Hypertension

Hypertension Overview

Hypertension or high blood pressure describes a condition where the force against the walls of your arteries as the heart pumps blood through the body exceeds normal levels. Normal blood pressure is below 120/80 (read “120 over 80”); blood pressure between 120/80 and 139/89 is called “pre-hypertension”; and blood pressure 140/90 or greater is considered high.

The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward in the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after a contraction.

Pressure that exceeds the normal rate places people at risk of heart disease, aneurysms, stroke and kidney damage.

The American Heart Association and other groups have labeled hypertension as a “silent killer” because it often has no symptoms in the earlier stages, yet chronic high blood pressure can lead to coronary heart disease and kidney failure.

Physicians recognize two types of hypertension. Primary or essential hypertension describes high blood pressure with no identifiable cause. This often develops gradually over many years. Secondary hypertension describes high blood pressure issues caused by an underlying condition. These tend to appear suddenly with a root cause such as kidney problems; adrenal gland tumors; congenital defects in blood vessels; medications such as birth control pills, cold remedies, decongestants, pain relievers and some prescription drugs; and illegal drugs such as cocaine and amphetamines.

Regardless of your condition, your WellStar physician can detect hypertension easily and provide essential treatment, if necessary.

Symptoms

Most people with hypertension display no signs or symptoms, even when their blood pressure is dangerously high. Some symptoms that could occur include:

Confusion
Buzzing in the ear
Fatigue
Headaches
Irregular heartbeats
Heavy perspiration
Nosebleeds

Hypertension Prevention

All adults should have their blood pressure checked on a routine basis. Also, it is never too late to adopt a healthier lifestyle through fitness and improved diet, managing stress, avoiding smoking and limiting alcohol consumption. If you have diabetes, maintaining control of your blood sugar is essential.

Reduce Your Risk of Hypertension

You can lower your chances of getting hypertension by:

Eating a diet rich in fruits, vegetables and low-fat dairy products while reducing total and saturated fat intake.
Exercising aerobically in a regimented fashion. If possible, exercise for at least 30 minutes each day.
Losing weight, if you are overweight. Excess weight adds strain to your heart. In some cases, weight loss alone can be the treatment for hypertension.
Avoid smoking
Limit alcohol consumption to one drink a day for women, two drinks for men
If diabetic, manage your blood sugar
Control your stress

Tests and Screenings

Blood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. The blood pressure reading—measured in millimeters of mercury (mm Hg)—provides two numbers. The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward in the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after a contraction.

Blood pressure measures fall into four general categories:

Normal blood pressure: Your measurement is normal if it’s below 120/80 mm Hg (read “120 over 80”).
Pre-hypertension: Pre-hypertension describes measurements ranging from 120/80 mm Hg to 139/89 mm Hg. Pre-hypertension is of concern because it tends to get worse over time.
Stage 1 hypertension: Stage 1 hypertension ranges from 140/90 mm Hg to 159/99 mm Hg.
Stage 2 hypertension: This stage reflects any systolic pressure reading 160 mm Hg or higher or any diastolic pressure reading of 100 mm Hg or higher.

If you have high blood pressure, your Wellstar physician may recommend additional tests including:

Blood tests
Urinalysis
Echocardiogram
Electrocardiogram
Ultrasound of the kidneys
Cholesterol tests

Hypertension Diagnosis

If screening tests are abnormal your Wellstar physician will perform further evaluations regarding hypertension and related concerns.

Diagnostic Procedures

Blood pressure test
Blood tests
Urinalysis
Echocardiogram
Electrocardiogram
Ultrasound of the kidneys
Cholesterol tests

Hypertension Treatment

The overall goal of treatment for hypertension is to lower your blood pressure. Your Wellstar physician will usually prescribe a combination of medications and lifestyle changes in order for you to reach your blood pressure goals. Your treatment hinges on adhering to the plan you and your physician devise, particularly making sure you take your medication exactly as prescribed.

In every case, your Wellstar physician will help you weigh the benefits of each treatment approach and make an experienced recommendation for the best outcome. You can feel confident your decision will be based on both your input and the expertise and recommendations of your experienced physician.

Taking Care of Hypertension

Changing your lifestyle, losing weight, quitting smoking and limiting alcohol intake can all go a long way toward controlling your blood pressure. When such changes are not enough, your Wellstar physician may recommend medication to lower your blood pressure. Such medicines include:

Diuretics: Sometimes called “water pills,” these medications work on your kidneys to help your body eliminate sodium and water, thus reducing blood volume. Diuretics are often among the first—but not the only—choice for high blood pressure medications.
Beta blockers: These medications reduce the heart’s workload and expand blood vessels, thus causing your heart to work slower with less force.
Angiotensin-converting enzyme (ACE) inhibitors: These medications help ease blood vessels by blocking the formation of natural chemicals that make vessels thinner.
Angiotensin II receptor blockers: These medications help relax blood vessels by blocking the action—not the formation—of natural chemicals that make vessels thinner.
Calcium channel blockers: These medications help relax the muscles of blood vessels.
Renin inhibitors, including aliskiren (Tekturna®): These medications slow down the production of rennin, an enzyme produced in your kidneys that can stimulate blood pressure.

Taking Care of Resistant Hypertension

When the usual medications and lifestyle changes fail to make a difference in blood pressure, your Wellstar physician may prescribe other medications such as:

Alpha blockers: These medications affect nerve impulses in ways to reduce how natural chemicals narrow blood vessels.
Alpha and beta blocker combination medications: In addition to reducing nerve impulses to blood vessels, these medications slow the heartbeat to reduce the amount of blood flowing through the vessels.
Central-acting agonists: These medications hinder your brain’s signals to the nervous system to increase your heart rate and narrow blood vessels.
Vasodilators: These medications work directly on the muscles in arterial walls, preventing them from tightening and, thus, making your arteries narrow.

Ongoing Care for Hypertension

Wellstar’s world-class, community-based physicians utilize state-of-the-art medical centers and hospitals with the latest technologies and medical resources. Our clinicians are dedicated to:

Helping you create and maintain healthy lifestyles.
Offering advice to prevent illness and injuries.
Providing early and appropriate care of acute illness to prevent its progression.

Ongoing Care at Home

Treatment for hypertension can often improve symptoms and help you live longer. You and your Wellstar physician can work together to make your life more comfortable, so pay close attention to your body and your post-treatment regiment and keep your doctor updated. As part of your post-treatment care and in addition to maintaining a healthy diet and exercise, you should:

Keep track of all medications you take.
Keep track of your weight and blood pressure.
Write down your questions and never be afraid to ask your WellStar physicians for clarification.