what is high blood pressure ? It's causes ? It;s symptans , It's diaghonosis , It's treatments , including medication , prevention, & self care at Home ;

High Blood Pressure's main descriptions ;-

Patient

The heart pumps blood into the arteries with enough force to push blood to the far reaches of each organ from the top of the head to the bottom of the feet. Blood pressure can be defined as the pressure of blood on the walls of the arteries as it circulates through the body. Blood pressure is highest as its leaves the heart through the aorta and gradually decreases as it enters smaller and smaller blood vessels (arteries, arterioles, and capillaries). Blood returns in the veins leading to the heart, aided by gravity and muscle contraction.

Hypertension is the medical term for high blood pressure. It is known as the "silent killer" since it has no initial symptoms but can lead to long-term disease and complications..

· Many people have high blood pressure and don't know it.

· Important complications of uncontrolled or poorly treated high blood pressure include heart attack, congestive heart failure, stroke, kidney failure, peripheral artery disease, and aortic aneurysms (weakening of the wall of the aorta, leading to widening or ballooning of the aorta).

How is blood pressure measured?

Blood pressure is measured with a blood pressure cuff and recorded as two numbers, for example, 120/80 mm Hg (millimeters of mercury). Blood pressure measurements are usually taken at the upper arm over the brachial artery.

· The top, larger number is called the systolic pressure. This measures the pressure generated when the heart contracts (pumps). It reflects the pressure of the blood against arterial walls.

· The bottom, smaller number is called the diastolic pressure. This reflects the pressure in the arteries while the heart is filling and resting between heartbeats.

The American Heart Association has recommended guidelines to define normal and high blood pressure.

· Normal blood pressure less than 120/80

· Pre-hypertension 120-139/ 80-89

· High blood pressure (stage 1) 140-159/90-99

· High blood pressure (stage 2) higher than 160/100

· Uncontrolled high blood pressure may be responsible for many cases of death and disability resulting from heart attack, stroke, and kidney failure.

According to research studies, the risk of dying of a heart attack is directly linked to high blood pressure, particularly systolic

What is high blood pressure?

Blood pressure is a measure of how hard the blood pushes against the walls of your arteries as it moves through your body. It's normal for blood pressure to go up and down throughout the day, but if it stays up, you have high blood pressure. Another name for high blood pressure is hypertension.

When blood pressure is high, it starts to damage the blood vessels, heart, and kidneys. This can lead to heart attack, stroke, and other problems. High blood pressure is called a "silent killer,'' because it doesn't usually cause symptoms while it is causing this damage.

Your blood pressure consists of two numbers: systolic and diastolic. Someone with a systolic pressure of 120 and a diastolic pressure of 80 has a blood pressure of 120/80, or "120 over 80." Blood pressure is measured in millimeters of mercury (mm Hg).

· The systolic number shows how hard the blood pushes when the heart is pumping.

· The diastolic number shows how hard the blood pushes between heartbeats, when the heart is relaxed and filling with blood.

High blood pressure is 140/90 or higher. Adults should have a blood pressure of less than 120/80. Many people fall into the category in between, called prehypertension. People with prehypertension need to make lifestyle changes to bring the blood pressure down and help prevent or delay high blood pressure.¹

What causes high blood pressure?

In most cases, doctors can't point to the exact cause. But several things are known to raise blood pressure, including being very overweight, drinking too much alcohol, having a family history of high blood pressure, eating too much salt, and getting older.

Your blood pressure may also rise if you are not very active, you don't eat enough potassium and calcium, or you have a condition called insulin resistance.

What are the symptoms?

High blood pressure doesn't usually cause symptoms. Most people don't know they have it until they go to the doctor for some other reason.

Very high blood pressure can cause headaches, vision problems, nausea, and vomiting.

These symptoms can also be caused by dangerously high blood pressure called malignant high blood pressure. It may also be called a hypertensive crisis or hypertensive emergency. Malignant high blood pressure is a medical emergency.

Most people find out that they have high blood pressure during a routine doctor visit. For your doctor to confirm that you have high blood pressure, your blood pressure must be at least 140/90 on three or more separate occasions. It is usually measured 1 to 2 weeks apart.

How is high blood pressure diagnosed?

YOU MAY Have to check your blood pressure at home if there is reason to think the readings in the doctor's office aren't accurate. You may have what is called white-coat hypertension, which is blood pressure that goes up just because you're at the doctor's office.

How is it treated?

Treatment depends on how high your blood pressure is, whether you have other health problems such as diabetes, and whether any organs have already been damaged. Your doctor will also consider how likely you are to develop other diseases, especially heart disease.

You can help lower your blood pressure by making healthy changes in your lifestyle. If those lifestyle changes don't work well enough, you may also need to take pills. Either way, you will need to control your high blood pressure throughout your life.

Most people take more than one pill for high blood pressure. Work with your doctor to find the right pill or combination of pills that will cause the fewest side effects.

What can you do to prevent high blood pressure?

Making lifestyle changes can help you to prevent high blood pressure.

You can:

· Stay at a healthy weight or lose extra weight.

· Eat heart-healthy foods.

· Eat less salt and salty foods.

· Exercise regularly.

· Cut back on drinking. Limit alcohol to 2 drinks a day for men and 1 drink a day for women.

· hypertension.

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

7 Things Doctors May Not Tell You About Healthy Blood Pressure

Taking readings in only one arm might not tell the whole story

Your doc likely checks to see if you have healthy blood pressure in one arm, but a Framingham Heart Study suggests that taking readings in both arms may help better identify patients at higher risk of heart disease. When researchers analyzed data on nearly 3,400 patients over 13 years, they found that about 10 percent of participants showed higher systolic readings (the upper number) in one arm. Those with arm-to-arm discrepancies of ten points or more were 38 percent more likely to have a heart attack, stroke, or other coronary event. Such imbalances may indicate plaque in major arteries.

Your BP might be lower than you think

The top blood pressure number (systolic pressure) averages seven points lower when a nurse measures it instead of a doctor, according to a University of Exeter study, reported byGood Housekeeping. Ask your doctor about this phenomenon—called white coat hypertension—before starting or tweaking a prescription.

Home monitors may be inaccurate

Blood pressure readings may be significantly different from those taken in the doctor’s office in up to 15 percent of patients, according to new research presented at an annual meeting of the American Society of Nephrology. If your doc recommends you check your BP at home, it’s a good idea to bring your monitor in to your doctor’s office to make sure the device is validated.

Gaining just a little weight can jack up your numbers

People who gained just 5 percent of their body weight (that’s 7.5 pounds for a 150-pound person) over an eight-week period saw a small but measurable uptick in their blood pressure—an average of 4 mm Hg for their systolic reading, according to a recent Mayo Clinic study. People who gained weight specifically in their belly had even higher increase

Exercise can keep your arteries young—really young

A recent study of nearly 14,000 men found that those who were sedentary developed early signs of high blood pressure in their mid-40s, while those who were fit didn’t start developing high blood pressure for another decade. While researchers can’t say exercise is the only factor responsible, there are many ways cardio exercise can strengthen your ticker. It helps the heart pump blood more efficiently and helps eliminate sodium from the body, which contributes to high blood pressure.

Probiotics may help nudge your BP down

An Australian review of nine studies on these good-for-your-gut bacteria found that people who took probiotic supplements lowered their systolic blood pressure (top number) by an average 3.56 mm Hg and diastolic blood pressure (bottom number) by an average 2.38 mm Hg, compared to those who didn't take them. The effects were only seen in people who took the supplements for eight weeks or longer. Those with more than one kind of bacterial strain lowered BP more than supplements with only one kind of bacteria. "Probiotics might help lower blood pressure by having other positive effects on health, including improving total cholesterol and low-density lipoprotein, or LDL, cholesterol; reducing blood glucose and insulin resistance; and by helping to regulate the hormone system that regulates blood pressure and fluid balance," lead study author Jing Sun, PhD, said in a press release.

Seeing your doc more often can help keep your numbers in check

Patients who saw their doctor at least twice a year were more than three times more likely to keep their blood pressure under control than those who visited only once or less often, according to a new study of 37,000 people published in the journalCirculation. After the researchers controlled for such variables as diabetes, health insurance, body mass index, and smoking, they found that doctor visits were the strongest predictor of blood pressure control.

By Lauren Gelman

High Blood Pressure ( more information )

High Blood Pressure Symptoms

High blood pressure usually causes no symptoms and high blood pressure often is labeled "the silent killer." People who have high blood pressure typically don't know it until their blood pressure is measured.

Sometimes people with markedly elevated blood pressure may develop:

· headache,

· dizziness,

· blurred vision,

· nausea and vomiting, and

· chest pain and shortness of breath.

People often do not seek medical care until they have symptoms arising from the organ damage caused by chronic (ongoing, long-term) high blood pressure. The following types of organ damage are commonly seen in chronic high blood pressure:

· Heart attack

· Heart failure

· Stroke or transient ischemic attack (TIA)

· Kidney failure

· Eye damage with progressive vision loss

· Peripheral arterial disease causing leg painwith walking (claudication)

· Outpouchings of the aorta, called aneurysms

About 1% of people with high blood pressure do not seek medical care until the high blood pressure is very severe, a condition known as malignant hypertension.

· In malignant hypertension, the diastolic blood pressure (the lower number) often exceeds 140 mm Hg.

· Malignant hypertension may be associated with headache, lightheadedness, nausea, vomiting, and stroke like symptoms

· Malignant hypertension requires emergency intervention and lowering of blood pressure to prevent brain hemorrhage or stroke.

It is of utmost importance to realize that high blood pressure can be unrecognized for years, causing no symptoms but causing progressive damage to the heart, other organs, and blood vessels.

High Blood Pressure Diagnosis

Blood pressure is measured with a blood pressure cuff (sphygmomanometer). This may be done using a stethoscope and a cuff and gauge or by an automatic machine. It is a routine part of the physical examination and one of the vital signs often recorded for a patient visit. Other vital signs include pulse rate, respiratory rate (breathing rate), temperature, and weight.

When discussing blood pressure issues, the health care practitioner may ask questions about past medical history, family history, and medication use, including prescriptions, over-the-counter medications, herbal remedies, and food additives. Other questions may include lifestyle habits, including activity levels,smoking, alcohol consumption, and illegal drug use.

Physical examination may include listening to the heart and lungs, feeling for pulse in the wrist and ankles, and feeling and listening to the abdomen looking for signs of an enlarged aorta. Eye examination with an ophthalmoscope may be helpful by looking at the small blood vessels on the retina in the back of the eyeball.

· Normal Blood Pressure

o Systolic less than 120 mm Hg; diastolic less than 80 mm Hg

· Prehypertension

o Systolic 120-139 or diastolic 80-89 mm Hg

· High Blood Pressure

o Stage 1: Systolic 140-159; diastolic 90-99 mm Hg

o Stage 2: Systolic more than 160; diastolic more than 100 mm Hg

Blood tests may be considered to assess risk factors for heart disease and stroke as well as looking for complications of hypertension. These include complete blood count (CBC), electrolytes, BUN (blood urea nitrogen), and creatinine and GFR (glomerular filtration rate) to measure kidney function. A fasting lipid profile will measure cholesterol and triglyceride levels in the blood. If appropriate, blood tests may be considered to look for an underlying cause of high blood pressure including abnormal thyroid or adrenal gland function.

Ultrasound of the kidneys, CT scan of the abdomen, or both may be done to assess damage or enlargement of the kidneys and adrenal glands.

Other studies may be considered depending upon the individual patient's needs

· Electrocardiogram (ECG) may help evaluate heart rate and rhythm. It is a screening test to help assess heart muscle thickness. If hypertension is long-standing, the heart muscle has to hypertrophy, or get larger, to push blood against the increased pressure within the arteries of the body.

· Echocardiogram is an ultrasound examination of the heart It is used to evaluate the anatomy and the function of the heart. A cardiologist is required to interpret this test and can evaluate the heart muscle and determine how thick it is, whether it moves appropriately, and how efficiently it can push blood out to the rest of the body. The echocardiogram can also assess heart valves, looking for narrowing (stenosis) and leaking (insufficiency or regurgitation). A chest X-ray may be used as a screening test to look for heart size, the shape of the aorta, and to assess the lungs.

· Doppler ultrasound is used to check blood flow through arteries at pulse points in your arms, legs, hands, and feet. This is an accurate way to detectperipheral vascular disease, which can be associated with high blood pressure. It also can measure blood flow in the arteries to both kidneys and sometimes depicts narrowings that can lead to high blood pressure in a minority of patients.

High Blood Pressure Treatment

Blood pressure control is a lifelong challenge. Hypertension can progress through the years, and treatments that worked earlier in life may need to be adjusted over time. Blood pressure control may involve a stepwise approach beginning with diet, weight loss, and lifestyle changes and eventually adding medications as required. In some situations, medications may be recommended immediately. As with many diseases, the health care practitioner and patient work together as a team to find the treatment plan that will work for that specific individual.

Medical Treatment

In about half of people with high blood pressure, limiting sodium intake by eliminating table salt, cooking salt, and salty and processed foods can reduce blood pressure by 5 mm Hg. Losing weight and participating in regular physical activity can reduce blood pressure further.

If these lifestyle changes and choices don't work, medications should be added. The medications have been proven to reduce the risk of stroke, heart disease, and kidney problems. Do not stop taking your medications High Blood Pressure Medications

It may take trial and error to find the proper medication or combination of medications that will help control hypertension in each case. It is important to take the medications as prescribed and only discontinue them on the advice of your health care practitioner.

Water Pills (diuretics)

· Diuretics are used very widely to control mildly high blood pressure, and are often used in combination with other medications.

· They increase sodium excretion and urine output and decrease blood volume. The sensitivity to the effect of other hormones in your body is decreased.

· One example of a diuretic ishydrochlorothiazide (HydroDIURIL)

· The most commonly used diuretics to treat hypertension include:

o hydrochlorothiazide (HydroDIURIL),

o the loop diuretics furosemide (Lasix) and torsemide (Demadex),

o the combination of triamterene and hydrochlorothiazide (Dyazide), and

o metolazone (Zaroxolyn).

Beta-Blockers

· Beta-blockers reduce heart rate and decrease the force of heart contraction by blocking the action of adrenaline receptors. Beta blockers are widely prescribed and effective but can cause increased fatigue and decreased exercise tolerance because they prevent an increased heart rate as a normal response to physical activity.

· They are also prescribed for people who have associated heart disease,angina, or history of a heart attack.

· Examples of beta blockers include, carvedilol (Coreg), metoprolol (Lopressor),atenolol (Tenormin)

Calcium Channel Blockers (CCBs)

· Calcium channel blocking agents work by relaxing the muscle in artery walls and by therefore reducing the force of contraction of heart muscle.

· Example of calcium channel blockers include,nifedipine (Procardia), diltiazem(Cardizem), verapamil (Isoptin, Calan), nicardipine (Cardene), amlodipine(Norvasc), and felodipine (Plendil)

Angiotensin-Converting Enzyme (ACE) Inhibitors

· ACE inhibitors stop the production in the body of a chemical called angiotensin II, which causes blood vessels to contract. Narrower blood vessels are associated with increased blood pressure. Relaxing artery walls leads to lower blood pressure.

· Examples of ACE inhibitors include Captopril (Capoten), enalapril (Vasotec),lisinopril (Zestril, Prinivil), quinapril (Accupril), and fosinopril (Monopril)

Angiotensin Receptor Blockers (ARBs)

· ARBs work block angiotensin II receptors and prevent vasoconstriction, or narrowing of blood vessels.

· Examples of ARBs include losartan (Cozaar), valsartan (Diovan), candesartan(Atacand), and irbesartan (Avapro)

Blockers of Central Sympathetic (autonomic nervous) System

· These agents block messages from the brain's autonomic nervous system that contract blood vessels. The autonomic nervous system is the part of the unconscious nervous system of the body that controls heart rate, breathing rate, and other basic functions.

· These medications relax blood vessels, thus lowering blood pressure.

· An example is clonidine (Catapres)

Direct Vasodilators

· Direct vasodilators relax (dilate) the blood vessels to allow blood to flow under lower pressure.

· These medications are most often used in times of hypertensive crisis and are injected intravenously to quickly lower blood pressure readings.

· Examples include nitroprusside (Nitropress), and diazoxide (Hyperstat).

Medically Reviewed by a Doctor on 5/2/2014

Other Therapy

Alternative therapies may be helpful to people trying to control their blood pressure.

· Acupuncture and biofeedback are well-accepted alternative techniques that may help some people with high blood pressure.

· Techniques that induce relaxation and reduce stress are recommended. These include meditation, yoga, and relaxation training.

· These techniques alone may not control high blood pressure for many people. They should not be used as a substitute for medical therapy without first consulting with your health care practitioner.

Dietary supplements and alternative medications and therapies are sometimes recommended for high blood pressure.

· Examples include vitamins, garlic, fish oil, L-arginine, soy, coenzyme Q10, herbs, phytosterols, and chelation therapy.

· While these substances may be beneficial, the exact nature of their benefits is not known.

Scientific studies have produced no evidence that these therapies lower blood pressure or prevent the complications of high blood prFollow-up

The most important element in the management of high blood pressure is follow-up care.

· Routine blood pressure check-ups are important to monitor readings and decide upon a treatment plan.

· With age and the natural progression of hardening of the arteries, systolic blood pressure may elevate over time. A treatment that once worked well may no longer work as well and your medication treatment may need to be changed.

· Routine physical exams and screening blood tests may be suggested to help monitor the success of blood pressure management.

· Follow-up visits are a good time to discuss with your health care practitioner any medication side effects you are experiencing. He or she will have suggestions for managing side effects or may change your treatment.

· Follow-up visits are a great opportunity for monitoring for other associated risk factors, such as high cholesterol, smoking cessation, and obesity.

Medically Reviewed by a Doctor on 5/2/2014

When to Seek Medical Care

Many symptoms present gradually after years of poorly blood pressure control. Many times, the first knowledge of hypertension occurs when a patient complains of chest pain or has stroke-like symptoms. Should these occur, it is appropriate to call 911 immediately (if available) to activate emergency medical services and seek care.

You may be directed to seek medical care if blood pressure readings are elevated if done as part of a community health screening. Isolated elevated blood pressure readings do not necessarily make the diagnosis of hypertension. Blood pressure readings vary throughout the day, and your primary care provider may record a different reading than the one that was measured in a screening that sent you in for care.

There are non-specific symptoms associated with hypertension that may cause a person to seek care, including lightheadedness, dizziness, headache with or without nausea, change in vision, or lethargy and fatigue. There are many other reasons to develop these symptoms other than high blood pressure.

Self-Care at Home

The management and control of high blood pressure involves two major options, lifestyle modification and medication.

Lifestyle Modifications to Manage High Blood Pressure

Weight Control

· Aim for a healthy weight range for your height and body type. Your health care practitioner can help you calculate a healthy target weight.

· Even a small amount of weight loss can make a major difference in lowering or preventing high blood pressure.

· You must burn more calories than you take in to lose weight.

· Crash or fad diets are not helpful and may be dangerous.

· Some weight loss medications also carry major risks and may even elevate blood pressure, and great caution is advised in using these drugs. Please ask your health care practitioner or pharmacist for help in deciding if a weight loss medication is appropriate for your situation.

Exercise or Increase Physical Activity

· Physical activity reduces total cholesterol and bad cholesterol (low density lipoprotein or LDL) and raises the good cholesterol (high density lipoprotein or HDL).

· Both the American Heart Association (AHA) and the U.S. Surgeon General recommend 30 minutes of physical activity on most days of the week.

· Physical activity includes many daily activities such as cleaning the house, raking the lawn, and walking. Other possible sources of activity can include using the stairs instead of an elevator or escalator, walking for errands instead of driving a car, and participating in a sport or social activity such dancing.

Medically Reviewed by a Doctor on 5/2/2014

Benjamin Wedro, MD, FACEP, FAAEM

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor