TO DAY IS WORLD HIGH BLOOD PRESSURE DAY . SOME INFORMATION OF HIGH BLOOD PRESSURE ' ( source Internate )
High
Blood Pressure
·
Overview
o Causes
o Symptoms
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Blood
pressure is a measurement of the force against the walls of your arteries as
your heart pumps blood through your body. Hypertension is another term used to
describe high blood pressure.
Blood
pressure readings are given as two numbers. The top number is called the
systolic blood pressure. The bottom number is called the diastolic blood
pressure. For example, 120 over 80 (written as 120/80 mmHg).
One or
both of these numbers can be too high.
·
Normal blood pressure is when your blood pressure is lower than
120/80 mmHg most of the time.
·
High blood pressure (hypertension) is when your blood pressure
is 140/90 mmHg or above most of the time.
·
If your blood pressure numbers are 120/80 or higher, but below
140/90, it is called pre-hypertension.
If you
have heart or kidney problems, or you had a stroke, your doctor may want your
blood pressure to be even lower than that of people who do not have these
conditions.
Times Essentials
Recent findings and perspectives on medical
research.
REPORTER'S
FILE
By ERIC SABO
One
high blood pressure drug or two? How about none at all?
·
EXPERT
Q & A
·
QUESTIONS
FOR YOUR DOCTOR
·
CLINICAL
TRIALS
See All »NEWS
& FEATURES
REFERENCE
FROM A.D.A.M.
Back to TopAlternative Names
Hypertension;
HBP
Many factors can affect
blood pressure, including:
·
The amount of water and salt you have in your body
·
The condition of your kidneys, nervous system, or blood vessels
·
Your hormone levels
You are more likely to be
told your blood pressure is too high as you get older. This is because your
blood vessels become stiffer as you age. When that happens, your blood pressure
goes up. High blood pressure increases your chance of having a stroke, heart
attack, heart failure, kidney disease, or early death.
You have a higher risk of
high blood pressure if:
·
You are African American
·
You are obese
·
You are often stressed or anxious
·
You drink too much alcohol (more than 1 drink per day for women
and more than 2 drinks per day for men)
·
You eat too much salt
·
You have a family history of high blood pressure
·
You have diabetes
·
You smoke
Most of the time, no
cause of high blood pressure is found. This is called essential hypertension.
High blood pressure that
is caused by another medical condition or medicine you are taking is called
secondary hypertension. Secondary hypertension may be due to:
·
Disorders of the adrenal gland (such as pheochromocytoma or Cushing syndrome)
·
Pregnancy or preeclampsia
·
Medications such as birth control pills, diet pills, some cold
medicines, and migraine medicines
·
Narrowed artery that supplies blood to the kidney (renal artery stenosis)
What is
blood pressure?The correct answer is a measurement of the force against the
walls of your arteries as your heart pumps blood through your body. Your blood
pressure is reported as two numbers: systolic over diastolic blood pressure. If
either number is too high, there will be extra stress on your heart and blood
vessels. A common sign of high blood pressure is:The correct answer is none of
the above. In most people, high blood pressure does not cause any symptoms.
This means you may only find out about the problem when your doctor or nurse
checks your blood pressure. Ask your doctor how to prevent high blood
pressure.When blood pressure stays high, it can lead to:The correct answer is
all of the above. Diagnosing high blood pressure early can help prevent these
health problems. Get your blood pressure checked every two years if it was
normal at your last reading and at least once a year if it was 120/80 or above.
If you have high blood pressure, your doctor may ask you to check it at home.
High blood pressure can cause the heart muscle to thicken.The correct answer is
true. As the heart muscle works harder, it can become so thick that it doesn't
get enough oxygen. This can cause chest pain and may lead to heart failure.
Heart failure occurs when the heart can't pump enough blood to the rest of your
body. Talk with your doctor about how to lower high blood pressure.High blood
pressure can make the blood vessels wider.The correct answer is false. High
blood pressure causes blood vessel walls to get thicker. Over time, fat and
cholesterol can also build up on vessel walls. These two problems together
cause blood vessels to become narrow, so blood can't flow as freely. Reduced
blood flow can increase the risk of heart attack and stroke.Which is a sign of
decreased blood flow?The correct answer is all of the above. High blood
pressure can raise your risk of peripheral artery disease (PAD). This is the
narrowing of the vessels that carry blood to the legs and feet. PAD occurs most
often in men over age 50. See your doctor if you have high blood pressure and
notice any discomfort in your legs or feet.Which of the following are risk
factors for stroke? The correct answer is all of the above. High blood pressure
is the number one risk factor. A stroke occurs when a blood vessel that
supplies the brain bursts or gets blocked by a blood clot. The symptoms depend
on which part of the brain is affected. Ask your doctor to explain warning
signs of stroke.Which is NOT a common warning sign of stroke?The correct answer
is chest pain. If you notice any signs of stroke listed above, call 9-1-1
immediately. Prompt treatment can save your life. If the stroke is caused by a
blood clot, a clot-busting drug may be given to dissolve the clot. For this
drug to work, you must be treated 3 to 4 1/2 hours after symptoms first
started.If high blood pressure affects your eyes, you might develop:The correct
answer is all of the above. High blood pressure can damage blood vessels in the
retina, the part of the eye that changes images into signals the brain can
read. You may not have symptoms at first. Tell your doctor right away if you
notice any changes in vision.Symptoms of kidney disease appear immediately.The
correct answer is false. Your kidneys remove wastes and excess water from your
body. High blood pressure damages the kidneys, making it harder for them to
function. Kidney disease often has no symptoms until a lot of damage has
occurred. Controlling high blood pressure can protect your kidneys.In-Depth Causes »
Most of the time, there
are no symptoms. For most patients, high blood pressure is found when they
visit their health care provider or have it checked elsewhere.
Because there are no
symptoms, people can develop heart disease and kidney problems without knowing
they have high blood pressure.
Malignant hypertension is a dangerous form of very high blood pressure. Symptoms
include:
·
Severe headache
·
Nausea or vomiting
·
Confusion
·
Vision changes
·
Nosebleeds
The goal of treatment is
to reduce your blood pressure so that you have a lower risk of complications.
You and your health care provider should set a blood pressure goal
for you.
If you have
pre-hypertension, your health care provider will recommend lifestyle changes to
bring your blood pressure down to a normal range. Medicines are rarely used for
pre-hypertension.
You can do many things to
help control your blood pressure at home, including:
·
Eat a heart-healthy diet, including potassium and fiber.
·
Drink plenty of water.
·
Exercise regularly for at least 30 minutes of aerobic exercise a
day.
·
If you smoke, quit.
·
Limit how much alcohol you drink to 1 drink a day for women, and
2 a day for men.
·
Limit the amount of sodium (salt) you eat -- aim for less than
1,500 mg per day.
·
Reduce stress. Try to avoid things that cause you stress, and
try meditation or yoga to de-stress.
·
Stay at a healthy body weight.
Your health care
provider can help you find programs for losing weight, stopping smoking,
and exercising.
You can also get a
referral from your health care provider to a dietitian, who can help
you plan a diet that is healthy for you.
How low your blood
pressure should be and at what level you need to start treatment is
individualized, based on your age and any medical problems you have.
There are many different
medicines to treat high blood pressure.
·
Often, a single blood pressure drug may not be enough to control
your blood pressure, and you may need to take two or more drugs.
·
It is very important that you take the medicines prescribed to
you.
·
If you have side effects, your doctor can substitute a different
medicine.
Back to TopPrevention
Most people can prevent
high blood pressure from occurring by following lifestyle changes designed to
bring blood pressure down.
Back to TopReferences
American Diabetes
Association. Standards of medical care in diabetes -- 2014. Diabetes Care . 2014;37 Suppl
1:S14-S80.
Goldstein LB, Bushnell
CD, Adams RJ, et al. Guidelines for the primary prevention of stroke: a
guideline for healthcare professionals from the American Heart Association/American
Stroke Association. Stroke . 2011
Feb;42:517-584.
Handler J, et al. 2014
evidence-based guideline for the management of high blood pressure in adults:
report from the panel members appointed to the Eighth Joint National Committee
(JNC 8). JAMA . 2014
Feb 5;311(5):507-520.
James PA, Oparil S,
Carter BL, et al. 2014 Evidence-Based Guideline for the Management of High
Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth
Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520.
Kaplan NM. Systemic
hypertension: Treatment. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular
Medicine . 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 46.
Peterson ED, Gaziano JM,
Greenland P. Recommendations for treating hypertension: what are the right
goals and purposes? JAMA . 2014
Feb 5;311(5):474-476.
Victor, RG. Systemic
hypertension: Mechanisms and diagnosis. In: Bonow RO, Mann DL, Zipes DP, Libby
P, eds. Braunwald's
Heart Disease: A Textbook of Cardiovascular Medicine . 9th
ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 45.
Weber MA, Schiffrin EL,
White WB, Mann S, Lindholm LH, Kenerson JG, et al. Clinical practice guidelines
for the management of hypertension in the community:a statement by the American
Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich) . 2014
Jan;16(1):14-26. Epub 2013 Dec 17.
Wright JT Jr, Fine LJ,
Lackland DT, Ogedegbe G, Dennison Himmelfarb CR. Evidence supporting a systolic
blood pressure goal of less than 150 mm hg in patients aged 60 years or older:
the minority view. Ann Intern Med . 2014
Apr 1;160(7):499-503.
Treatments for high
blood pressure (hypertension)
·
Simple lifestyle
changes can often help reduce high blood pressure (hypertension), although some
people may need to take medication as well.
Your GP can advise you
about changes you can make to your lifestyle and discuss whether they think you
would benefit from medication.
This page covers:
When treatment is recommended
Everyone with high
blood pressure is advised to make the healthy lifestyle changes outlined below.
Whether medication is
recommended depends on your blood pressure reading and your risk of developing
problems such as heart attacks or strokes.
Your doctor will
carry out some blood and urine tests, and ask questions about your health
to determine your risk of other problems:
- if your blood pressure is
consistently above 140/90mmHg (or 135/85mmHg at home) but your risk of
other problems is low –
you'll be advised to make some changes to your lifestyle
- if your blood pressure is
consistently above 140/90mmHg (or 135/85mmHg at home) and your risk
of other problems is high –
you'll be offered medication to lower your blood pressure, in addition to
lifestyle changes
- if your blood pressure
is consistently above 160/100mmHg – you'll be offered medication to lower your blood
pressure, in addition to lifestyle changes
The various treatments
for high blood pressure are outlined below. You can also read a summary of the pros and cons of the treatments for high
blood pressure, allowing you to compare your treatment options.
Lifestyle changes
Below are some changes
you could make to your lifestyle to reduce high blood pressure. Some of these
will lower your blood pressure in a matter of weeks, while others may take
longer.
These include:
- cutting your salt intake to
less than 6g (0.2oz) a day –
find out how you can reduce the amount of salt in your diet
- eating a low-fat, balanced
diet – including plenty of fresh
fruit and vegetables; get tips on eating more healthily
- being active – read some tips about getting more exercise
- cutting down on alcohol – get tips on cutting down, including downloading a
drinks diary and keeping track of your drinking
- losing weight – find out what your ideal weight is using the BMI healthy weight calculator and
read advice about losing weight if you're overweight
- drinking less caffeine – found in coffee, tea and cola
- stopping smoking – get help quitting
- getting at least six
hours of sleep a night if you can – read some tips for getting to sleep
You can take these
steps today, regardless of whether or not you're taking blood pressure
medication. In fact, by making these changes early on you may be able to avoid
needing medication.
Read more advice about lifestyle changes to prevent and reduce high blood
pressure.
Medication for high blood pressure
Several medications
can be used to help control high blood pressure. Many people need to take a
combination of different medicines.
The medication
recommended for you at first will depend on your age and ethnicity:
- if you're under 55 years
of age – you'll usually be
offered an ACE inhibitor or an angiotensin-2 receptor blocker (ARB)
- if you're aged 55 or older, or
you're any age and of African or Caribbean origin – you'll usually be offered a calcium channel
blocker
You may need to take
blood pressure medication for the rest of your life. But your doctor might
be able to reduce or stop your treatment if your blood pressure stays under control
for several years.
It's really
important to take your medications as directed. If you miss doses, it
won't work as effectively. The medication won't necessarily make you feel any
different, but this doesn't mean it's not working.
Medications used to treat
high blood pressure can have side effects, but most people don't experience
any. If you do, changing medication will often help.
Common blood pressure
medications are described below.
ACE inhibitors
Angiotensin-converting
enzyme (ACE) inhibitors reduce blood pressure by relaxing your blood vessels.
Common
examples are enalapril, lisinopril, perindopril and ramipril.
The most common side
effect is a persistent dry cough. Other possible side effects include headaches, dizziness and a rash.
Find out more
about ACE inhibitors.
Angiotensin-2 receptor blockers (ARBs)
ARBs work in a similar
way to ACE inhibitors. They're often recommended if ACE inhibitors cause
troublesome side effects.
Common examples are
candesartan, irbesartan, losartan, valsartan and olmesartan.
Find out more
about ARBs.
Calcium channel blockers
Calcium channel
blockers reduce blood pressure by widening your blood vessels.
Common examples are
amlodipine, felodipine and nifedipine. Other medicines such as diltiazem and
verapamil are also available.
Possible side effects
include headaches, swollen ankles and constipation.
Drinking grapefruit juice while taking
some calcium channel blockers can increase your risk of side effects.
Find out more
about calcium channel blockers.
Diuretics
Sometimes known as
water pills, diuretics work by flushing excess water and salt from the body
through urine. They're often used if calcium channel blockers cause
troublesome side effects.
Common examples are
indapamide and bendroflumethiazide.
Possible side effects
include dizziness when standing up, increased thirst, needing to go to the toilet
frequently, and a rash.
Low potassium level
(hypokalaemia) and low sodium level (hyponatraemia) may also be seen after
long-term use.
Find out more
about thiazide diuretics.
Beta-blockers
Beta-blockers can
reduce blood pressure by making your heart beat more slowly and with less
force.
They used to be a
popular treatment for high blood pressure, but now only tend to be used when
other treatments haven't worked.
This is because
beta-blockers are considered less effective than other blood pressure
medications.
Common
examples are atenolol and bisoprolol.
Possible side effects
include dizziness, headaches, tiredness, and cold hands and feet.
Find out more about beta-blockers.
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