Blood / HematologyCardiovascular / CardiologyHypertensionVascular

What to know about high blood pressure

Once doctors take blood pressure from a person they calculate the force that blood exerts on the artery walls as it passes through them.

It can do significant damage to the blood vessels if blood pressure is too high for too long.ll

This damage can lead to a variety of complications, some of which may be life-threatening. These include heart failure, loss of vision, stroke, kidney disease and other health issues.

There are ways of managing high blood pressure, or hypertension. High blood pressure often does not cause symptoms, but regular screening can help a person know if they need to take preventive action.

According to the Centers for Disease Control and Prevention (CDC), about 75 million people in the United States, or 29 per cent of the population, have high blood pressure.

We look at the causes of high blood pressure in this post, and how to treat it. They also describe the measures of blood pressure which health authorities regard as safe and too high.

What is high blood pressure?

A woman checking his blood pressure test
Leaving high blood pressure untreated may damage the blood vessels.

The heart is a muscle pumping blood throughout the body. The blood is supplying oxygen to vital organs of the body as it flows.

A imbalance in the body also makes it more difficult for the heart to pump blood. For example, this may happen when an artery gets too small.

Persistent high blood pressure may put a strain on artery walls. It can cause a number of health problems, some of which could be life-threatening.

High blood pressure chart

According to the American Heart Association (AHA) the map below indicates tests for normal and elevated blood pressure.

Doctors calculate the blood level of mercury in millimeters (mm Hg).

As the heart contracts, systolic pressure tests the pressure in the arteries, which is the highest number on reading blood pressure. Diastolic, which is the smaller amount, is the blood pressure when the heart rests between beats.

Systolic (mm Hg)Diastolic (mm Hg)
NormalBelow 120Below 80
Elevated (hypertension)120–129Below 80
Stage 1 hypertension130–13980–90
Stage 2 hypertension140 or above90 or above
Hypertensive crisisOver 180Over 120

What is a normal blood pressure? Find out here.

Signs and symptoms

Many people with high blood pressure will have no symptoms, which is why people often call hypertension the “silent killer.”

But, if blood pressure hits around 180/120 mm Hg, it turns into a hypertensive situation, which is a medical emergency.

One individual may have at this stage:

  • headache
  • nausea
  • vomiting
  • dizziness
  • blurred or double vision
  • nosebleeds
  • heart palpitations
  • breathlessness

Anybody who experiences these symptoms should see their doctor immediately.

Symptoms in women

Hormonal causes suggest males and females may be at different risk of high blood pressure.

Factors that can increase women’s risk of high blood pressure include:

  • pregnancy
  • menopause
  • the use of birth control pills

High blood pressure can be a sign of preeclampsia during pregnancy, a potentially dangerous condition which can affect the woman and her unborn child.

Symptoms of preeclampsia include:

  • headaches
  • vision changes
  • abdominal pain
  • swelling due to edema

All women should follow the screening guidelines and attend all health inspections, especially during pregnancy.

Symptoms in teens

Teenagers may develop high blood pressure due to obesity or a medical condition underlying it.

Possible medical factors include:

  • aspects of metabolic syndrome, such as type 2 diabetes
  • kidney disease
  • endocrine disease, which affects the hormones
  • vascular disease, which affects the blood vessels
  • a neurological condition

These conditions may have symptoms of their own.

The symptoms of high blood pressure, if they occur, will be the same as for other groups.

Symptoms in children

Children can get affected by high blood pressure. It raises the risk of obesity and diabetes, but it can also be a sign of:

  • a tumor
  • heart problems
  • kidney problems
  • thyroid problems
  • a genetic condition, such as Cushing’s syndrome

As with adults, high blood pressure often does not cause symptoms in children.

However, if symptoms do occur, they may include:

  • a headache
  • fatigue
  • blurred vision
  • nosebleeds

They may also have signs of another condition.

Symptoms in babies

Regardless of an underlying health disorder, such as kidney or heart disease, newborns and very young babies can also have high blood pressure.

Symptoms may include:

  • a failure to thrive
  • seizures
  • irritability
  • lethargy
  • respiratory distress

Other symptoms will depend on the condition that is causing the high blood pressure.

Causes

High blood pressure can occur when certain changes happen in the body or if a person is born with specific genetic features that cause a health condition.

It can affect people with:

  • obesity
  • type 2 diabetes
  • kidney disease
  • obstructive sleep apnea
  • lupus
  • scleroderma
  • underactive or overactive thyroid
  • congenital conditions, such as Cushing’s syndrome, acromegaly, or pheochromocytoma

Occasionally, there is no apparent cause. For this case the main hypertension is treated by a doctor.

Further raising the risk is eating a high fat diet, carrying extra weight, drinking plenty of alcohol, smoking tobacco and using certain medicines.

How to lower blood pressure

Treatment will depend on several factors, including:

  • how high the blood pressure is
  • the risk of cardiovascular disease or a stroke

As blood pressure increases the doctor may prescribe various treatments. We may recommend making lifestyle changes and controlling the blood pressure for slightly elevated blood pressure.

They’ll prescribe medicine if blood pressure is high. The options can vary over time, depending on how serious the hypertension is and if complications, such as kidney disease, occur. Many people can need several different drugs combined.

Medications

Conventional drugs for treating high blood pressure include:

1) Angiotensin converting enzyme inhibitors

Angiotensin converting enzyme (ACE) inhibitors block the action of certain hormones, such as angiotensin II, that regulate blood pressure. Angiotensin II causes constriction of the arteries and raises blood flow, leading to elevated blood pressure.

ACE inhibitors can reduce the supply of blood to the kidneys, thereby making them less effective. As a result, people who take ACE inhibitors need to have daily blood tests.

If people use ACE inhibitors they do not:

  • are pregnant
  • have a condition that affects the blood supply to the kidneys

ACE inhibitors may cause the following side effects, which usually resolve after a few days:

  • dizziness
  • fatigue
  • weakness
  • headaches
  • a persistent dry cough

If the side effects are chronic or too painful to handle, then a doctor can prescribe an antagonist of the angiotensin II receptor.

These alternative medications also cause less side effects, which can include dizziness, headaches and elevated levels of potassium in the blood.

2) Calcium channel blockers

Calcium channel blockers (CCBs) tend to lower levels of calcium in the blood vessels. It would relax the vascular smooth muscle, causing less vigorous contraction of the heart, widening of the arteries and lowering of blood pressure.

CCBs can not always be sufficient for people with a history of heart disease, hepatic disease, or circulation problems. A physician can advise on taking CCBs and what form of CCB is safe to use.

There may be the following side effects but they typically resolve within a few days:

  • redness of the skin, generally on the cheeks or neck
  • headaches
  • swollen ankles and feet
  • dizziness
  • fatigue
  • skin rash
  • swollen abdomen, in rare cases

3) Thiazide diuretics

Thiazide diuretics help remove sodium and water from the kidneys. It lessens the intensity and pressure of the blood.

The following side effects can occur, and some of them may persist:

  • low blood potassium, which can affect heart and kidney function
  • impaired glucose tolerance
  • erectile dysfunction

Those taking diuretics with thiazide will have daily blood and urine tests to monitor blood sugar and potassium levels.

4) Beta-blockers

Beta-blockers were once common for the treatment of hypertension, but doctors only continue to prescribe them now that other therapies have failed.

Beta-blockers slow down the heart rate and increase the pulse power, causing blood pressure to decrease.

There may be side effects

  • fatigue
  • cold hands and feet
  • slow heartbeat
  • nausea
  • diarrhea
  • Less common side effects are:
  • disturbed sleep
  • nightmares
  • erectile dysfunction

Beta-blockers are also the prescribed treatment, known as a hypertensive crisis, for a person with extremely high blood pressure.

5) Renin inhibitors

Aliskiren (Tekturna, Rasilez) decreases renin activity, which is an enzyme released by the kidneys.

Renin helps produce a hormone that narrows the channels of the blood and increases blood pressure. Reducing this hormone induces narrowing of the blood vessels, and dropping blood pressure.

This medication is fairly new, and its optimum use and dosage is still determined by health care professionals.

Potential side effects include:

  • diarrhea
  • dizziness
  • flu-like symptoms
  • fatigue
  • a cough

It is essential to read the packaging of any medication to check for interactions with other drugs.

Diet

Diet therapy can be an efficient way to help avoid and treat high blood pressure.

Plant-based foods

A stable, balanced diet contains plenty of fruits and vegetables, vitamin and omega-oils and good quality, unrefined carbohydrates, such as whole grains. Those who add animal products into their diet should cut out all the fat and avoid processed meats.

Lowering salt intake

Experts recommend reducing salt consumption and increasing the intake of potassium to control high blood pressure or avoid it. Limiting salt consumption to less than 5–6 grams per day in humans with hypertension may help improve cardiovascular health and reduce systolic blood pressure by 5.6 mm Hg.

Healthful fats

Plant sources of fats, such as avocados, almonds, olive oil, and omega oils can be safe in moderation. People can restrict their consumption of saturated fats and trans fats, which are abundant in foods produced and processed from animals.

The DASH diet

DASH diet is recommended by health professionals for people with high blood pressure. The DASH diet focuses on an eating plan emphasizing whole grains, fruits, vegetables, nuts, seeds, beans and low-fat dairy products.

Food groupsNumber of weekly servings for those eating 1,600–3,100 calories a dayNumber of weekly servings for those on a 2,000-calorie diet
Grains and grain products6–127–8
Fruits3–63–5
Vegetables4–64–5
Mostly low-fat or non-fat dairy foods2–42–3
Lean meat, fish, or poultry1.5–2.52
Nuts, seeds, and legumes3–64–5
Fats and candy2–4Limited

Alcohol

Several studies show that taking any alcohol will help lower blood pressure. Others reports the opposite, however, noting that even drinking a small amount could raise blood pressure.

Those who drink more than moderate levels of alcohol on a daily basis will almost certainly experience high blood pressure.

Caffeine

There have been contradictory findings from studies of the relationship between caffeine and blood pressure. A study released in 2017 found that for people with high blood pressure a moderate intake of coffee seems healthy.

Home remedies

The AHA recommend a range of lifestyle adjustments that can help reduce blood pressure, such as:

  • managing stress
  • quitting smoking
  • eating healthfully
  • getting exercise
  • following any treatment plan the doctor prescribes

Talk with a health care provider regarding any proposed lifestyle changes before adopting them.

Regular exercise

Regular exercise in adult
Regular exercise may help lower blood pressure

The AHA states that most healthy people can do physical activity at least 150 minutes of moderate intensity a week. It could be 30 minutes on 5 days of the week — or three lots of 10 minutes a day —

This amount of exercise is also ideal for those with high blood pressure.

However, a person who hasn’t been exercising for a while or who has a new condition should speak to their doctor before beginning a new physical activity plan to ensure that the decisions they make are acceptable to them.

Losing weight

Studies have revealed that losing as little as 5–10 pounds in weight can help reduce blood pressure.

Weight loss can also make blood pressure drugs more effective.

Ways to reach a healthy weight and sustain it include:

  • getting regular exercise
  • following a diet that emphasizes plant-based foods and limits the intake of fat and added sugars

Sleep

Increasing sleep alone is unlikely to treat hypertension but too little sleep and poor quality of sleep will make it worse.

A 2015 review of data from a Korean national health survey showed that hypertension was more common for people who had less than 5 hours of sleep a night.

You will find more information in this article on how to control high blood pressure.

Natural remedies

The following may help lower blood pressure, according to the National Center for Complementary and Integrative Health (NCCIH):

  • meditation, yoga, qi gong, and tai chi
  • biofeedback and transcendental meditation
  • supplements such as garlic, flaxseed, green or black tea, probiotics, cocoa, and roselle (Hibiscus sabdariffa)

The NCCIH add, however, that there is not yet enough evidence to confirm that these can make a difference.

They also warn that:

Some supplements can have adverse effects. They may raise blood pressure or interact with medications.

Meditation and exercise therapies are usually safe, but some poses may not be suitable for people with high blood pressure.

Anyone who is considering an alternative therapy should speak to their doctor first.

Diastolic and systolic pressure

There are two parts to a blood pressure measurement:

Systolic pressure: This is the blood pressure when the heart contracts.

Diastolic pressure: This is the blood pressure between heartbeats.

When blood pressure is 120/80 mm Hg, the systolic pressure is 120 mm Hg and the diastolic pressure is 80 mm Hg, respectively.

Diagnosis

Blood pressure control systems are different. A doctor will also use a stethoscope hand-held sphygmomanometer. It has a pressure cuff which they place around the arm of the individual.

Mobile devices are ideal for home use, and are available in pharmacies and for online purchase.

When a person is reading blood pressure, they’ll have one of the following:

Normal: Less than 120/80 mm Hg.

Elevated: 120–129/80 mm Hg. At this stage, a doctor will advise the individual to make lifestyle changes to return their blood pressure to the normal range.

Stage 1 hypertension: 130–139/80–89 mm Hg.

Stage 2 hypertension: Over 140/90 mm Hg.

Hypertensive crisis: 180/120 mm Hg or above.

A individual suffering from a hypertensive crisis needs urgent medical treatment.

Typically a person would require more than one reading to validate a diagnosis, as various factors will influence the outcome.

Can fluctuate blood pressure:

  • according to the time of day
  • when a person feels anxiety or stress
  • after eating

Furthermore, if a reading indicates extremely high blood pressure or if there are signs of organ failure or other symptoms a doctor should take prompt action.

Additional tests

Other tests can help in confirming a diagnosis.

Urinary and blood tests: These will search for underlying conditions such as urinary infection or damage to the kidneys.

Exercise stress test: A health care professional can assess the blood pressure of a person before, during and after a stationary bicycle or treadmill is used. The findings can provide valuable insights into heart safety.

Electrocardiogram (ECG): An ECG tests electrical activity in the heart. For a person with hypertension and high cholesterol levels, a doctor may order an ECG as a baseline for comparing future results.

Changes in future results might show that coronary artery disease is developing or that the heart wall is thickening.

Holter monitoring: For 24 hours, the individual carries an ECG portable device that connects to their chest through electrodes. This device can provide an overview of blood pressure throughout the day and show how it changes as the level of activity varies.

Echocardiogram: Ultrasound waves show the heart in motion. The doctor will be able to detect problems, such as thickening of the heart wall, defective heart valves, blood clots, and excessive fluid around the heart.

Dangers and side effects of hypertension

A healthy blood pressure is essential for maintaining bodily functions.

High blood pressure can have a severe impact on:

The cardiovascular system: High blood pressure can cause the arteries to harden, increasing the risk of a blockage.

The heart: A blockage can reduce blood flow to the heart, increasing the risk of angina, heart failure, or a heart attack.

The brain: A blockage in the arteries can lower or prevent blood flow to the brain, leading to a stroke.

The kidneys: High blood pressure can result in kidney damage and chronic kidney disease.

All of these effects can be life threatening.

Can you take decongestants?

When people have a stuffy or runny nose, decongestants are a good over – the-counter treatment, but certain decongestants can increase blood pressure.

Ingredients that can have this effect include:

  • oxymetazoline
  • phenylephrine
  • pseudoephedrine

An individual should clarify that they have high blood pressure to their pharmacist, and ask them to suggest an suitable alternative.

Is high blood pressure genetic?

The key risk factors for high blood pressure are generally environmentally friendly, although genetic factors that play a role. Hypertension can run in families, and it seems that people with certain ethnic and racial groups are at higher risk.

However, individuals within a family often share similar habits, such as dietary preferences, according to the CDC.

If a person has genetic factors that increase their vulnerability to high blood pressure, and they also make lifestyle choices that increase this risk, they would likely be more likely to develop hypertension.

How much sodium per day?

The AHA suggests that people restrict their salt consumption to no more than 2.300 milligrams (mg) a day and reduce it to 1.500 mg preferably. People in the U.S. actually eat an average of more than 3,400 mg of sodium per day.

For most people, for example, the natural sodium content in vegetables is appropriate for the needs of their bodies. Eating fewer refined and premade products and avoiding the salt shaker are effective ways to reduce salt consumption.

Complications

Excessive pressure on the artery walls can lead to damage to the blood vessels, which is a type to cardiovascular disease, without medication or taking steps to control blood pressure. It can damage other vital organs, too.

Possible complications of high blood pressure include:

  • stroke
  • heart attack and heart failure
  • blood clots
  • aneurysm
  • kidney disease
  • thickened, narrow, or torn blood vessels in the eyes
  • metabolic syndrome
  • brain function and memory problems

The quest for early diagnosis and blood pressure control will help prevent many health problems.

Risk factors

The risk factors for high blood pressure include the following:

Age: The risk increases with age because the blood vessels become less flexible.

Family history and genetic factors: People who have close family members with hypertension are more likely to develop it.

Ethnic background: African Americans have a higher risk of developing hypertension than other groups in the United States.

Obesity and being overweight: People with overweight or obesity are more likely to develop high blood pressure.

Physical inactivity: A sedentary lifestyle increases the risk.

Smoking: When people smoke, the blood vessels narrow, and blood pressure rises. Smoking also reduces the blood’s oxygen content, so the heart pumps faster to compensate. This, too, increases blood pressure.

Alcohol intake: Drinking a lot of alcohol increases the risk of blood pressure and its complications, such as heart disease.

Diet: A diet that is high in unsaturated fat and salt increases the risk of high blood pressure.

High cholesterol: Over 50% of people with high blood pressure have high cholesterol. Consuming unhealthful fats can contribute to a buildup of cholesterol in the arteries.

Mental stress: Stress can have a severe impact on blood pressure, especially when it is chronic. It can occur as a result of both socioeconomic and psychosocial factors.

Stress: Persistent stress can lead to high blood pressure, and it may increase the risk of unhealthful choices, such as smoking.

Diabetes: High blood pressure often occurs alongside type 1 diabetes. Following a treatment plan to manage diabetes can reduce the risk.

Pregnancy: High blood pressure is more likely during pregnancy due to hormonal changes. Hypertension is also a symptom of preeclampsia, a potentially severe placental disorder.

Sleep apnea: People with sleep apnea momentarily stop breathing while they sleep. Experts say there are links with hypertension.

When to see a doctor

Most individuals with high blood pressure have no signs. For this purpose, they must be screened regularly, particularly those with a higher risk.

This group includes:

  • people with obesity or overweight
  • African Americans
  • those with a previous history of high blood pressure
  • those with blood pressure that is at the high end of normal (from 130–139/ 85–89 mm Hg)
  • people with certain health conditions

The U.S. Preventive Services Task Force (USPSTF) recommend annual screening for:

  • adults aged 40 years or older
  • those with an elevated risk of high blood pressure
  • Persons with a higher risk include those who:
  • have high to normal blood pressure (130 to 139/85 to 89 mm Hg)
  • have overweight or obesity
  • are African Americans

Adults aged 18–39 years who have normal blood pressure (less than 130/85 mm Hg) and who do not have any other risk factors should have further screening every 3–5 years.

When rescreening in the doctor’s office reveals that blood pressure has risen, the USPSTF recommends that the individual use a 24-hour outpatient blood pressure monitor to better assess their blood pressure. Doctor can diagnose hypertension if this appears to show elevated blood pressure.

Currently the USPSTF does not recommend regular screening for people aged 17 and under.

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