Health Topic: High Blood Pressure
Blood pressure is measured in millimeters of mercury (mm Hg). Hypertension
(high blood pressure) is when your blood pressure frequently goes
over 140/90 mm Hg.
A patient is considered "pre-hypertensive"
if the top (systolic) number of the blood pressure reading is 120-139
mm Hg and if the bottom (diastolic) number is over 80-89 mm Hg on
People with pre-hypertension are likely to develop
high blood pressure at some point, unless lifestyle changes to lower
blood pressure to normal are made.
About 1 in every 5 adults in the U.S. has high blood pressure. High
blood pressure occurs more often in men than in women, and in African
Americans almost twice as often as in Caucasians.
Most people feel no symptoms with uncomplicated high
blood pressure. Essential hypertension (hypertension with no known
cause) is not fully understood, but accounts for between 80-85%
of all hypertension cases in people over 45 years of age.
Even though many times high blood pressure does not
have a known cause, the condition can still be treated effectively
with both lifestyle changes and medications.
Lifestyle changes include following a low sodium diet,
exercising, quitting smoking, losing weight, and avoiding excessive
alcohol intake. There are dozens of different medications available
for the management of high blood pressure.
Most of the time, no cause is identified. This is called essential
hypertension. High blood pressure that results from a specific condition,
habit, or medication is called secondary hypertension. Some reasons
for secondary hypertension include:
Use of certain medications (such as appetite suppressants,
cold preparations, and migraine medications)
- Habitual alcohol use
- Excess sodium (salt) in your diet
- Anxiety or stress
- Coarctation of the aorta
- Renal artery stenosis
- Drugs such as alcohol toxicity or cocaine
- Renal disease
The goal of treatment is to reduce blood pressure, which will lower
the risk of complications. The goal is blood pressure at least below
140/90 and below 130/80 for those with diabetes or kidney disease.
A proper diet, weight loss, exercise, and salt and
alcohol reduction are often recommended for patients with hypertension
For those with a blood pressure reading consistently
above 140/90 mmHg, phsicians may prescribe medication. For those
with other risk factors for heart disease, especially diabetes,
doctors will consider starting medications sooner rather than later.
Regular blood pressure checks, as recommended by a
health care provider, are recommended to monitor overall condition
and response to treatment.
Diagnostic tests that may be performed include:
- Blood tests, such as a chem-20
- X-rays of the kidneys
- EKG or echocardiogram
In people with hypertension, modification of sodium intake may be
Products containing sodium (e.g., salt, MSG, and baking
soda) often have little effect in people without hypertension, but
may have a profound effect in those with hypertension.