High Blood Pressure (Hypertension)
What is High Blood Pressure?
High blood pressure, or hypertension, occurs when your blood pressure increases to an unhealthy level. Blood pressure is the measurement of how much blood is passing through your blood vessels and the amount of resistance the blood meets while the heart is pumping. Narrow arteries increase resistance, leading to high blood pressure.
Over the long term, high blood pressure can lead to heart disease; it can also cause damage to your blood vessels and organs, especially the brain, heart, eyes, and kidneys.
Hypertension is quite common. In fact, since the guidelines have recently changed, it’s expected that nearly half of American adults will now be diagnosed with this condition.
Risk Factors of High Blood Pressure
Some risk factors include:
- Family History (of high blood pressure, heart disease, etc.)
- Age (the older you are, the more likely you are to develop hypertension)
- Gender (Until age 64, men are more likely to get high blood pressure than women are. At 65 and older, women are more likely to get high blood pressure.)
- Race (African-Americans tend to develop high blood pressure more often than people of any other racial background in the United States. It also tends to be more severe in African Americans, and some medications are less effective.)
- Chronic Kidney Disease (CKD)
- Poor Diet
- Lack of Excercise
Causes of High Blood Pressure
There are two types of hypertension, each one having a different cause.
Primary hypertension (also known as essential hypertension) develops over time with no identifiable cause. Of the two types, primary hypertension is the most common.
Researchers are still unclear what mechanisms cause blood pressure to slowly increase. A combination of factors may play a role.
These factors include:
Genes – Some people are genetically predisposed to hypertension due to gene mutations or genetic abnormalities inherited from their parents.
Physical Changes – If something in your body changes, you may begin experiencing issues throughout your body. High blood pressure may be one of those issues. For example, it’s thought that changes in your kidney function due to aging may upset the body’s natural balance of salts and fluid, which can cause your body’s blood pressure to increase.
Environment – Over time, unhealthy lifestyle choices like lack of physical activity and poor diet can take their toll on your body. Lifestyle choices can lead to weight problems. Being overweight or obese can increase your risk for hypertension.
Secondary hypertension often occurs quickly and can become more severe than primary hypertension.
Several conditions that can cause secondary hypertension include:
- kidney disease
- obstructive sleep apnea
- congenital heart defects
- problems with your thyroid
- side effects of medications
- use of illegal drugs
- alcohol abuse or chronic use
- adrenal gland problems
- certain endocrine tumors
Symptoms of High Blood Pressure
Hypertension is generally a silent condition; in most cases, there are no symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become obvious. Even then, these symptoms may be attributed to other issues.
Symptoms of severe hypertension can include:
- shortness of breath
- chest pain
- vision changes
- blood in the urine
These symptoms don’t occur in everyone with hypertension. Waiting for a symptom of this condition to appear could be life-threatening, so if you are experiencing any of these symptoms, seek immediate medical attention.
Diagnosis of High Blood Pressure
Because symptoms are almost non-existent until the condition becomes very severe, regular blood pressure readings are very important to ensure an early diagnosis. They can help your doctor notice gradual changes in your blood pressure. A hypertension diagnosis is rarely given after just one reading. If your blood pressure becomes elevated, your doctor may have you check your blood pressure over a few weeks to see if the number remains high or falls back to normal levels. Your doctor needs to see evidence of a sustained problem, as your environment can contribute to increased blood pressure (i.e. stress). In addition, it is normal for blood pressure levels to change throughout the day.
If you don’t receive a blood pressure reading at your next appointment, request one, and if you only have a yearly physical, talk to your doctor about your risks for hypertension and other readings you may need to help you watch your blood pressure.
If your blood pressure remains high, your doctor will likely conduct more tests to rule out underlying conditions. These tests can include:
- urine test
- cholesterol screening and other blood tests
- test of your heart’s electrical activity with an electrocardiogram (EKG)
- ultrasound of your heart or kidneys
These tests can help your doctor identify any secondary issues that may be causing your elevated blood pressure. They can also look at the effects high blood pressure may have had on your organs.
During this time, your doctor may begin treating your hypertension. Early treatment may reduce your risk of lasting damage.
Treatment of High Blood Pressure
The best treatment option for you varies greatly depending on which type of hypertension you have and what causes (if any) have been identified.
Primary Hypertension Treatment Options
If your doctor diagnoses you with primary hypertension, lifestyle changes may help reduce your high blood pressure. If lifestyle changes alone aren’t enough, or if they stop being effective, your doctor may prescribe medication.
Secondary Hypertension Treatment Options
If your doctor discovers an underlying issue causing your hypertension, treatment will focus on that other condition. Sometimes, hypertension is persistent despite treatment of the underlying cause. In this case, your doctor may work with you to develop lifestyle changes and prescribe medications to help reduce your blood pressure.
- Beta-blockers – A type of medication that makes your heart beat slower and with less force. This reduces the amount of blood pumped through your arteries with each beat, which lowers blood pressure. It also blocks certain hormones in your body that can raise your blood pressure.
- Diuretics – High sodium levels and excess fluid in your body can increase blood pressure. Diuretics help your kidneys remove excess sodium from your body. As the sodium leaves, extra fluid in your bloodstream moves into your urine, which helps lower your blood pressure.
- ACE Inhibitors – Angiotensin is a chemical that causes blood vessels and artery walls to tighten and narrow. ACE (angiotensin converting enzyme) inhibitors prevent the body from producing as much of this chemical, which helps blood vessels relax to reduce your blood pressure.
- Angiotensin II Receptor Blockers (ARBs) – While ACE inhibitors aim to stop the creation of angiotensin, ARBs block angiotensin from binding with receptors. Without the chemical, blood vessels won’t tighten. That helps relax vessels and lower blood pressure.
- Calcium Channel Blockers – These medications block some of the calcium from entering the cardiac muscles of your heart. This leads to less forceful heartbeats and a lower blood pressure. These medicines also cause blood vessels to relax which further lowers blood pressure.
- Alpha-2 Agonists – This type of medication changes the nerve impulses that cause blood vessels to tighten.
A healthy lifestyle can help you control the factors that cause hypertension. Some elements that are important to a healthy lifestyle include:
A Healthy Diet
A healthy diet is crucial in helping to reduce high blood pressure. It’s also important for managing hypertension that is under control and reducing the risk of complications.
A healthy diet should include:
- whole grains
- lean proteins (i.e. fish or chicken)
Things to avoid include:
- red meats
- unhealthy saturated and trans fats
Regular Physical Activity
Aim to get 150 minutes of moderate physical activity each week. That’s about 30 minutes five times per week. In addition to helping you lose weight, exercise can help reduce stress, lower blood pressure naturally, and strengthen your cardiovascular system.
Exercise is a great way to manage stress. Some proven stress-reducing activities include:
- deep breathing
- muscle relaxation
- yoga or tai chi
- getting enough sleep
Adopting a Cleaner Lifestyle
- Quit Smoking/Vaping (The chemicals in tobacco smoke, as well as nicotine itself, damage the body’s tissues, restrict blood vessels, and harden blood vessel walls.)
- Limit Alcohol Consumption (If you regularly consume too much alcohol or have an alcohol dependency, reduce the amount you drink or stop entirely. Alcohol can raise blood pressure, amongst other negative health effects.)
Complications of High Blood Pressure
Complications can include:
Damaged Blood Vessels
A Damaged Heart
- an enlarged heart
- heart disease
- a heart attack
- temporary blockage of blood flow and oxygen to the brain
- one or multiple stroke/s
- reduced memory and ability to learn
- reduced ability to recall, speak, and/or reason
eye disease, which causes a deterioration of your vision
Outlook of High Blood Pressure
If left untreated, hypertension could become very severe, and even prove fatal due to any one of the associated complications, or a combination of multiple.
Early detection is crucial, as much of the damage caused by high blood pressure is irreversible. If diagnosed early enough, and treated through lifestyle changes, medication, or both, the long-term outlook of hypertension is quite good.