressure medications are working or if they need to be adjusted.
Lifestyle Changes and High Blood Pressure
Lifestyle changes are important for preventing and treating high blood pressure. Healthy changes include maintaining a normal weight, exercising regularly, quitting smoking, limiting alcohol consumption to no more than one or two drinks a day, reducing sodium (salt) intake, and increasing potassium intake. The DASH diet is a diet plan proven to help improve blood pressure.
Medications for High Blood Pressure
Drug treatment for high blood pressure is tailored to the individual patient. There are many different types of blood pressure medications. Although some patients need only one drug to control blood pressure, the most recent guidelines from the American College of Cardiology and the American Heart Association recommend a combination of two or more medications for patients with blood pressure above 140/90 mm Hg.
Blood pressure measurements can fluctuate throughout the day and in different environments. The decision to start or increase blood pressure medications
should not be based on a single blood pressure reading. To obtain the most accurate estimate of your true blood pressure, your doctor will use an average of multiple readings. These may include repeated readings made in the doctor’s office as well as blood pressure measurements you performed at home.
High blood pressure, also called hypertension, is elevated pressure of the blood in the arteries. Hypertension results from two major factors, which can be present independently or together:
- The heart pumps blood with excessive force.
- The body's smaller blood vessels (known as the arterioles ) narrow, so that blood flow exerts more pressure against the vessels' walls.
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Blood pressure is the force applied against the walls of the arteries as the heart pumps blood through the body. The pressure is determined by the force and amount of blood pumped and the size and flexibility of the arteries.
Although the body can tolerate increased blood pressure for months and even years, eventually the heart may enlarge (a condition called hypertrophy ), which is a major factor in heart failure.
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Such pressure can also injure blood vessels in the heart, kidneys, the brain, and the eyes.
Two numbers are used to describe blood pressure: the systolic pressure (the higher and first number) and the diastolic pressure (the lower and second number). Health dangers from blood pressure may vary among different age groups and depending on whether systolic or diastolic pressure (or both) is elevated. A third measurement, pulse pressure. may also be important as an indicator of severity.
Systolic Blood Pressure. The systolic pressure (the first and higher number) is the force that blood exerts on the artery walls as the heart contracts to pump out the blood. High systolic pressure is a greater risk factor than diastolic pressure for brain, heart, kidney, and circulatory complications and for death, particularly in middle-aged and elderly adults.
Diastolic Blood Pressure. The diastolic pressure (the second and lower number) is the measurement of force as the heart relaxes to allow the blood to flow into the heart. High diastolic pressure is a strong predictor of heart attack and stroke in young adults.
Pulse Pressure. Pulse pressure is the difference between the systolic and the diastolic readings. It indicates stiffness and inflammation in the blood-vessel walls. The greater the difference between systolic and diastolic numbers, the greater the risk to health.
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