This overview is a sample of the type of information available to you at Griffin Hospital's Community Health Resource Center. It is not intended to replace your physician's instructions in the management of your health problems, but to better inform you about a particular illness and alert you to the availability of other materials. If you have a question about any piece of information presented in theses fact sheets, please call your physician, or stop by the Community Health Resource Center at your convenience.

HIGH BLOOD PRESSURE

Blood pressure is the force of blood against the inside walls of blood vessels as it circulates through the body. Your blood pressure varies during the day, rising higher during periods of activity or anxiety, and falling during periods of sleep or rest. It is normal to have temporary rises in blood pressure which last a few moments, hours, or even days. However, for those who have a condition known as high blood pressure (also called hypertension), the blood pressure remains high all the time.

When the blood pressure remains high for a long time (many months to many years), blood vessel walls become weakened and damaged. This can lead to strokes and heart problems. High blood pressure can also cause damage to the kidneys and eyes. When blood pressure is adequately controlled, much of the damage can be prevented and many of these problems can be avoided.

WHAT CAUSES IT?

Many factors have been found to contribute to hypertension, however, in most people, there is no clear cause. In some people, hypertension is caused by another medical condition (this is called secondary hypertension), and once the other condition is treated, the blood pressure returns to normal. Things that can increase blood pressure are stress, smoking, caffeine, excessive use of alcohol, certain medications, and being overweight.

WHO GETS HIGH BLOOD PRESSURE?

Anyone can develop hypertension at any age. The most common ages are from 25-55 years of age. Some people are more likely to develop hypertension than others. Hypertension tends to run in families. Hypertension is also more common in African Americans, and can develop during pregnancy or in women who take birth control pills.

WHAT ARE THE SYMPTOMS?

Most people with hypertension have no symptoms. Many people have hypertension for years without knowing it. That is why it is a good idea to get your blood pressure checked periodically, or at least once every year or two.

DIAGNOSING HIGH BLOOD PRESSURE

The only way to diagnose hypertension is by measuring the blood pressure. This is a simple procedure which can be performed anywhere, including at home or in the local drugstore if the proper equipment is available. The blood pressure is measured by placing a special cuff around your arm, inflating it with air, and then listening for the pulse while the air is let out of the cuff. The blood pressure reading consists of two numbers. The first, or top number is called the systolic pressure, and is the pressure when the heart is pumping. The second or bottom number is called the diastolic pressure and is the pressure in-between heartbeats. Both numbers are important. High blood pressure is when either or both numbers are consistently higher than 140 for the top number and 90 for the bottom number.

Blood pressure readings should be taken at least three times over a period of several months and be consistently high before a diagnosis of hypertension can be made. Many people have high blood pressure temporarily during visits to the doctor just because they get nervous there. The doctor may ask you to have your blood pressure checked at other times and places to see if it is still high after you leave.

TREATMENT: WHAT YOU CAN DO

Treatment for hypertension depends on many things, such as your age, overall health, and other risk factors. Treatment also depends on how high your blood pressure is. Many people with mild to moderate hypertension are able to bring their blood pressure down with changes in diet and physical activity. For those who need medication, exercise and diet have been shown to lessen the amount of medication needed.

Regular aerobic activity such as walking, jogging, or swimming for 30 minutes three times a week and a low-fat diet rich in fruits and vegetables can lower blood pressure an average of 10 points. If you have other medical problems, however, you may want to check with your doctor before beginning a new exercise program. It is also recommended that people with hypertension lose any extra weight, stop smoking, limit caffeine intake, and reduce alcohol consumption (to less than the equivalent of 2 drinks per day for men, one for lighter weight men and women), and stay within the recommended daily allowance for salt (2400 mg per day). Some people are able to lower their blood pressure through stress management and relaxation techniques.

For those who are unable to control their blood pressure through lifestyle changes alone, there are several types of medications that can be used to treat hypertension. These are covered in the next section.

Once you have been diagnosed with hypertension, you should have regular checkups to monitor your blood pressure, review your medications, and get any blood tests that may be needed. Your doctor may ask you to check your blood pressure or pulse regularly. Once your blood pressure is stable, you may continue with the same medication for many years, however adjustments may be needed from time to time as your body and life circumstances change. Most people who have stabilized their blood pressure and treatment regimen see their doctor at least once a year to see if any adjustments are needed.

If the doctor is unable to get your blood pressure under control, or if the doctor is concerned about the possibility of damage to other organs due to long-standing hypertension, further tests such as an EKG, blood and urine tests, or an eye exam may be considered.

MEDICATION

If your doctor feels that you need medication to control your blood pressure, there are many different drugs that can be considered. These include diuretics which remove salt and excess fluid, beta blockers which helps the heart pump more effectively, and vasodilators which relax the blood vessels.

The doctor may need to increase the dosage, add a second medication, or change to a different kind of medication before finding which plan will work the best for you. Some people do best on a combination of medications. Which medication or combination you end up with will depend on how your body responds.

It is important to remember that these medications will control your blood pressure only while they are in your bloodstream. When you stop taking them, your blood pressure will most likely go back up. Medications should not be increased, decreased, or stopped without talking with your doctor. For some people, the medications can have unpleasant side effects, such as dizziness and fainting, a dry mouth, stuffy nose, or drowsiness. Although it is not unusual to feel tired or dizzy when you first start taking these medications, this should go away in 2-3 days. If you continue to have bothersome side effects, ask your doctor about changing to another kind of medication.

COPING

If you control your blood pressure early and successfully, you may be able to prevent most or all of the serious consequences of hypertension. There are many programs which provide information and assistance on how to stop smoking, control weight, stay fit, and manage stress. Many are free or available at a low cost. Some companies and insurances offer discounts. Check with your doctor, health plan, employer or local hospital or community center to see what's available near you.

Please note that this information is intended to give you a general overview of the topic. It is not intended to replace advice or instruction of a health professional. We recommend that you consult your physician, nurse, or qualified health professional regarding the information in this publication. © 1994 Planetree, Inc. Reproduction of this material in any form is limited to license agreement.

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