Because it was, at one time, measured with a device using a column of mercury, blood pressure measurements are expressed in millimeters of mercury, or mm Hg.
The heart, blood vessels, brain, and kidneys control blood pressure. Blood pressure is also influenced by the amount of fluid and salt in the body. Certain hormones in the body can affect both blood vessels and body fluids.
The force of the contraction of the heart, the heart rate and the elasticity of the arteries are other factors that affect blood pressure. In most people who have high blood pressure, the cause is unknown. When this is the case, high blood pressure is called primary, or essential, hypertension.
Often, a person will have high blood pressure without any symptoms.
Over time, however, a person may develop any or all of the following symptoms: chest paindizzinessheadachesshortness of breathvisual impairments, such as blurred vision
Either the systolic, or the diastolic, or both blood pressure readings can be elevated. Blood pressure tends to rise with stress or exercise. It should return to normal when the person is at rest.
Ninety to 95% of the time, high blood pressure is labeled as essential hypertension, meaning that the cause is unknown. The American Heart Association has identified both controllable and noncontrollable risk factors for high blood pressure.
Uncontrollable risk factors for high blood pressure include age, heredity, and race. In men, high blood pressure occurs most often between 35 and 50 years of age, whereas in women, it generally starts after menopause.
An individual is more likely to develop high blood pressure if his or her parents or close relatives have it. Certain races have a higher incidence of high blood pressure. For example, African Americans develop high blood pressure earlier and more often than Caucasians.
Controllable risk factors for high blood pressure include the following: diet high in sodiumexcess or frequent consumption of alcohollack of exerciseobesitysmokingstress that is not well-managed
Secondary high blood pressure is caused by one or more other medical conditions, such as the following: acute lead poisoning alcohol abusecocaine and other illegal drugscongenital heart disease, such as coarctation of the aortahormonal abnormalities, such as a hyperactive condition of the adrenal glands known as Cushing's syndromeinjury or radiation therapy to the kidneyskidney disease, such as glomerulonephritis and polycystic kidney diseasemedications, such as corticosteroidsoral contraceptives, or birth control pillspregnancy with preeclampsiatumors of the adrenal gland, such as a pheochromocytoma
The American Heart Association guidelines to reduce high blood pressure include: for those who smoke, quitting smokingmoderate sodium intakemoderation in alcohol intakephysical activityweight control
Adults should have their blood pressure measured at least every two years. The diagnosis of high blood pressure is made on the basis of two or more blood pressure readings. It is diagnosed if two or more readings show a systolic blood pressure greater than 140 or a diastolic blood pressure greater than 90. Other tests may be ordered to look for conditions causing the high blood pressure.
Uncontrolled high blood pressure can lead to many serious long-term effects. Damage can occur in the brain, kidneys, and heart. There can also be blood vessel damage to the eye.
High blood pressure can lead to serious health issues, including the following: arrhythmias, or irregular heartbeatsatherosclerosis, which is hardening of the arterieschronic kidney failure that requires dialysis or a kidney transplantcongestive heart failure, in which a weakened heart fails to pump blood effectivelyheart attackstroke, or a brain attack
High blood pressure is not contagious and poses no risk to others.
Secondary high blood pressure can sometimes be controlled by treating the underlying condition. Effective treatment of Cushing's syndrome may lower blood pressure. If the high blood pressure is due to coarctation of the aorta, open heart surgery can correct it.
Medications are recommended if the person's blood pressure is greater than 140/90 after 3 months of lifestyle modifications. They are also used if the initial blood pressure is greater than 160/100.
There are many types of medications used to treat high blood pressure. The medications are classified as follows: Angiotensin-converting enzyme inhibitors, or ACE inhibitors, block the production of a body chemical that constricts the arteries. ACE inhibitors include benazepril hydrochloride (i.e., Lotensin), enalapril maleate (i.e., Vasotec), and quinapril hydrochloride (i.e., Accupril).Angiotensin II receptor blockers block the effect of a body chemical that constricts the arteries and are similar ACE inhibitors. This group of medications includes valsartan (i.e., Diovan), losartin potassium (i.e., Cozaar), and candesartan (i.e., Atacand).Beta-blockers reduce blood pressure by lowering the heart rate and decreasing the force of each heartbeat. Common beta-blockers include atenolol (i.e., Tenormin), propranolol hydrochloride (i.e., Inderal, InnoPran), and nadolol (i.e., Corgard).Calcium channel blockers are divided into two types. Some calcium channel blockers relax the blood vessels. These include amlodipine besylate (i.e., Norvasc) and nifedipine (i.e., Adalat, Procardia). The calcium channel blockers diltiazem hydrochloride (i.e., Cardizem, Cartia, Dilacor, Diltia, Tiazac) and verapamil (i.e., Calan, Covera, Isoptin, Verelan) work by lowering the heart rate.Diuretics, or water pills, help the body get rid of extra fluid and sodium. Common diuretics include furosemide (i.e., Lasix), hydrochlorothiazide (i.e., Esidrix, HydroDIURIL, Microzide, Oretic, HCTZ), and chlorthalidone.Sympathetic nerve inhibitors keep the nervous system from constricting arteries. This group includes clonidine hydrochloride (i.e., Catapres), guanabenz acetate (i.e., Wytensin), and alpha methyldopa (i.e., Aldomet).Vasodilators relax the muscles in the blood vessel walls and allow the vessels to dilate. Common vasodilators include isosorbide dinitrate (i.e., Dilatrate, Isordil) and hydralazine.
The American Heart Association recommends discussing the risks and benefits of the medication with the healthcare professional. The choice of medication varies depending on a person's medical history. For example, beta-blockers usually are avoided in someone with breathing problems such as asthma. ACE inhibitors and diuretics are especially useful for people with kidney disease or diabetes.
A person who has high blood pressure may be on multiple medications. In fact, the JNC 7 guidelines recommend 2 drugs be used as initial therapy in patients with stage 2 hypertension. The goal of treatment is to keep the systolic pressure below 130 and the diastolic below 85. In a person with diabetes, the goal is a systolic less than 120 and a diastolic below 80.
For an individual with heart disease or kidney disease, the goal is to get the blood pressure as low as can be tolerated.
The side effects of treatment of high blood pressure vary according to the medications used. Beta-blockers can worsen asthma and may cause dizziness and fatigue. Diuretics can cause dehydration as well as salt and potassium imbalance. Calcium channel blockers can cause swelling of the legs. ACE inhibitors may lead to chronic dry cough. Vasodilators can cause headache and fluid retention. Clonidine, if stopped abruptly, can cause significantly worsened hypertension.
A person who has high blood pressure needs to continue to take the prescribed medications daily. Blood pressure may return to normal as a result of lifestyle changes. These changes include weight loss, increased physical activity, reduction of alcohol intake, and a diet low in sodium. In most cases, a person will need to continue to take blood pressure medications for life.
High blood pressure is monitored through frequent visits to a healthcare professional. A person who has high blood pressure should also record blood pressure readings between office visits. Any new or worsening symptoms should be reported to the healthcare professional.