Hypertension or high blood pressure is often called a “silent disease” because you usually don’t know that you have it, thus making it dangerous. In fact, one third of people who have high blood pressure are not aware that they are already suffering from it. There may be no symptoms or signs but it damages the body and may eventually lead to serious ailments such as stroke, heart disease, kidney failure or eye problems.
It is important to regularly monitor your blood pressure, especially if it has ever been high or above the “normal” range, or if you have a family history of hypertension. Other risk factors include obesity, drinking too much alcohol, and smoking.
The symptoms to look out for which could determine if you have hypertension include severe headache, fatigue or confusion, vision problems, chest pain, difficulty in breathing, irregular heartbeat, blood in the urine, and pounding in your chest, neck or ears. See a doctor immediately if you have any of these symptoms as you could be having a hypertensive crisis.
Measuring your blood pressure
Blood pressure is measured by a devise known as sphygmomanometer which consists of a stethoscope, arm cuff, dial, pump, and valve. You can have your blood pressure read by a health care provider or at a pharmacy. You can also purchase a blood pressure monitor for your home but it is important to have it checked by your doctor for reliability.
Blood pressure or BP is recorded as two numbers: systolic (maximum pressure during a heartbeat) and diastolic (lowest pressure between heartbeats). It is measured in millimeters of mercury (mm Hg) and is written systolic over diastolic (for example, 120/80 mm Hg, or “120 over 80”).
According to the most recent guidelines, a normal blood pressure is less than 120/80 mm Hg and that which is greater than 140/90 is considered hypertension. For people over age 60, high blood pressure is defined as 150/90 or greater. Prehypertension consists of BP that is 120 to 139/80 to 89.
Your BP may increase or decrease depending on your age, heart condition, emotions, activity, and the medications you take. One high reading does not mean you have high blood pressure. It is necessary to measure your blood pressure at different times, while you are resting comfortably for at least five minutes. To make the diagnosis of hypertension, at least three readings that are elevated are usually required.
In addition to measuring your BP, your doctor will ask about your medical history (whether you’ve had heart problems before), assess your risk factors (whether you smoke, have high cholesterol, diabetes, etc.), and talk about your family history (whether any members of your family have had high blood pressure or heart disease).
Your doctor will also conduct a physical exam to examine your heart for any abnormal sounds and your arteries for any whooshing or swishing that may indicate partial blockage. He may also check the pulses in your arm and ankle to determine if they are weak or even absent.
If you are diagnosed with hypertension, your doctor may recommend other tests, such as Electrocardiogram (EKG or ECG) which measures the electrical activity, rate, and rhythm of your heartbeat or Echocardiogram which uses ultrasound waves to provide pictures of the heart’s valves and chambers.
Types of hypertension
- Malignant hypertension is extremely high blood pressure that develops rapidly and causes some type of organ damage. “Normal” blood pressure is below 140/90, while a person with malignant hypertension has a blood pressure above 180/120. Malignant hypertension should be treated as a medical emergency.
- Secondary high blood pressure, which is not common, is caused by another disease or condition or by certain medicines. The risk of secondary high blood pressure is higher in children than in adults. Five out of 10 adults who have high blood pressure are classified as secondary.
- Renal hypertension, also called renovascular hypertension, is caused by kidney disease. It can usually be controlled by blood pressure drugs. Angioplasty, stenting, or surgery on the blood vessels of the kidney can also help.
Treating hypertension and choosing the best medicine for you may depend on the following factors:
- How high your blood pressure is and what your blood pressure goal is.
- Whether you have signs that high blood pressure has caused organ damage, such as an enlarged heart or early damage to your arteries, kidneys, or eyes.
- Whether you have other medical conditions, such as coronary artery disease, diabetes, kidney or lung disease; or risk factors for heart disease, such as diabetes or high cholesterol.
- Whether you think you can succeed at making lifestyle changes.
Doctors usually prescribe a single, low-dose medicine first. If blood pressure is not controlled, your doctor may change the dosage or use another to get the best result. It is common to try several medicines or combinations thereof before blood pressure is successfully controlled. Work with your doctor to find the right one with the fewest side effects, making sure that you take the medicines regularly as prescribed.
Medicine choices include diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, calcium channel blockers, direct renin inhibitors, alpha-blockers and vasodilators. These are all effective in lowering the risk of heart attack and stroke.
Do not take over-the-counter drugs, vitamins, or supplements unless you talk to your doctor first. [pq]Medicines can interact with each other and keep blood pressure medications from working right or cause a bad reaction.[/pq]
– Denn Meneses, Medical Observer