Monitoring blood pressure

Hypertension is a disorder characterized by chronically high blood pressure. It must be monitored, treated and controlled by medication, lifestyle changes, or a combination of both.

Untreated hypertension

Hypertension is a disorder characterized by chronically high blood pressure. It must be monitored, treated and controlled by medication, lifestyle changes, or a combination of both.

High blood pressure tests

Routine lab tests are recommended before beginning treatment of high blood pressure to determine organ or tissue damage or other risk factors. These lab tests include urinalysis, blood cell count, blood chemistry (potassium, sodium, creatinine, fasting glucose, total cholesterol and HDL cholesterol), and an ECG (electrocardiogram). Additional tests may be recommended based on your condition.

Exercise can lower blood pressure

Reducing your weight by just 10 pounds may be enough to lower your blood pressure. Losing weight can help to enhance the effects of high blood pressure medication and may also reduce other risk factors, such as diabetes and high bad cholesterol.

Blood pressure check

To measure blood pressure, your doctor uses an instrument call a "sphygmomanometer," more often referred to as a blood pressure cuff. The cuff is wrapped around your upper arm and inflated to stop the flow of blood in your artery. As the cuff is slowly deflated, your doctor uses a stethoscope to listen to the blood pumping through the artery. These pumping sounds register on a gauge attached to the cuff. The first pumping sound your doctor hears is recorded as the systolic pressure, and the last sound is the diastolic pressure.

Blood pressure

Blood pressure is the force applied against the walls of the arteries as the heart pumps blood through the body. The pressure is determined by the force and amount of blood pumped and the size and flexibility of the arteries.

Hypertension

Hypertension is the term doctors use for high blood pressure.

Blood pressure readings are measured in millimeters of mercury (mmHg) and usually given as 2 numbers. For example, 140 over 90 (written as 140/90).

• The top number is your systolic pressure, the pressure created when your heart beats. It is considered high if it is consistently over 140.
• The bottom number is your diastolic pressure, the pressure inside blood vessels when the heart is at rest. It is considered high if it is consistently over 90.

Either or both of these numbers may be too high.

Pre-hypertension is when your systolic blood pressure is between 120 and 139 or your diastolic blood pressure is between 80 and 89 on multiple readings. If you have pre-hypertension, you are more likely to develop high blood pressure at some point.

Blood pressure measurements are the result of the force of the blood produced by the heart and the size and condition of the arteries.

Many factors can affect blood pressure, including how much water and salt you have in your body, the condition of your kidneys, nervous system, or blood vessels, and the levels of different body hormones.

High blood pressure can affect all types of people. You have a higher risk of high blood pressure if you have a family history of the disease. High blood pressure is more common in African Americans than Caucasians.

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.

Too much salt in your diet can lead to high blood pressure. Secondary hypertension may also be due to:

• Adrenal gland tumor
• Alcohol poisoning
• Anxiety and stress
• Appetite suppressants
• Arteriosclerosis
• Birth control pills
• Certain cold medicines
• Coarctation of the aorta
• Cocaine use
• Cushing syndrome
• Diabetes
• Kidney disease, including:
• Glomerulonephritis (inflammation of kidneys)
• Kidney failure
• Renal artery stenosis
• Renal vascular obstruction or narrowing
• Migraine medicines
• Hemolytic-uremic syndrome
• Henoch-Schonlein purpura
• Obesity
• Pain
• Periarteritis nodosa
• Pregnancy (called gestational hypertension)
• Radiation enteritis
• Renal artery stenosis
• Retroperitoneal fibrosis
• Wilms' tumor

Most of the time, there are no symptoms. Symptoms that may occur include:

• Confusion
• Chest pain
• Ear noise or buzzing
• Irregular heartbeat
• Nosebleed
• Tiredness
• Vision changes

If you have a severe headache or any of the symptoms above, see your doctor right away. This may be a signs of a complication or dangerously high blood pressure called malignant hypertension.

The goal of treatment is to reduce blood pressure so that you have a lower risk of complications.

There are many different medicines that can be used to treat high blood pressure. Such medicines include:

• Alpha blockers
• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin receptor blockers (ARBs)
• Beta-blockers
• Calcium channel blockers
• Central alpha agonists
• Diuretics
• Renin inhibitors, including aliskiren (Tekturna)
• Vasodilators

Medicines used if the blood pressure is very high may include:

• Clonidine
• Diazoxide
• Furosemide
• Hydralazine
• Minoxidil
• Nitroprusside

Your doctor may also tell you to exercise, lose weight, and follow a healthier diet. If you have pre-hypertension, your doctor will recommend the same lifestyle changes to bring your blood pressure down to normal range.

Most of the time, high blood pressure can be controlled with medicine and lifestyle changes.

Possible Complications

• Aortic dissection
• Blood vessel damage (arteriosclerosis)
• Brain damage
• Congestive heart failure
• Kidney damage
• Kidney failure
• Heart attack
• Hypertensive heart disease
• Stroke
• Vision loss

Lifestyle changes may help control your blood pressure:

• Lose weight if you are overweight. Excess weight adds to strain on the heart. In some cases, weight loss may be the only treatment needed.
• Exercise regularly.
• Eat a healthy diet. Eat less fat and sodium. Salt, MSG, and baking soda all contain sodium. Eat more fruits, vegetables, and fiber.
• Avoid smoking.
• If you have diabetes, keep your blood sugar under control.

Follow your health care provider's recommendations to modify, treat, or control possible causes of secondary hypertension.