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You can have high blood pressure (hypertension) for years without a single symptom. But silence isn't golden. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke. Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. High blood pressure typically develops without signs or symptoms. And it affects nearly everyone eventually. If you don't have high blood pressure by age 55, you have a 90 percent chance of developing it at some point in your life, according to the National Heart, Lung, and Blood Institute. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.
Signs and symptoms
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don't occur until high blood pressure has reached an advanced — possibly life-threatening — stage.
In 90 percent to 95 percent of high blood pressure cases, the American Heart Association says there's no identifiable cause. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years. The other 5 percent to 10 percent of high blood pressure cases are caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions can lead to secondary hypertension, including kidney abnormalities, tumors of the adrenal gland or certain congenital heart defects. Certain medications — including birth control pills, cold remedies, decongestants, over-thecounter pain relievers and some prescription drugs — also may cause secondary hypertension.
Through early middle age. • Race. Serious complications. • blood. heavy drinking can damage your heart. The higher your heart rate. Over time.In a 2005 study. women who took an average of 500 milligrams or more of acetaminophen (Tylenol. As the volume of blood circulated through your blood vessels increases. The chemicals in tobacco can damage the lining of your artery walls. also can increase blood pressure. Women are more likely to develop high blood pressure after menopause. People who are inactive tend to have higher heart rates. If you don't consume or retain enough potassium. • Excessive alcohol. Various illicit drugs. The greater your body mass. • Excess weight. including cocaine and amphetamines. High blood pressure tends to run in families. Risk factors High blood pressure has many risk factors. others) daily over several years were more likely to develop high blood pressure than were women who didn't take any acetaminophen. Some you can't control. • Family history. Other risk factors for high blood pressure are within your control. so does the pressure on your artery walls. you may accumulate too much sodium in your . the harder your heart must work with each contraction — and the stronger the force on your arteries. The risk of high blood pressure increases as you get older. • Tobacco use. • Age. Potassium helps balance the amount of sodium in your cells. the more blood you need to supply oxygen and nutrients to your tissues. such as stroke and heart attack. • Sodium intake. Lack of physical activity also increases the risk of being overweight. often developing at an earlier age than it does in whites. • Inactivity. which promotes narrowing of the arteries. High blood pressure is particularly common among blacks. Too much sodium in your diet — especially if you have sodium sensitivity — can lead to fluid retention and increased blood pressure. It's not known if the same holds true for men. high blood pressure is more common in men. also are more common in blacks. Low potassium intake.
Lung. poor lifestyle habits — such as an unhealthy diet and lack of exercise — contribute to high blood pressure. When to seek medical advice Ask your doctor for a blood pressure reading at least every two years. the risk of cardiovascular disease begins to increase. But for a growing number of kids. He or she may recommend more frequent readings if you have prehypertension. A blood pressure reading. too. Sometimes pregnancy contributes to high blood pressure. Your blood pressure is normal if it's below 120/80 mm Hg — but some data indicate that 115/75 mm Hg should be the gold standard. you may only fuel problems with high blood pressure. Certain chronic conditions also may increase your risk of high blood pressure. kidney disease and sleep apnea. less exercise. The first. number measures the pressure in your arteries between beats (diastolic pressure). divide blood pressure measurements into four general categories: • Normal blood pressure. . The second. children may be at risk. issued in 2003 by the National Heart. and Blood Institute. or upper. adults who worked more than 40 or 50 hours a week — particularly clerical and unskilled workers — were more likely to have high blood pressure than were those who worked 40 hours or less a week. has two numbers. given in millimeters of mercury (mm Hg). Screening and diagnosis Blood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. more stress and less sleep. diabetes. or lower. number measures the pressure in your arteries when your heart beats (systolic pressure). high blood pressure or other risk factors for cardiovascular disease.• Stress. using tobacco or drinking alcohol. In a 2006 study. If you try to relax by eating more. Although high blood pressure is most common in adults. Researchers tied the higher risk for workers with longer hours to unhealthy eating. High levels of stress can lead to a temporary but dramatic increase in blood pressure. high blood pressure is caused by problems with the kidneys or heart. Once blood pressure rises above 115/75 mm Hg. including high cholesterol. For some children. The latest blood pressure guidelines.
your doctor may recommend routine tests. stage 2 hypertension is a systolic pressure of 160 or higher or a diastolic pressure of 100 or higher. • Stage 1 hypertension. Your doctor may ask you to record your blood pressure at home and at work to provide additional information. But after age 50. blood tests and an electrocardiogram (ECG) — a test that measures your heart's electrical activity. The most severe hypertension. such as a urine test (urinalysis). Within four years of being diagnosed with prehypertension. Both numbers in a blood pressure reading are important. To pump blood against the higher pressure in your vessels. Isolated systolic hypertension (ISH) — when diastolic pressure is normal but systolic pressure is high — is the most common type of high blood pressure among people older than 50. Because blood pressure normally varies throughout the day — and sometimes specifically during visits to the doctor — diagnosis is based on more than one reading taken on more than one occasion. the thickened muscle may have a hard time pumping enough blood to meet your body's needs. If you have any type of high blood pressure. This can result in hardening and thickening of the arteries (atherosclerosis). which can lead to a heart attack or other complications. Uncontrolled high blood pressure can lead to: • Damage to your arteries. Eventually. nearly one in three adults ages 35 to 64 and nearly one in two adults age 65 or older progress to definite high blood pressure. the systolic reading is even more significant. • Heart failure. More extensive testing isn't usually needed. An enlarged. your heart muscle thickens. The higher your blood pressure and the longer it goes uncontrolled. Prehypertension tends to get worse over time. the greater the damage. which can lead to heart failure. . Complications Excessive pressure on the artery walls can damage your vital organs. Stage 1 hypertension is a systolic pressure ranging from 140 to 159 or a diastolic pressure ranging from 90 to 99. A single high blood pressure reading usually isn't enough for a diagnosis. bulging blood vessel (aneurysm) also is possible. • Stage 2 hypertension.• Prehypertension. Prehypertension is a systolic pressure ranging from 120 to 139 or a diastolic pressure ranging from 80 to 89.
If you have high blood pressure. Your doctor also may suggest steps to control conditions that can contribute to high blood pressure. or "good. high blood pressure and high insulin levels. the greater your risk of developing diabetes. Blood pressure goals aren't the same for everyone. low high-density lipoprotein (HDL). In addition to diet and exercise. Treatment Treating high blood pressure can help prevent serious — even life-threatening — complications. which can reduce side effects. diabetes or coronary artery disease or are at high risk of coronary artery disease If your heart isn't pumping as well as it should (left ventricular dysfunction or heart failure) or you have severe chronic kidney disease 120/80 mm Hg or lower Changing your lifestyle can go a long way toward controlling high blood pressure. your doctor may recommend medication to lower your blood pressure. Blood pressure treatment goals 140/90 mm Hg or lower 130/80 mm Hg or lower If you are a healthy adult If you have chronic kidney disease. This can lead to stroke. This can result in vision loss. doctors recommend lower readings for people with certain conditions. The more components you have. • • Thickened. Cognitive impairment and dementia are more common in people who have high blood pressure. heart disease or stroke. Uncontrolled high blood pressure also may affect your ability to think. This syndrome is a cluster of disorders of your body's metabolism — including elevated waist circumference. such as diabetes and high cholesterol. high triglycerides. Weakened and narrowed blood vessels in your kidneys. Metabolic syndrome. remember and learn. But sometimes lifestyle changes aren't enough.• • A blocked or ruptured blood vessel in your brain. narrowed or torn blood vessels in the eyes. This can prevent these organs from functioning normally. Which category of medication your doctor prescribes depends on your stage of high blood pressure and whether you also have other medical conditions. Although everyone should strive for blood pressure readings below 140/90. your doctor may prescribe a combination of low-dose medications rather than larger doses of one . you're more likely to have other components of metabolic syndrome. To reduce the number of doses you need a day." cholesterol.
When prescribed alone. ACE inhibitors may be especially important in treating high blood pressure in people with coronary artery disease. Tekturna works by reducing the ability of renin to begin this process. beta blockers don't work as well in blacks — but they're effective when combined with a thiazide diuretic. The major types of medication used to control high blood pressure include: • Thiazide diuretics. Sometimes finding the most effective medication — or combination of drugs — is a matter of trial and error. For now. Thiazide diuretics are often the first — but not the only — choice in high blood pressure medications. A word of caution for grapefruit lovers. but they're effective when combined with a thiazide diuretic. Like beta blockers. talk to your doctor or pharmacist if you're concerned about interactions. A new drug Tekturna (aliskiren) is a renin inhibitor. These medications help relax the muscles of your blood vessels. • Renin inhibitors. ACE inhibitors don't work as well in blacks when prescribed alone. • Beta blockers. though. These medications help relax blood vessels by blocking the action — not the formation — of a natural chemical that narrows blood vessels. heart failure and kidney failure. • Calcium channel blockers. Grapefruit juice interacts with some calcium channel blockers. heart failure or kidney failure. however. diuretics were a key factor in preventing heart failure associated with high blood pressure. Renin is an enzyme produced by your kidneys that starts a cascade of chemical steps that increases blood pressure. These medications act on your kidneys to help your body eliminate sodium and water. • Angiotensin-converting enzyme (ACE) inhibitors. Like ACE inhibitors. Calcium channel blockers may work better for blacks than do ACE inhibitors or beta blockers alone. These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. In a 2006 study. causing your heart to beat slower and with less force. angiotensin II receptor blockers often are useful for people with coronary artery disease. Some slow your heart rate. These medications reduce the workload on your heart. reducing blood volume. increasing blood levels of the medication and putting you at higher risk of side effects. Researchers have identified the substance in grapefruit juice that causes the potentially dangerous interaction. In fact. Tekturna acts earlier in your body's blood pressure regulation process than most other blood pressure . • Angiotensin II receptor blockers. which may one day lead to commercial grapefruit juices that don't pose a risk of interaction.single drug. two or more blood pressure drugs often work better than one.
• Vasodilators. This doesn't mean your blood pressure will never get lower. These medications prevent your brain from signaling your nervous system to increase your heart rate and narrow your blood vessels. reducing the effects of natural chemicals that narrow blood vessels. You may have to fine-tune your medications to come up with the most effective combination and doses. • Central-acting agents. there's a good chance you can meet your goal with the help of treatment that's more effective. • Alpha-beta blockers. your doctor may prescribe: • Alpha blockers. You may need to see a hypertension specialist if your primary care doctor isn't able to pinpoint a cause. Resistant hypertension: When your blood pressure is difficult to control If your blood pressure has remained stubbornly high despite taking at least three medications from different classes of antihypertensive drugs. one of which is a diuretic. These medications reduce nerve impulses to blood vessels. Tekturna can be used alone. These medications work directly on the muscles in the walls of your arteries. In addition to reducing nerve impulses to blood vessels. you may have resistant hypertension — blood pressure that is resistant to treatment. alpha- beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels. It also can be used well with the other major classes of blood pressure drugs to improve their actions.medications. In fact. if you and your doctor can identify what's behind your persistently high blood pressure. . so it can be taken once daily in oral tablet form. Once your blood pressure is under control. Your doctor or hypertension specialist can evaluate whether the medications and doses you're taking for your high blood pressure are appropriate. If you're having trouble reaching your blood pressure goal with combinations of the above medications. preventing the muscles from tightening and your arteries from narrowing. such as water pills (diuretics). Tekturna's effects on blood pressure last more than 24 hours. but it's more effective when used in combination with existing high blood pressure medications. your doctor may add aspirin to your regimen to reduce your risk of cardiovascular disorders.
Eat less saturated fat and total fat. Try the Dietary Approaches to Stop Hypertension (DASH) diet. Here's what you can do: • Eat healthy foods. Regular physical activity can help lower your blood pressure and keep your weight under control. vegetables. • Maintain a healthy weight. If you're overweight. losing even 5 pounds can lower your blood pressure. too. limiting sodium intake to 1. Self-care Lifestyle changes can help you control and prevent high blood pressure — even if you're taking blood pressure medication. which can help prevent and control high blood pressure. alcohol can raise your blood pressure. Those or other substances or foods can worsen high blood pressure or prevent your medications from working effectively. ask your doctor to help you quit. If you smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. . substances. talk to your doctor about solutions. Reduce stress as much as possible. In addition. Be open and honest with your doctor about all the medications.500 mg a day will have a more dramatic effect on your blood pressure. If you choose to drink alcohol. Underlying causes of resistant hypertension should also be considered such as sleep apnea and kidney or hormonal abnormalities. your blood pressure can pay the price. such as muscle relaxation and deep breathing.400 milligrams (mg) of sodium a day is the current limit for otherwise healthy adults. two drinks a day for men. whole grains and low-fat dairy foods. • Limit alcohol. Even if you're healthy. supplements and products you take. Limit the amount of sodium in your diet. Don't alter your treatment without your doctor's guidance. • Manage stress. Although 2. • Don't smoke. • Increase physical activity. Get plenty of potassium. If you skip doses because you can't afford the medication. Getting plenty of sleep can help. Strive for at least 30 minutes of physical activity a day. do so in moderation — up to one drink a day for women.If you don't strictly follow the prescribed medication regimen. Practice healthy coping techniques. which emphasizes fruits. you and your doctor can review medications you're taking for other conditions. because you have disagreeable side effects or because you simply forget to take your medications.
• Schedule regular doctor visits. release negative thoughts. Say no to extra tasks. Do it on your own or try device-guided paced breathing. lose excess weight and get regular physical activity. It's a condition you need to manage for the rest of your life. • Take your medications properly. Work with your doctor to bring your blood pressure to a safe level — and keep it there. If side effects or costs pose problems. . maintain good relationships. Sticking with all this can be difficult — especially if you don't see or feel any symptoms of high blood pressure. • Manage stress. Ask your doctor about other options. To keep your blood pressure under control: • Measure your blood pressure at home. Your doctor can't do it alone. deep breathing. Home blood pressure monitoring can help you keep closer tabs on your blood pressure. If you need motivation. and neither can you. Eat healthy foods. It takes a team effort to treat high blood pressure successfully. In various clinical trials. remember the risks associated with uncontrolled high blood pressure. • Adopt healthy habits. If you smoke. Limit alcohol.• Practice slow. and even alert you and your doctor to potential complications. quit. Coping skills High blood pressure isn't a problem that you can treat and then ignore. and remain patient and optimistic. show if medication is working. regular use of Resperate — an over-the-counter device approved by the Food and Drug Administration to analyze breathing patterns and help guide inhalation and exhalation — significantly lowered blood pressure. don't stop taking your medications. It may help to enlist the support of your family and friends as well.