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Hypertension, or high blood pressure (HBP), is a common disease in which blood flows through blood vessels (specifically arteries) at higher than normal pressures. Blood pressure is the force of blood pushing against the artery walls as the heart pumps blood. High blood pressure, sometimes called arterial hypertension, happens when this force is too high. This happens when the arteries are not as elastic as they should be because of scarring or the build-up of cholesterol and plaque. This causes the heart to pump harder to get blood into the arteries. Over time, this increased effort can result in damage to the heart itself, particularly in the heart’s muscles and valves.
Approximately 67 million Americans—or 31% of the American population has high blood pressure. It can occur at any age, though it is more common in older age. In the United States, an estimated 65% of men and 70% of women over the age of 60 suffer from high blood pressure.
Most people with high blood pressure have no symptoms; in fact, you can have high blood pressure for years and not know it. For this reason, it’s often referred to as a “silent killer.” The only way to know if your blood pressure is high is to have it checked regularly, which is why blood pressure is always taken at check ups. Everyone, from kids to adults, should have their blood pressure checked regularly.
For most adults with high blood pressure—as many as 95%—there’s no identifiable cause of high blood pressure. This type of high blood pressure is called primary or essential hypertension, and typically develops over many years. There are numerous risk factors linked to high blood pressure. It tends to run in families, is more prevalent in men than women. And ethnicity and age are also factors—for example, in the USA, African Americans are twice as likely to have high blood pressure as compared to other groups.
Some people, however, have high blood pressure that is connected to an underlying condition, and is called secondary hypertension. This type of high blood pressure tends to appear more suddenly, and often causes higher blood pressure than essential or primary hypertension. There are a number of conditions and medications that can lead to secondary hypertension, such as:
The following are risk factors for hypertension:
Blood pressure is measured with a device known as a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve.
Blood pressure is measured in two ways:
According to guidelines, a normal blood pressure is less than 120/80 mm Hg. Hypertension is blood pressure that is greater than 140/90. For people over age 60, high blood pressure is defined as 150/90 or greater.
You may not know you have hypertension, which is why high blood pressure is often referred to as called the “Silent Killer.” The American Heart Association says one out of every three adults has high blood pressure, and estimates that almost 20 percent don’t know it.
Some symptoms of hypertension are:
Pounding in your chest, neck, or ears
Comprehensive treatment, including lifestyle changes like modifying diet and salt intake, along with blood pressure medications, usually controls high blood pressure and results in a generally good prognosis.
There are several things that you can do to help lower your blood pressure and boost your overall health to prevent your risk of future heart problems, like:
Since hypertension is one of the most common precursors to cardiovascular disease, blood pressure is taken at almost every doctors’ visit.
For healthy people, the following steps have been shown to help prevent or reduce the risk factors for heart disease. Keep in mind that reducing one risk factor may help reduce others:
Your doctor can choose from several dozen possible medications and/or a combination of medications to treat your high blood pressure.
Diuretics help the kidneys eliminate sodium and water from the body. This process decreases blood volume, so your heart has less to pump with each beat, which in turn lowers blood pressure. Among the most popular are:
Side effects of diuretics include:
Anti-adrenergics lower blood pressure by limiting the action of the hormones epinephrine and norepinephrine, thereby relaxing the blood vessels and reducing the speed and force of the heart’s contractions. This class of medicines includes:
Side effects of anti-adrenergics include:
Direct-acting vasodilators relax the arteries. They act quickly and are often used in emergencies. Vasodilators include:
Side effects of direct-acting vasodilators include:
Calcium channel blockers slow the movement of calcium into the smooth-muscle cells of the heart and blood vessels. This weakens heart muscle contractions and dilates blood vessels, lowering blood pressure. Some calcium channel blockers include:
Side effects of calcium channel blockers include:
ACE (Angiotensin-converting enzyme) inhibitors lower your blood pressure by inhibiting the formation of angiotensin, which causes blood vessels constriction and increases blood pressure. . Some ACE inhibitors are:
Side effects of ACE inhibitors include:
Angiotensin-receptor blockers (ARBs) blocks angiotensin II, a substance in the body, from constricting the blood vessels and stimulating salt and water retention. They include:
Side effects of ARBs include:
Direct renin inhibitors, which block the action of angiotensin II. They represent a newer generation of blood pressure medications. Renin inhibitors work by inhibiting the activity of renin, the enzyme largely responsible for angiotensin II levels.
Side effects of direct renin inhibitors include:
The following list of supplements is offered by the University of Maryland Medical Center. Always check with your cardiologist or primary doctor before adding supplements to your regimen for treating and preventing heart failure. Many people with heart conditions take multiple medications, including blood-thinning medications, blood pressure medications, and others. The supplements below may interact with these (and other medications) and may not be right for people with certain medical conditions.
Stress reduction practices. Since stress is associated with heart disease, it’s prudent to try techniques to help reduce it. The following methods have been shown to reduce stress in some people:
Being diagnosed with heart disease can be difficult for you and your family, but there are things you can do to make your life easier and healthier.
If you are being treated for hypertension, call your doctor if:
In addition to your primary care physician, you may want to include a cardiologist (heart specialist) and a dietitian (nutritional specialist).
You will probably have different questions to ask your doctor depending on your heart condition. Be open about all your concerns. If you’re having difficulty focusing, bring along a friend or family member. Below you’ll find general questions you might want to ask your doctor about heart disease as suggested by the American Heart Association.
QUESTIONS ABOUT MEDICATION
QUESTIONS ABOUT DIET
QUESTIONS ABOUT EXERCISE
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