High blood pressure is also known as hypertension. Blood pressure is the amount of force exerted against the walls of the arteries as blood flows through them.

1. WHAT IS HIGH BLOOD PRESSURE?
Overview
Highbloodpressure isalsoknownashypertension.Bloodpressureisthe amountof force exerted
againstthe wallsof the arteriesas bloodflowsthroughthem.
If a personhashighbloodpressure itmeansthatthe wallsof the arteriesare receivingtoomuch
pressure repeatedly –the pressure needstobe chronicallyelevatedforadiagnosisof hypertensiontobe
confirmed.Inmedicine,chronicmeansforasustainedperiod;persistent.
In the UnitedStates,approximately85millionpeoplehave highbloodpressure –about1 inevery3
adultsover20, accordingto the AmericanHeartAssociation.The National Institutesof Health(NIH)
estimate thatabouttwo-thirdsof peopleoverthe age of 65 inthe U.S. have highbloodpressure.
If leftuntreatedoruncontrolled,highbloodpressurecancause manyhealthproblems.These conditions
include heartfailure,visionloss,stroke,andkidneydisease.
Bloodpressure isthe amountof force your bloodexertsagainstthe wallsof yourarteries.Normal blood
pressure effectivelyandharmlesslypushesthe bloodfromyourhearttoyour body’sorgansand muscles
so theycan receive the oxygenandnutrientstheyneed.
Bloodpressure isvariable—itrisesandfallsduringthe day.Whenbloodpressure stayselevatedover
time,however,itiscalledhighbloodpressure orhypertension.Accordingtothe AmericanHeart
Association,76.4millionAmericanshave highbloodpressure.Highblood pressure wasaprimary
contributingcause of deathfor326,000 Americansin2006.
Hypertensioncanoccurin bothchildrenandadults,butitis more commoninadults,particularlyAfrican
Americansandthe elderly.Peoplewithotherconditionssuchasdiabetesandkidneydisease are likely
to become hypertensive.Inaddition,beingoverweight,drinkingalcohol excessively(definedasmore
than twodrinksa day formen andone drinka dayfor women) andtakingoral contraceptivesmay
increase bloodpressure.
Abouthalf of Americanswithhighbloodpressure are women.More menthanwomenhave
hypertension,untilwomenreachmenopause,whentheirriskbecomesgreaterthanmen’s.About30
percentof womenhave highbloodpressure.
Bloodpressure istypicallyexpressedastwonumbers,one overthe other,andismeasuredin
millimetersof mercury(notedasmmHg). The firstnumberisthe systolicbloodpressure,the pressure
usedwhenthe heartbeats.The secondnumber,diastolicbloodpressure,isthe pressure thatexistsin
the arteriesbetweenheartbeats.
Dependingonyouractivities,yourbloodpressuremayincrease ordecrease throughoutthe day.If you
are notacutelyill,are over18 yearsof age and are not takingantihypertensivedrugs,abloodpressure

2. readingof 119 mmHg or belowsystolicand/or79 mm Hg or below diastolic(119/79) is considered
normal.
If your systolicbloodpressure is120 to 139 mm Hg systolicand/oryourdiastolicpressure is80 to 89
mm Hg, youhave prehypertension.Thismeansthatyoudon’thave highbloodpressure now butare
more likelytodevelopitinthe future,andyouhave increasedriskfactorsforcardiovasculardisease and
otherconditionsrelatedtohypertension.
A blood pressure level of140/90 mm Hg or higheris consideredhigh.
You have stage 1 hypertensionif yoursystolicpressure is140 to 159 and/ordiastolicisbetween90and
99. If your systolicpressure is160 or above and/oryour diastolicis100 or more,youhave stage 2
hypertension.Onlyone of the numbersneedstobe above normal fora diagnosisof highblood
pressure;thatis,youcan have isolatedsystolicordiastolichypertension.Isolatedsystolichypertension
(ISH) isthe most commonformof highbloodpressure inolderAmericans.The National Heart,Lung,and
BloodInstitute (NHLBI) estimatesthat65 percentof people withhypertensionoverage 60 have ISH.
The cause of approximately90percentto95 percentof all hypertensionisn’tknown.Thistype of
hypertensioniscalledprimaryoressential highbloodpressure.Secondaryhypertensionissomewhat
differentbecause itrepresentsall of the specificdiseasesthatcause elevatedbloodpressure.Itis
importantto diagnose thistype of hypertensionbecausethe treatmentdiffersfromprimary
hypertension. While there isnocure forprimaryhypertension,itiseasilydetectedandisusually
controllable.
Still,nearlyone-thirdof those whosufferfromhighbloodpressuredon’tknow theyhave it,andpeople
can have highbloodpressure foryearswithoutknowingtheyhave it.That’swhyhighbloodpressure
has beencalled“the silentkiller.”
Of those withhypertension,onlyabout30percenthave the problemundercontrol,definedasalevel
below140/90 mm Hg. Leftuntreated,hypertensioncanresultinpermanentdamage tothe small blood
vesselsof the body,whichcandamage organssuch as the heart,brain andkidneys,leadingtoheart
attacks,stroke and kidneyfailure.Itcanalso cause acute or chronic circulatoryproblems.
Elevatedbloodpressurelevelssignificantlyincrease yourriskforcoronaryheartdisease,includingheart
attack and stroke.Consistenthighbloodpressurealsoincreasesyourriskforcongestive heartfailure
and can leadto otherproblemssuchas:
Atherosclerosis:Plaque collectsonthe wallsof hypertension-damagedbloodvessels,whichcan
eventuallyleadtoblockagesthatmayresultina stroke or heartattack. Althoughthisplaque buildsup
for manyreasonsas youage,highbloodpressure hastensthe process.
Eye damage:High pressure inbloodvesselscancause tinyhemorrhagesintheretina,the light-sensitive
membrane inthe backof your eye onwhichimagesare formed.If thishappens,youmaylose some of
your vision.

3. Heart enlargementorfailure:There are twotypesof heartfailure.Inthe first,the wallsof the heartare
weakand thinas a resultof beingstretchedbyincreasingamountsof poolingbloodinthe heart.Inthe
second,commonlyseeninpeople withhypertension,the heartmuscle enlargesinresponsetothe
higherpressure andincreasedworkload.Itbecomessobigitbeginstoclose off the ventricularchamber,
decreasingthe amountof bloodthatcan fill the heart.Thisiscalleddiastolicdysfunction,because the
heartmuscle can’t relax normallyandallow bloodto fill the chamber.
Kidneydamage andfailure:Hypertensioncausesarteriesgoingtoyourkidneystobecome constricted,
makingthemlessefficientatfilteringwaste fromyourbody.Each year,highbloodpressure causesmore
than 25,000 newcasesof kidney failure inthe UnitedStates.AfricanAmericansare particularlyatrisk.
Early treatmentof hypertensioncanhelppreventkidneydamage.
You shouldhave yourbloodpressure checkedwheneveryousee ahealthcare professional.Because
bloodpressure canbe variable,itshouldbe checkedonseveral daysbeforeahighbloodpressure
diagnosisismade.One elevatedbloodpressurereadingdoesn’tnecessarilymeanyouhave highblood
pressure,butitdoeswarrantrepeatedmeasurementsandmeansyouhave towatch your blood
pressure carefully.
Dietaryandlifestylechangesmayhelpyoucontrol highbloodpressure.If youhave mildhypertension,
youmay be able to loweryourbloodpressure byreducingthe amountof sodium(salt) inyourdiet,
reducingfatintake, eatingadiethighinfruits,vegetablesandlow-fatdairy(suchasthe DASH diet) and
reducingalcohol consumption.If youare overweight,losingweightmayreduce yourbloodpressure.
Increasingyourphysical activity,evenif youdon’tlose weight,can alsoreduce bloodpressure.
For some people,lifestyle changesaren’tenoughtolowerbloodpressure.Luckily,highbloodpressure
can be successfullytreatedwithlong-termmedication.
Commonlyprescribeddrugsinclude diuretics,betablockers, angiotensin-convertingenzyme inhibitors
(ACEinhibitors),angiotensinIIreceptorblockers(ARBs),directrenininhibitors(DRIs),calciumchannel
blockers(CCBs),vasodilators,alpha-betablockers,central-actingagentsandalphablockers.Because
there isno cure for most hypertensioncases,treatmentgenerallymustbe carriedoutforlife toprevent
bloodpressure fromrisingagain.
Many of these drugsare also available totreatisolatedsystolichypertension(ISH) toreduce yourriskof
coronary heartdisease andstroke.

4. What is highblood pressure?
The heart isa muscle thatpumpsbloodaroundthe bodyconstantly – duringeverysecondof ourlives.
Highbloodpressure isconsideredtobe 140/90 mmHg or higher.
Bloodthat has lowoxygenlevelsispumpedtowardsthe lungs,where oxygensuppliesare replenished.
The oxygenrichbloodisthenpumpedbythe heart aroundthe bodyto supplyourmusclesandcells.
The pumpingof bloodcreatespressure –bloodpressure.
Anyone whose bloodpressure is140/90 mmHg or more fora sustainedperiodissaidtohave highblood
pressure,orhypertension.
Bloodpressure isusuallydividedintofivecategories:
Hypotension(lowblood pressure)
SystolicmmHg90 or less,or
DiastolicmmHg60 or less
Normal
SystolicmmHg90-119, and
DiastolicmmHg60-79
Prehypertension
SystolicmmHg120-139, or
DiastolicmmHg80-89
Stage 1 Hypertension
SystolicmmHg140-159, or
DiastolicmmHg90-99
Stage 2 Hypertension
SystolicmmHgover160, or
DiastolicmmHgover100
Causesof Hypertension

5. The 90 percentto95 percentof hypertensioncasesinwhichthe cause can’tbe determinedare called
essential orprimaryhypertensioncases.Hypertensionmayalsobe a symptomof an identifiedproblem
(see below)thatgenerallycorrectsitself whenthe cause iscorrected.Thistype of highbloodpressure is
calledsecondaryhypertension.
 Renal arterystenosis(narrowingof the arteriesleadingtoyourkidneys)
 Adrenal glanddisease (Cushing’sdisease) oradrenal tumors
 Kidneydisease
 Preeclampsia(hypertensionandincreasedurine proteinlevelssometimescausedbypregnancy)
 Thyroiddisease
Otherfactors affectingbloodpressure include:
 Use of birthcontrol pills
 Psychologicstress
 Severe pain
 Drug or alcohol withdrawal
 Use of amphetamines,cocaineorotherstimulants
 Use of steroids
 Overuse of nicotine nasal sprays,gum, patchesandlozengesdesignedtohelpsmokerskickthe
habit
 Sleepapnea
Your healthcare professional shouldmonitoryourbloodpressure if youare takingoral contraceptives.
Your bloodpressure shouldalsobe carefullymonitoredif you’repregnant,because some women
developpreeclampsia-relatedhypertensionduringpregnancy.One of the leadingcausesof maternal
death,preeclampsiaishypertensioncombinedwithproteininthe urine and/orswollenhandsandfeet.
It typicallyoccursafterthe 20th weekof pregnancy.Itcan leadto premature andlow-birth–weight
babies.
Symptoms of highblood pressure
Most people withhighbloodpressure will notexperience anysymptomsuntil levelsreachabout
180/110 mmHg.
 Highbloodpressure symptomstypicallyinclude:
 Headache – usually,thiswill lastforseveral days.
 Nausea– a sensationof unease anddiscomfortinthe stomachwithanurge to vomit.
 Vomiting–lesscommonthanjustnausea.
 Dizziness –Lightheadedness,unsteadiness,andvertigo.
 Blurredor double vision(diplopia).
 Epistaxis –nosebleeds.
 Palpitations –disagreeable sensationsof irregularand/orforceful beatingof the heart.

6.  Dyspnea– breathlessness,shortnessof breath.
 Anybodywhoexperiencesthesesymptomsshouldseetheirdoctorimmediately.
Childrenwithhighbloodpressure mayhave the followingsignsandsymptoms:
 Headache.
 Fatigue.
 Blurredvision.
 Nosebleeds.
Bell’spalsy –inabilitytocontrol facial musclesonone side of the face.
Newbornsandveryyoungbabieswithhighbloodpressure mayexperience the followingsignsand
symptoms:
 Failure tothrive.
 Seizure.
 Irritability.
 Lethargy.
 Respiratorydistress.
People whoare diagnosedwithhighbloodpressureshould have theirbloodpressure checked
frequently.Evenif yoursisnormal,youshouldhave itcheckedatleastonce everyfive years,andmore
oftenif youhave any contributoryfactors.
Complications
If the hypertensionisnottreatedorcontrolledthe excessive pressure onthe arterywallscanleadto
damage of the bloodvessels(cardiovasculardisease),aswell asvital organs.The extentof damage
dependsontwofactors;the severityof the hypertensionandhow longitgoesonfor untreated.
Belowisa listof some of the possible complicationsof highbloodpressure:
 Stroke – bloodflowtothe brainisimpairedbyblockage orrupture of an artery to the brain,and
braincellsdie.
 Heart attack – heartmuscle diesdue toa lossof bloodsupply.
 Heart failure –the heart strugglestopumpenoughbloodtomeetthe needsof the whole body.
Thishappensbecause afterpumpingbloodagainsthigherpressure intothe bloodvesselsthe
heartmuscle thickens.
 Bloodclot– some bloodconvertsfroma liquidintoasolid (thrombus).Some bloodclotscan
cause seriouscomplications.
 Aneurysm–a bulge formsonthe wall of a vein,arteryorthe heart. The wall isweakenedand
may rupture.

7.  Kidneydisease–hypertensionoftendamagesthe small bloodvesselsinthe kidneys,resultingin
kidneysthatdonot workproperly.Eventuallythe kidneyscanfail completely(kidneyfailure).
 Eyes(hypertensiveretinopathy)–untreatedhypertensioncanleadtothickened,narrowedor
torn bloodvesselsinthe eyes,whichcanleadtovisionloss.
 Metabolicsyndrome –thisis a disorderof the body’smetabolism, includinganenlarged
waistline,lowbloodHDLlevels(the goodcholesterol),hypertension,andhighlevelsof insulin.If
the patienthashypertensionhe/sheismore likelytohave othercomponentsof metabolic
syndrome,significantlyraisingthe riskof diabetes,stroke andheartdisease.
 Cognitive andmemoryproblems –if the highbloodpressure continuesuntreatedthe patient’s
abilitytorememberthings,learnandunderstand conceptsmaybe eventuallybecome affected.
Causes
Whenreferringtothe causesof highbloodpressure,itisdividedintotwocategories:
 Essential highbloodpressure(primaryhighbloodpressure) –nocause hasbeenidentified.
 Secondaryhighbloodpressure –the highbloodpressure hasan underlyingcause,suchas
kidneydisease,oraspecificmedicationthe patientistaking.
Eventhoughthere isno identifiable cause foressential highbloodpressure,there isstrongevidence
linkingsome riskfactors tothe likelihoodof developingthe condition.Mostof the causesbelow are
essential highbloodpressureriskfactors;there are alsoa couple of secondaryhighbloodpressure
examples:
1) Age
The olderyouare the higheryourrisk of havinghighbloodpressure.
2) Familyhistory
If you have close familymemberswithhypertension,yourchancesof developingitare significantly
higher.Aninternationalscientificstudyidentifiedeightcommongeneticdifferencesthatmayincrease
the riskof highbloodpressure.
3) Temperature
A studythat monitored8,801 participantsoverthe age of 65 foundthatsystolicanddiastolicblood
pressure valuesdifferedsignificantlyacrossthe yearandaccording to the distributionof outdoor
temperature.Bloodpressure was lowerwhenitgotwarmer,androse whenitgot colder.
4) Ethnic background
Evidence indicatesthatpeople withAfricanorSouthAsianancestryhave ahigherriskof developing
hypertension,comparedtopeoplewithpredominantlyCaucasianorAmerindian(indigenousof the
Americas) ancestries.

8. 5) Obesityandoverweight
Both overweightandobese people are more likelytodevelophighbloodpressure,comparedtopeople
of normal weight.
6) Some aspectsof gender
In general,highbloodpressure ismore commonamongadultmenthanadultwomen.However,after
the age of 60 bothmenand womenare equallysusceptible.
7) Physical inactivity
Lack of exercise,aswell ashavingasedentarylifestyle,raisesthe riskof hypertension.
8) Smoking
Smokingcausesthe blood vesselstonarrow,resultinginhigherbloodpressure.Smokingalsoreduces
the blood’soxygencontentsothe hearthasto pumpfasterin orderto compensate,causingarise in
bloodpressure.
9) Alcohol intake
People whodrinkregularlyhave highersystolicbloodpressurethanpeople whodonot,accordingto
researchers.Theyfoundthatsystolicbloodpressure levelsare about7 mmHg higherinfrequent
drinkersthaninpeople whodonotdrink.
10) Highsaltintake
Researchersreportedthatsocietieswhere people don’teatmuchsalthave lowerbloodpressuresthan
placeswhere peopleeatalot of salt.
11) Highfat diet
Many healthprofessionalssaythata diethighinfatleadsto a raisedhighbloodpressure risk.However,
mostdietitiansstressthatthe problemisnothow muchfat isconsumed,butratherwhat type of fats.
Fats sourcedfromplantssuchas avocados,nuts,olive oil,andomegaoilsare goodforyou.Saturated
fats,whichare commoninanimal-sourcedfoods,aswell astransfats,are bad for you.
12) Mental stress
Variousstudieshave offeredcompellingevidence thatmental stress,especiallyoverthe longterm,can
have a seriousimpactonbloodpressure.One studysuggestedthatthe waythat air trafficcontrollers
handle stresscanaffect whethertheyare at riskof developinghighbloodpressure laterinlife.
13) Diabetes

9. People withdiabetesare at a higherriskof developinghypertension.Amongpatientswithtype 1
diabetes,highbloodsugarisariskfactor for incidenthypertension –effective andconsistentblood
sugar control,withinsulin,reducesthe long-termriskof developinghypertension.
People withtype 2diabetesare atriskof hypertensiondue tohighbloodsugar,aswell asotherfactors,
such as overweightandobesity,certainmedications,andsome cardiovasculardiseases.
14) Psoriasis
A studythat followed78,000 womenfor14 yearsfoundthathavingpsoriasiswaslinkedtoahigherrisk
of developinghighbloodpressure anddiabetes.Psoriasisisanimmune systemconditionthatappears
on the skininthe form of thick,red scalypatches.
15) Pregnancy
Pregnantwomenhave ahigherriskof developinghypertensionthanwomenof the same age whoare
not pregnant.Itisthe mostcommonmedical problemencounteredduringpregnancy,complicating2%
to 3% of all pregnancies.
Diagnosis
Your healthcare professional shouldcheckyourbloodpressure atleastonce everytwoyears,andmore
oftenif it’shigh.A highbloodpressure diagnosisisusuallybasedonat leastthe average of twoor more
readingspervisit,takenattwodifferentvisitsafteraninitial screening.
The onlyway to properlycheckyourbloodpressure istomeasure itwitha device calleda
sphygmomanometer,commonlycalledabloodpressure cuff.Thisisaquickand painlesstestinwhicha
rubbercuff is wrappedaroundyourupperarm and inflated.Asthe cuff inflates,itcompressesalarge
artery,stoppingthe blood’sflowthroughthatartery.Whenyourhealthcare professionalreleasesthe
air inthe cuff,he or she can listenwithastethoscope forthe bloodtostart flowingthroughyourartery
again.Your healthcare professional canwatchthe sphygmomanometergauge todetermine systolic
pressure—thepressurewhenthe firstsoundof pulsingbloodisheard—andthe diastolicpressure,the
pressure whenthe lastsoundof pulsingbloodisheard.
In May 2003, the NHLBI releasedupdatedclinical practice guidelinesforthe prevention,detectionand
treatmentof highbloodpressure.These guidelinesnow covernew blood pressurecategories,including
a “prehypertension”level,whichcoversabout25percentof Americans.
Thisprehypertensioncategoryalertsyoutoyourreal riskof highbloodpressure.People with
prehypertensionare likelytodevelophypertensionoverthe nextfew yearsif theydon”tgetthe
conditionundercontrol.Youdon’tneedmedicationtherapy,unlessyouhave anotherconditionlike
diabetesorchronickidneydisease.However,youshouldmake anynecessarylifestyle changes,suchas
losingexcessweight,becomingphysicallyactive,limitingalcohol consumptionandfollowingaheart-
healthyeatingplan,includingcuttingbackonsalt and otherformsof sodium, toreduce yourblood
pressure levels.

10. Bloodpressure above 140 mm Hg systolicand/or90 mm Hg diastolicisconsideredhypertensive.There
are 2 stagesof hypertension.Stage 1hypertensionissystolicbloodpressurebetween140 to 159 mmHg
and/ordiastolicbloodpressure 90to 99 mm Hg. Stage 2 hypertensionisbloodpressure greaterthan
160 mmHg systolicand/or100 mmHg diastolic.Whensystolicanddiastolicpressuresfallintodifferent
categories,yourhealthcare professional shouldselectthe highercategorytoclassifyyourblood
pressure.Forexample,160/80 mmHg wouldbe consideredstage 2hypertension.
If you are hypertensiveandhave begunreceivinginitialmedicationtherapy,youwill probablyneedto
returnfor follow-upandadjustmentof medicationsonce amonthuntil yourbloodpressure goal is
reached.More frequentvisitsmaybe necessaryforthose withstage 2hypertension.
A small numberof people experience “whitecoathypertension,”whichisveryelevatedbloodpressure
whenvisitingtheirhealthcare professionalwhile bloodpressureathome isnormal.Athome,youcan
checkyour bloodpressure inasettingthat’smore comfortable foryouto geta more accurate reading.
Home bloodpressure monitoringalsogivesyouthe opportunitytomeasure yourownbloodpressure
whenyourhealthcare professional’soffice isnotopen.Inexpensive devicesforhome bloodpressure
monitoringare available atmostpharmacies.Be sure tohave yourhealthcare professional checkyour
home bloodpressure device whenyoustartusingitto make sure it’sprovidingaccurate readings.
Also,don’tmake anychangesinyour medicationbasedonhome bloodpressurereadingswithoutfirst
consultingyourhealthcare professional.Home bloodpressuremonitoringisanexcellentadjunctto
monitoringbyyourhealthcare professional,butshoulditnotbe done in lieuof professional monitoring.
For manyolderAmericans,onlythe systolicbloodpressure ishigh,aconditionknownas“isolated
systolichypertension,”orISH(systolicator above 140 mm Hg anddiastolicunder90 mm Hg).Research
findsthatdiastolicbloodpressure risesuntil aboutage 55 andthendeclines,while systolicblood
pressure increasessteadilywithage.
The systolicbloodpressure isconsideredamore importantnumberthanthe diastolicpressure whenit
comesto the diagnosisandtreatmentof hypertension,aswell asindeterminingriskforheartdisease
and stroke.
In additiontotakingbloodpressure readingsfrombotharms,yourhealthcare professional may
conduct the followingduringahypertensionexam:
 A complete medical history.Make sure youtell yourdoctoraboutany alternative medicines
you’re takingsuchas herbs,over-the-counterdrugsandsupplements.The AmericanHeart
Associationnotesthatsome maybe life-threateningwhencombinedwithmedicinestotreat
highbloodpressure.
 A physical examination.Thisincludescheckingyourretinasandabdomen,listeningtoyourlungs
and heart,takingyourpulse inseveral areas,includingyourfeet,andlookingforswellinginyour
ankles.
 A urinalysis.The urine istestedforelevated protein,sugar,whitebloodcellsorother
abnormalities.

11.  An electrocardiogram.Yourhealthcare professional will positionanumberof small contactson
your arms,legsand chestto connectthemto an ECG machine.The resultswill be analyzedfor
any abnormalitiesindicatinganenlargedheartorotherabnormality.
 A kidneyprofile.The bloodistestedforabnormalitiessuchaselevatedcreatinine.
 A thyroidprofile.The bloodistestedforabnormalitiessuchasan elevatedlevel of thyroid
hormone,and the thyroidglandisphysicallyfeltforenlargement.
Whenwe measure bloodpressure,we gauge two types of pressure:
 Systolicpressure –the bloodpressure whenthe heartcontracts,specificallythe momentof
maximumforce duringthe contraction.Thishappenswhenthe leftventricle of the heart
contracts.
 Diastolicpressure –the bloodpressure betweenheartbeats,whenthe heartisrestingand
dilating(openingup,expanding).
Whena person’sbloodpressure istakenthe doctoror nurse needstomeasure boththe systolicand
diastolicpressures.The figuresusuallyappearwithalargernumberfirst(systolicpressure),followedby
a smallernumber(diastolicpressure).The figure will be followedbythe abbreviation“mmHg,”which
meansmillimetersof mercury.
If you are toldthat yourbloodpressure is120 over80 (120/80 mmHg),itmeansa systolicpressure of
120mmHg and a diastolicpressure of 80mmHg.
Sphygmomanometer
Most lay people have seenthisdevice.Itconsistsof aninflatable cuff thatiswrapped aroundthe upper
arm. Whenthe cuff is inflateditrestrictsthe bloodflow.A mercuryormechanical manometermeasures
the pressure.
A sphygmomanometerisalwaysusedtogetherwithameansto determine atwhatpressure bloodflow
isjust starting,andat what pressure itisunimpeded.Forexample,amanual sphygmomanometeris
usedtogetherwithastethoscope.
o The cuff isplacedsnuglyandsmoothlyaroundthe upperarm, at approximatelythe same
altitude asthe heartwhile the patientissittingupwiththe armsupported(restingon
something).Itiscrucial thatthe size of the cuff isappropriate.If itis toosmall the readingwill
be inaccuratelyhigh;if itistoo large the readingwill be toolow.
o The cuff isinflateduntil the arteryiscompletelyobstructed(occluded).
o The nurse,doctor,or whoeverisdoingthe examinationlistenswithastethoscope tothe
brachial arteryat the elbowandslowlyreleasesthe cuff’spressure (deflatesit).
o As the cuffspressure fallsthe examinerwillhearawhooshing soundora poundingsoundwhen
bloodflowstartsagain.
o The pressure at the pointwhenthe soundbeganisnoteddownandrecordedas the systolic
bloodpressure.

12. o The cuff isdeflatedfurtheruntil nosoundcanbe heard.Atthispointthe examinernotesdown
and recordsthe diastolicbloodpressure.
Witha digital sphygmomanometereverythingisdone withelectrical sensors.
Withadvancesinnewwearable technology,people cannow keeptrackof theirbloodpressure athome.
You can read our reviewof the best home bloodpressure monitorscurrentlyavailabletobuy.
Confirmationof highblood pressure requiresseveral readings
One bloodpressure readingisnotenoughtodiagnose hypertensioninapatient.People’sblood
pressure canvary duringthe day,a visit tothe doctor may spike the readingbecause the patientis
anxiousorstressed,havingjusteatenmayalsotemporarilyaffectbloodpressure readings.
As the definitionof hypertensionisdefinedas“repeatedlyelevatedbloodpressure”the GP(general
practitioner,primarycare physician) will have totake several readingsoveraset period.Thismay
require three separate measurementsone weekapart – oftenthe monitoringgoesonformuchlonger
before adiagnosisisconfirmed.
On some rare occasions,if the bloodpressure isextremelyhigh,orend-organdamage ispresent,
diagnosismaybe made immediatelysothattreatmentcanstart promptly.End-organdamage generally
referstodamage to major organsfedby the circulatorysystem, suchas the heart,kidneys,brainor
eyes.
Kidneydisorder–if the patienthasa urinarytract infection,urinatesfrequently,orreportspaindown
the side of the abdomen,theycouldbe signs/symptomsof akidneydisorder.If the doctorplacesthe
stethoscope onthe side of the abdomenandhearsthe soundof a rushof blood(abruit),itcouldbe a
signof stenosis –a narrowingof an artery supplyingthe kidney.
Additional testsfor highblood pressure
The doctor may alsoorderthe followingteststoaidindiagnosisof highbloodpressure:
 Urine and bloodtests – underlyingcausesmightbe due tocholesterol,highpotassiumlevels,
bloodsugar,infection,kidneymalfunction,etc.Proteinorbloodinurine mayindicate kidney
damage.Highglucose inthe bloodmayindicate diabetes.
 Exercise stresstest – more commonlyusedforpatientswithborderline hypertension.This
usuallyinvolvespedalingastationarybicycle orwalkingonatreadmill.The stresstestassesses
howthe body’scardiovascularsystemrespondstoincreased physical activity.If the patienthas
hypertensionthisdataisimportanttoknow before the exerciseteststarts.The testmonitors
the electrical activityof the heart,aswell asthe patient’sbloodpressureduringexercise.An
exercise stresstestsometimesrevealsproblemsthatare not apparentwhenthe bodyisresting.
Imagingscansof the heart’sbloodsupplymightbe done atthe same time.
 ECG (electrocardiogram) –thisteststhe heart’selectrical activity.Thistestismore commonly
usedforpatientsat highriskof heart problems,suchashypertensionandelevatedcholesterol

13. levels.The initial ECGiscalledabaseline.SubsequentECGsmay be comparedwiththe baseline
to reveal changeswhichmaypointtocoronary arterydisease orthickeningof the heartwall.
 Holtermonitoring–the patientcarriesan ECG portable device thatisattachedto electrodeson
theirchestfor about24 hours.
 Echocardiogram– thisdevice usesultrasoundwaveswhichshow the heartinmotion.The
doctor will be able todetectproblems,suchasthickeningof the heartwall,defective heart
valves,bloodclots,andexcessivefluidaroundthe heart.
Risk Factors for Hypertension
Althoughthere are several riskfactorsforhypertension,familyhistoryisthe primaryone.High blood
pressure tendstorun infamilies.
AfricanAmericansandHispanicAmericansare more likelytodevelophighbloodpressure than
Caucasians.Studiesfindthathaving“Type A”qualities—beingverydriven,beingaperfectionistwho
doesn’tcope well withstressorknowhow torelax andhavinga quicktemper—increasesthe riskof
hypertensioninmenandmayincrease the riskforwomen.
Otherriskfactors forhypertensioninclude:
 Increasingage
 Saltsensitivity
 Obesity
 Heavyalcohol consumption,defined asmore thantwodrinksa day formenand more than one
drinka day for women.
 Use of oral contraceptives
 An inactive lifestyle
 Regularsmokingoruse of smokeless-tobacco,like snufforchewingtobacco
 Highuric acid levels(anythingover7mg/ml of blood)
Unfortunately,there isnoprovenmethodof preventingpreeclampsiaorpregnancy-induced
hypertensionandnoteststo diagnose orpredictthese conditions.The onlywaytoensure asafe
pregnancyiswithregularvisitstoyourhealthcare professional forchecksof the level of proteininyour
urine andyour bloodpressure.
You alsoshoulddoeverythingyoucanon yourownto preventpregnancy-inducedhighbloodpressure,
includingregularphysical activityandlimitingsaltintake.
Treatment
Treatmentforhighbloodpressure dependsonseveral factors,suchitsseverity,associatedrisksof
developingstroke orcardiovascular,disease,etc.
Slightlyelevatedbloodpressure

14. The doctor may suggestsome lifestyle changesif the patient’sbloodpressure isonlyslightlyelevated
and the riskof developingcardiovasculardisease consideredtobe small.
Moderatelyhighblood pressure
If the patient’sbloodpressure ismoderatelyhighandthe doctorsbelievesthe riskof developing
cardiovasculardisease duringthe nexttenyearsisabove 20%,the patientwill probablybe prescribed
medicationandadvisedonlifestyle changes.
Severe hypertension
If bloodpressure levelsare 180/110 mmHgor higher,the doctor will referthe patienttoa specialist
(cardiologist).
There are several drugclassestochoose fromwhenselectingahighbloodpressure medication,
includinghundredsof single medicationsandcombinations.Generally,all canloweryourblood
pressure,butoftenpeopleresponddifferentlytoeachdrug.
You will probablyhave totrya fewof thembefore findingthe one thatworksthe bestforyou withthe
fewestside effects.
The drug classesare:
 Diuretics.Diuretics,whichridthe bodyof excessfluidsandsalt,are the most frequentlyused
drugsto treat highbloodpressure.However,inlarge doses,some diureticsmaydeplete the
bodyof potassium,whichcanleadtoirregularheartbeatandreduce yourglucose tolerance,
whichcan cause diabetes.There are,however,potassium-sparingdiureticsthatdon’tcause this
problem.Overall,diureticsare inexpensiveand,insmall doses,boostthe effectivenessof many
otherantihypertensive drugs.National guidelinesrecommendthatdiureticsalone shouldbe the
firstagentof choice providedyoudon’thave anyotherconditionsthatprohibittheiruse.Some
commonlyprescribeddrugsinthisclassinclude amiloride (Midamar),bumetanide (Bumex),
chlorthalidone(Hygroton),chlorothiazide(Diuril),furosemide (Lasix),hydrochlorothiazide
(Microzide,Esidrix,Hydrodiuril) andindapamide (Lozol).
 Beta-blockers.These drugsreduce yourheartrate and bloodpressure andthereforeyour
heart’soutputof blood.You shouldnotbe on one of these drugsif you alreadyhave alowheart
rate,an airwaydisease suchas asthmaor peripheral vasculardisease.Betablockerscanalso
maskhypoglycemia,orlowbloodsugar,soyoushoulduse withcautionif youhave diabetesand
take insulinorsulfonylureadrugs.Commonside effectsincludefatigue,breathlessness,
depressionandcoldhandsandfeet.Other,milderside effectscaninclude sleepproblemsand
numbnessortinglingof the toes,fingersorscalp.Onthe plusside,betablockerscanreduce
your riskforsecondheartattack, irregularheartbeat,anginaandmigraines.Some commonly
prescribeddrugsinthisclassinclude atenolol (Tenormin),betaxolol (Kerlone),bisoprolol
(Zebeta),carteolol (Cartrol),acebutolol(Sectral),metoprolol (Lopressor,Toprol-XL),nadolol
(Corgard),propranolol (Inderal),sotolol (Betapace)andtimolol (Blocadren).

15.  Angiotensin-convertingenzymeinhibitors(ACEinhibitors).Thesedrugsinterfere withthe body’s
productionof angiotensinII,ahormone thatcausesthe arteriestoconstrict.The drugs enable
musclesinyourarteriestorelax sotheycan openwider.The mostcommonside effectisadry,
persistentcough.Anaddedbenefitof ACEinhibitorsisthattheyslow the rate at whichyour
kidneysdeteriorate if youhave diabetes-relatedkidneydisease.Forpeople withhighblood
pressure anddiabetesorkidney disease,nationalguidelinesrecommendthatinitialdrug
treatmentsinclude ACEinhibitors.However,youshouldnotbe onACEinhibitorsif youare
pregnantbecause theycancause life-threateningcomplicationsinthe baby.Some commonly
prescribe drugsinthisclassinclude captopril (Capoten),enalapril (Vasotec),lisinopril (Prinivel,
Zestril),benazepril (Lotensin),fosinopril (Monopril),moexipril (Univasc),perindopril (Aceon),
ramipril (Altace) andtrandolapril (Mavik).
 AngiotensinIIreceptorblockers.AngiotensinIIreceptorblockersworksimilarlytoACEinhibitors
to blockthe hormone angiotensinII,whichnormallycausesbloodvesselstonarrow.Asa result,
the bloodvesselsrelaxandbecome wider,causingbloodpressure togodown.They’re more
effectiveif youalsotake a diuretic.These drugsdonotcause any coughlike ACEinhibitors.
Some commonlyprescribeddrugsinthisclassare candesartan(Atacand),eprosartan(Teveten),
irbesarten(Avapro),losartan(Cozaar),telmisartan(Micardis)andvalsartan(Diovan).
 Calciumchannel blockers(calciumantagonists).Calciumchannel blockersrelaxarterymuscles
and dilate coronaryarteriesandotherarteriesbyblockingthe transportof calciumintothese
structures,thusloweringbloodpressure.There are twoclassesof calciumblockers:the
dihydropyridinesandthe non-dihydropyridines:
 Non-dihydropyridines.These drugshelpreduce chestpain(angina)andheart-rhythm
irregularitiessuchasatrial fibrillation.Some commonlyprescribeddrugsinthisclassinclude
verapamil (Isoptin,Verelan,Calan) anddiltiazem(Cardizem).
 Dihydropyridines.These drugsare alsoeffectiveintreatingpatientswithangina.Theyare
sometimesusedintreatingsystolichypertensioninelderlypatients.Dihydropyridines generally
have a weakereffectonthe heartand some,suchas amlodipine,take longertowork.But once
theystart working,theyworkwell throughoutthe day,makingthemagood“once-a-day”drug.
Some commonlyprescribeddrugsinthisclassinclude nifedipine (Adalat,Procardiaandothers),
nicardipine (Cardene),isradipine (DynaCirc),amlodipine (Norvasc) andfelodipine (Plendil).One
dihydropyridine,fast-actingnifedipine,mayincrease yourriskof heartattack whenusedfor
acute hypertension;therefore,nifedipine shouldonlybe usedinthe treatmentof chronichigh
bloodpressure.Itisunclearwhetherothercalciumchannel blockersshare thisrisk,sodiscuss
thisand otherpotential riskswithyourhealthcare professionalif youreceiveaprescriptionfor
a calciumchannel blocker.Dihydropyridinesalsomaycause ankle swelling,rapidheartbeatand
headachesandmay make youflush.
 Alpha-blockers.Thesedrugsworkbyrelaxingcertainmusclestohelpsmall vesselsremainopen.
Alphablockersworkbystoppingthe hormone norepinephrine fromconstrictingsmall arteries
and veins,whichimprovesbloodflow andlowersbloodpressure.Alphablockersmayincrease
your heartrate andcan cause youto retainfluid,sotheymaybe combinedwithdiureticsor
betablockers.Otherside effectsinclude adrasticdropin bloodpressure whenyoustandup—

16. oftenseenafteronlyone dose—andheadache.However,some studiessuggestalphablockers
have addedbenefitsif youhave highbloodcholesterol levelsorglucose intolerance.Some
commonlyprescribeddrugsinthisclassinclude doxazosin(Cardura),prazosin(Minipress) and
terazosin(Hytrin).
 Alpha-betablockers.Alpha-betablockersreduce nerveimpulsestobloodvessels,thus
decreasingvessel constriction,andthey slow the heartbeattoreduce the amountof bloodthat
mustbe pumpedthroughthe vessels.Some commonlyprescribedalpha-betablockersinclude
caredilol (Coreg) andlabetololhydrochloride (Normodyne).Potentialside effectsof alpha-beta
blockersinclude fatigue,decreasedsex drive,anxietyandinsomnia.More serioussideeffects
include difficultybreathing,depression,feelingfaintandswellingof the lips,tongue,throator
face.
 Vasodilators.Vasodilatorsworktorelax the musclesinthe wallsof the bloodvessels,which
helpsthe vesselswiden.Some commonlyprescribedvasodilatorsinclude hydralazine
hydrochloride (Apresoline) andminoxidil (Loniten).More seriouspotential sideeffectsof
vasodilatorsincludedifficultybreathing;swellinginyour face,throat,lips,tongue,feetorhands;
and jointpain.Lessseriousside effectsincludenausea,vomiting,diarrhea,headache and
anxiety.
 Central-actingagents(orcentral agonists).These medicationsworkbypreventingyourbrain
fromtellingyournervoussystemtoincrease yourheartrate andnarrow bloodvessels.Some
commonlyprescribeddrugsinthisclassinclude alphamethyldopa(Aldomet),clonidine
hydrochloride (Catapres),guanabenzacetate (Wytensin) andguanfacine hydrochloride(Tenex).
Potential side effectsof central agonistsinclude dizziness,drymouth,nausea,vomitingand
sleepproblems.More seriousside effectsinclude allergicreaction,fast,poundingheartrate and
confusion.
 Directrenininhibitors.Aliskiren(Tekturna) isthe firstdruginthe classof renininhibitorstobe
approvedbythe U.S. Foodand Drug Administration(FDA) forthe treatmentof highblood
pressure.Tekturnaworksbyinhibitingrenin,akidneyenzyme thathelpsregulate blood
pressure.While otheravailable bloodpressure medicationsactat laterstagesof the blood
pressure regulationprocess,Tekturnaactsatthe beginning.Side effectsof Tekturna,whichare
usuallymild,include diarrheaandinrare cases,allergicreactions.Tekturnashouldnotbe used
inwomenwhoare pregnant.
Changesinlifestyle canhelplowerhighbloodpressure
Regular exercise
A regularprogramof exercise canprove beneficial inloweringbloodpressure.
Exercisingfor30 to 60 minutesfivedaysaweekwill usuallyloweraperson’s bloodpressureby4 to 9
mmHg. If youembarkon an exercise programyoushouldsee the benefitsfairlysoon –withinamatter
of twoto three weeks,especiallyif youhave beenleadingasedentarylifestyle foralongtime.

17. It isimportantto make sure you check withyourdoctor before embarkingonanyphysical activity
program.Exercise needstobe tailoredtothe needsandhealthof the patient.
The secretof gettingsuccessoutof exercise istodo itregularly.Exercisingatweekendsanddoing
nothingfromMondayto Fridaywill be muchlesseffective.
Reducingalcohol consumption
Alcohol consumptionisadouble-edgedsword.Some studiesindicate ithelpslowerbloodpressure,
while othersreportthe opposite.Inverysmall amountsitmaylowerbloodpressure.Butif youdrinktoo
much,evenmoderate amountsregularlyinsome cases,bloodpressurelevelsmaygoup.
People whodrinkmore thanmoderate amountsof alcohol regularlyvirtuallyalwaysexperience
elevatedbloodpressurelevels.
Eating healthily
Thismeanseatingplentyof fruitsandvegetables,goodqualityunrefinedcarbohydrates,vegetable oils,
and omegaoils.If youeatanimal productsmake sure all the fatis trimmedandavoidprocessedmeats.
Loweringsalt (sodium) intake
Studieshave shown thatevenamoderate reductioninsodiumintakecanlowerbloodpressurelevelsby
2 to 8 mmHg.
A studyfoundthatmost Americanswhoare diagnosedwithhypertensionstill consume more thanthe
recommendedlevelsof salt.Studyleader,UmedAjani,anepidemiologistwiththe NationalCenterfor
ChronicDisease PreventionandPromotion,said“Perhapsthe moststrikingfindingisthatnodifference
insodiumintake wasobservedbetweenthose whoreceivedadvice andthose whodidnot.”
A reportpublishedinMarch,2009 bythe CentersforDisease Control andPrevention(CDC),USA,
suggeststhat7 inevery10 adultAmericansshouldlimittheirsodiumintake to1,500 mg a day(about
2/3 of a teaspoonof salt).The reportestimatedthat145 millionAmericans –70% of the adult
population –have one of three riskfactorsfor hypertension.
The AmericanHeart Associationprovide auseful tablethatlistscommonmeasurementsof saltandtheir
mg equivalents.
Losing weight
Studieshave revealedthatevenmoderate weightloss –justtenpounds – can have a significantimpact
inloweringelevatedbloodpressure.If youare overweight,the neareryougettoyourideal weightthe
more your bloodpressure islikelytofall.Anyhighbloodpressure medicationsyouare takingwill
become more effective whenyoulose weight.Reducingyourwaistlinewill have the greatesteffect.
Achievingyourideal bodyweightinvolvesacombinationof exercise,gooddiet,andatleast7 hours
goodqualitysleepeachnight.

18. Keepingafooddiarycan double weightlossaspartof a managedprogram, scientistsatKaiser
Permanente’sCenterforHealthResearchdiscovered.
Loweringcaffeine consumption
There are scoresof studiesthatreporton whethercaffeine hasanimpacton bloodpressure.Asmanyof
themhave conflictingconclusionsitisunderstandablethatpeople become exasperated.
Habitual coffee drinkingisnotlinkedtoanincreasedriskof highbloodpressure inwomen,althougha
linkwasfoundwithsugaredordietcolas, reportedresearchersfromBrighamandWomen’sHospital
and the Harvard School of PublicHealth.
Researchersfoundthathealthyadultswhodranktwocansa dayof a popularenergydrinkexperienced
an increase intheirbloodpressure andheartrate.The researchers,fromHenryFordHospital believe
the caffeine andtaurine levelsinenergydrinkscouldbe responsibleforincreasesinbloodpressure and
heartrate.
All researchersagree onone thing:Excessivecaffeineconsumptionisnotgoodforpeople whohave
hypertension.Therefore,itwouldbe wise tokeepaneye onyourcaffeine consumption.Rememberthat
caffeine ispresentinmostcoffees,manyteas,sodas(carbonateddrinks),chocolates,andsome other
foodsanddrinks.
Relaxationtechniques
ResearchersatMassachusettsGeneral Hospital foundthataddingthe relaxationresponse,astress-
managementapproach,tootherlifestyle modificationsmaysignificantlyimprove treatmentof the type
of hypertensionmostcommoninthe elderly.
Harvard Women’s HealthWatchreportedthatin one study,tai chi significantlyboostedexercise
capacity,loweredbloodpressure,andimprovedlevelsof cholesterol,triglycerides,insulin,andC-
reactive proteininpeopleathighriskforheart disease.
Sleep
Notgettingenoughsleepcanincrease aperson’sriskof developinghighbloodpressure,scientistsfrom
the Universityof Chicagoreportedaftermonitoringover500 middle agedpeoplefor5 years.
Some studieshave suggestedthatadultssleepnolessthan7hours andno more than 8 hoursperday.
In 2008 the AmericanAcademyof SleepMedicine publishedastudysuggestingthatpeople withsleep
durationabove or belowthe recommended7-to-8hourspernightface an increasedriskof
hypertension.
Prevention
Because we don’tknowthe cause of mostcases of highbloodpressure,it’shardtosay how to prevent
it.However,dietandlifestylechangescanbe key.Youshouldconsiderthese tips:

19. Increase the amountof exercise youget.Regularaerobicphysicalactivitycanenhance weightlossand
reduce the riskfor cardiovasculardisease.Youcanreduce your bloodpressure withmoderatelyintense
physical activity,suchasa 30- to 60-minute briskwalkmostdays.If you have cardiac or otherserious
healthissues,youshould have athoroughmedical evaluation,andperhapshave acardiacstresstest,
before beginninganyexercise program.
Lose weight.Losingjust10 poundscan helploweryourbloodpressure.Some obese peoplealsohave
sleepapnea,inwhichtheystopbreathing dozensorhundredsof time anight,snore loudlyandsuffer
fromdaytime sleepiness.Sleepapneaislinkedwithhighbloodpressure.
Reduce alcohol consumption.Mostmenwithhighbloodpressure shouldn’tdrinkmore thantwodrinks
perday, and womenshouldn’thave more thanone alcoholicdrinkperday.A drinkisequal to 12 ounces
of beer,five ouncesof wineorone anda half ouncesof 80-proof liquor.
Reduce stress.Whenyourelax,yourheartrate slows,whichreducesthe amountof oxygenyourbody
needs,reducingyourpressure.
Quitsmoking.Evenmore thanloweringyourbloodpressure perse,itwillreduce youroverall
cardiovasculardisease riskmore thananyothersingle move.
Reduce yoursodiumintake.Saltcancause fluidretentionsodon’taddsaltto foods.Limitsodiumintake
to no more than 2,300 mg per day—the amountcontainedinone teaspoonof salt.Steerclearof
processedfoods(sauces,mixesand“instant”productssuchas flavoredrice,cerealsandpasta).A lower
sodiumlevel of 1,500 milligramsperdayisrecommendedforpeopleage 51 and olderandanyone who
isAfricanAmericanor whohas highbloodpressure,diabetesorchronickidneydisease.Getinthe habit
of checkinglabelsforsodiumcontent.If one portionhasmore than300 mg,choose a lower-saltbrand.
Eat more vegetablesthatare fresh,frozenwithoutsauce orcannedwithno salt.Saltsubstitutesmay
workfor you,but checkwithyourhealthcare professional becausetheycanbe harmful if youhave
certainmedical problems.
Increase dietarypotassium.Ananalysisof several studiesindicatesthatpotassiumcanreduce blood
pressure.Bananasare naturallyhighinpotassium, andthe mineral canalsobe purchasedinsupplement
form.For people withbloodpressure valuesabove optimal levels,NHBPEPrecommendsincreasingyour
dietarypotassiumintake tomore than3,500 mg per day—especiallyimportantif youhave ahigh
sodiumintake.Increasingpotassiumintake isnotrecommendforpatientswithkidneydisease.Askyou
healthcare professional before increasingyourpotassiumintake.
Eat a healthydiet.Aimforadietrichin fruits,vegetablesandlow-fatdairyproducts,andlow in
saturatedand total fat.
You can make all of yourlifestylechangesatthe same time.Studiesfindthe bestresultscome from
adoptingthe DASHdiet,whichisrich infruits,vegetablesandlow-fatdairyproducts.
Fishoil (omega-3polyunsaturatedfattyacids) andcalciumsupplementslowerbloodpressure only
slightlyinthose withhypertension.Additionally,herbal andbotanical supplements,whichgetverylittle

20. scrutinyfromthe FDA, have notbeenproventosafelylowerbloodpressure andmay,infact,
dangerouslyinteractwithsome medications.
Finally,if youhave highbloodpressure,be sure toinform yourhealthcare professional aboutall
medicinesyouare taking,includingover-the-counterdrugs.Itisparticularlyimportantthatyoumention
drugssuch as steroids;nonsteroidal anti-inflammatorydrugs(NSAIDs)likeibuprofen;nasal
decongestantsand othercoldremedies;appetite suppressants;cyclosporine;erythropoietin;
antidepressants;andmonoamineoxidase (MAO) inhibitors.
You shouldtake care whenchoosingover-the-counterdrugsforcolds.Manycold remediescontain
decongestantsthatmayraise yourbloodpressure.These medicinescanalsointerfere withyourblood
pressure drug’seffectiveness.Checkwithyourhealthcare professional before takinganyover-the-
counterdrug if youhave highbloodpressure.
Facts to Know
1. About76.4 millionAmericanshave highbloodpressure.Itisa contributingfactorinan
estimated326,000 deathsperyear.
2. More menthan womenhave hypertensionuntil womenreachmenopause,whenawoman’s
riskbecomesgreaterthana man’s.
3. Abouthalf of the 76.4 millionAmericanswithhighbloodpressureare women,withthe
incidence becominggreaterinwomenastheygetolder.About30 percentof womenhave high
bloodpressure,andthe riskishigherinolderwomenandAfricanAmericanwomen.
4. Your bloodpressure consistsof two numbers—the systolicpressure andthe diastolicpressure.
The highernumber,the systolicpressure,representsthe pressure whilethe heartisbeating.
The lowernumber,the diastolicpressure,representsthe pressurewhenthe heartisresting
betweenbeats.
5. Bloodpressure canfluctuate witheating,sleepingandchangesinposture,butanormal blood
pressure readingshouldbe equal toorlessthan119 mm Hg systolicand/or79 mm Hg diastolic.
Bloodpressure between120–139/80–89 isconsideredprehypertensionandanythingabove this
level (140/90) is consideredhypertensionorhighbloodpressure.
6. If you have prehypertension,youare more likelytodevelophypertensioninthe future andhave
increasedriskfactorsforcardiovasculardisease andotherconditionsrelatedtohypertension.In
fact, yourriskof stroke triplesif youhave prehypertension.
7. You may alsohave hypertensionif eitheryoursystolicoryour diastolicpressureisgreaterthan
or equal to 140 or 90 mmHg, respectively.Thatis,youcan have isolatedsystolicordiastolic
hypertension.Isolatedsystolichypertensionisthe mostcommonformof highbloodpressure in
olderAmericans.The National Heart,Lung,andBloodInstitute (NHLBI) estimatesthat65
percentof people withhypertensionoverage 60 have ISH.
8. Dietaryandlifestylechangesmayhelpyoucontrol highbloodpressure.If youhave mild
hypertension,youmaybe able toloweryourbloodpressure byreducingthe amountof sodium

21. inyour dietandcuttingback on alcohol consumption.If youare overweight,losingweightwill
help,aswill physical activity.
9. Many people thinkhighbloodpressure isthe resultof lifestylefactors,suchasstress,lack of
exercise,drinkingorsmoking,butthe cause of approximately90percentto95 percentof all
hypertensioncasescan’tbe determined.
10. There isno cure forhypertension,butitiseasilydetectedandusuallycontrollable.
11. Many people whosufferfromhighbloodpressure don’tknow theyhave itbecause itusually
producesnosymptoms.Andof those whohave hypertension,lessthanhalf have the problem
undercontrol,definedasa level below 140/90 mm Hg.
12. If leftuncontrolled,highbloodpressure canhave veryseriousconsequences.The conditioncan
leadto stroke,heartattack,hardeningof the arteries,congestive heartfailure and/orkidney
disease.Insevere cases,itcanleadtoblindness.
13. There are several drugclasses—andhundredsof individualandcombinationmedications—to
choose fromwhentreatinghighbloodpressure.Generally,all canloweryourbloodpressure,
but people oftenrespondverydifferentlytoeachdrug,soyou will probablyhave totrya fewof
thembefore findingthe one thatworksbestforyou.
14. Takingbirthcontrol pillshasbeenlinkedwithhighbloodpressureinwomen.The combination
of birthcontrol pillsandsmokingmaybe particularlydangerous.Askyourhealthcare
professionaltotake yourbloodpressure before youstarttakingthe pill andhave itchecked
everysix monthsorso afteryoustart takingit.
15. If you alreadyhave highbloodpressure andyougetpregnant,yourpregnancycouldmake the
conditionmore severe,especiallyinthe lastthree months.If itgoesuntreated,highblood
pressure inpregnancycanbe dangeroustobothmotherand baby.Therefore,healthcare
professionalsusuallycloselymonitorbloodpressure duringpregnancy.
Key Q&A
1. What exactlyishypertension?Hypertensionisalsocalledhighbloodpressure.Bloodpressure is
the pressure inside yourarteriesthatharmlesslypushesthe bloodtoyourbody’sorgansand
musclessotheycan receive the oxygenandnutrientstheyneed.Bloodpressure isvariable-it
risesandfallsduringthe day.Whenbloodpressure stayselevatedovertime,itiscalledhigh
bloodpressure orhypertension.A bloodpressure readingator above 140 systolicor 90 diastolic
(presented140/90 mm Hg) is consideredhypertensive.
2. What causeshypertension?Noone knowsforsure,althoughanumberof factorsare thoughtto
contribute toit,such as familyhistory.If youhave two immediatefamilymemberswho
developedhighbloodpressure before age 60,youhave two timesthe risk,andyour riskgoesup
evenfurtherwitheachadditional immediatefamilymemberwithhighbloodpressure youhave.
Otherriskfactors include increasing age,saltsensitivity,obesity,heavyalcohol consumption,
use of oral contraceptives,aninactive lifestyle,regularsmokingoruse of smokeless-tobacco
(like snuff orchewingtobacco) andhighuricacid levels.
3. Are there differenttypesof hypertension?Yes,thereare twotypesof hypertension:Primary
hypertensionandsecondaryhypertension.Primaryhypertension,the mostcommontype,is

22. alsocalledessentialhypertension.There isnoknowncause.About5 percentto10 percentof
people withhighbloodpressure have itasa resultof anotherconditionorproblem, suchas
such as kidneydisease,orthe use of certainmedications,suchasbirthcontrol pills.Thisis
secondaryhypertension.
4. Can hypertensionleadtootherseriousmedical problems?Yes!All stagesof hypertensionare
associatedwithriskof cardiovasculardisease.Evenslightlyelevatedbloodpressure levelscan
double yourriskforcoronary heartdisease.Consistenthighbloodpressurealsoincreasesyour
riskfor congestive heartfailure andcanleadto otherproblemssuchasatherosclerosis,eye
damage,heartenlargementorfailure andkidneydamage andfailure.
5. Who developshighbloodpressure?AfricanAmericansandHispanicAmericansare more likelyto
develophighbloodpressure thanCaucasians.More menthanwomenhave hypertensionuntil
womenreachmenopause,whenawoman’srisksurpassesaman’s.
6. How oftenshouldIhave mybloodpressure checked?Youshouldhave yourbloodpressure
checkedwheneveryousee ahealthcare professional-buteverytwoyearsatthe least.
7. What can I do to preventhypertension?Dietandlifestylechangesare key.Youshouldincrease
your exercise,maintainahealthyweightandreduce alcohol consumption.Mostmenshouldn’t
drinkmore than twodrinksperday and womenshouldn’tdrinkmore thanone drinkperday.
(One drinkisdefinedas12 ouncesof beer,five ouncesof wine oranounce and a half of 80-
proof liquor).Youshouldalsoreduce yourstresslevelsandloweryoursodiumintake,aswell as
followadietrich in fruits,vegetablesandlow-fatdairyproducts,andlow insaturatedandtotal
fat.
8. How ishypertensiontreated?Yourhealthcare professional hasseveral drugclassesfromwhich
to choose whenselectingahypertensiondrugforyou.Generally,all canloweryourblood
pressure,butoftenpeoplerespondverydifferentlytoeachdrug.You will probablyhave totry
out a fewof thembefore findingthe one thatworksthe bestfor you,withthe leastamountof
side effects.
For more informationvisitusour website:http://www.healthinfi.com