High Blood Pressure

You may be surprised if your doctor says you have high blood pressure (HBP) because it does not cause symptoms and you can have it even though you feel fine. But HBP is a serious condition that can lead to stroke, heart disease, kidney failure, and other health problems. The good news is that there are simple ways to control it.

What Is HBP?

As blood flows from the heart out to the blood vessels, it creates pressure against the blood vessel walls. Your blood pressure reading is a measure of this pressure. When that reading goes above a certain point, it is called high blood pressure. Hypertension is another name for HBP.

As many as 50 million Americans may have HBP. Among people age 65 and older, about 40 percent of Whites and 50 percent of Blacks have HBP.

How Is It Tested?

To test blood pressure, a doctor or nurse places a cuff around your arm above the elbow, pumps air into the cuff, and then reads the measurements as the air is let out. The test is painless and takes only a few minutes.

Your blood pressure measurement may be taken several times. You may be asked to stand one time and sit another. If your blood pressure is high the first day, the doctor will want measurements from different days before deciding whether you really have high blood pressure. These steps are needed because blood pressure changes so quickly. Also, it is affected by many things, including the normal feelings of worry during a visit to the doctor.

Because HBP is so common, everyone should have his or her blood pressure tested once a year. Blood pressure readings are given in two numbers. Although the average blood pressure reading for adults is 120/80, a slightly higher or lower reading (for either number) may not be a problem. If blood pressure goes above 140/90, however, some form of treatment diet or drugs may be needed. Lower blood pressure readings (for example, 110/70) are thought to be safe for most people.

What If Just The First Number is High?

Often in older adults the first number (the upper or systolic number) is high while the second (the lower or diastolic) number is normal. This condition is called isolated systolic hypertension, and it also should be treated. Studies prove that lowering the systolic number cuts down on strokes and heart attacks in people age 60 and over.

What Causes HBP?

Some cases of HBP are caused by other illnesses. This kind of HBP is called secondary hypertension, and it is often cured once the original medical problem is cured. Most HBP, however, is essential or primary hypertension. This kind cannot be cured but can be kept under control by regular, ongoing treatment.

Doctors think that many things combine to cause HBP. Being overweight, drinking too much alcohol, and eating too much salt are risk factors because they raise your risk of having HBP. They do not cause it directly.

Blood pressure goes up in all people during periods of stress or exercise. But avoiding stress will not prevent high blood pressure. You can have HBP even though you are usually a calm, relaxed person.

How Is HBP Treated?

If you have mild HBP, your doctor may suggest that you lose weight and keep it off, eat less salt, cut down on alcohol, and get more exercise. You may bring your blood pressure down simply by following this advice. Even if medicine is needed, these daily habits may help it work better.

Some people think that when their blood pressure comes down, they no longer need treatment. If your doctor has prescribed medicine, you may have to take it for the rest of your life. Later on, though, you may be able to take less of it.

Can HBP Be Prevented?

There is now good evidence that HBP can be prevented in many people. The keys to prevention are:

• Keeping your weight moderate;
• Cutting down on salt;
• Exercising regularly; and
• If you drink, having no more than two drinks a day.

HBP Checklist

• HBP may not make you feel sick, but it is serious and should be treated by a doctor.
• You can bring down your blood pressure with changes in diet and daily habits and by taking medicines if necessary.
• Losing weight, cutting down on salt and alcohol, and getting regular exercise may be helpful, but only as suggested by your doctor. Do not assume these are substitutes for medicine unless your doctor says they are.
• If one day’s dose of medicine is missed, do not double up the next day. Instead, call your doctor for advice.
• Take your medicine at the same time each day-for example, in the morning or evening after brushing teeth to help set a regular, easy to remember routine.