High Blood Pressure

• What is high blood pressure?

Blood pressure is the force of blood against the walls of arteries. Blood pressure rises and falls during the day. When blood pressure stays elevated over time, it is called high blood pressure (also called hypertension).

• Is high blood pressure serious?

High blood pressure is a serious condition, which often has no symptoms. Once high blood pressure occurs, it usually lasts a lifetime. But by taking action, you can prevent and control it.

High blood pressure is dangerous because it makes the heart work too hard. It also makes the walls of the arteries hard. High blood pressure increases the risk of heart disease and stroke, the first- and third-leading causes of death for Americans. High blood pressure can also cause other problems, such as heart failure, kidney disease, and blindness.

• Who can develop high blood pressure?

High blood pressure is common. More than 50 million American adults — 1 in 4 — have high blood pressure. It is very common in African Americans, who may get it earlier and more often than whites. Many Americans tend to develop high blood pressure as they get older, but this is not a part of healthy aging. About 60% of all Americans age 60 and older have high blood pressure.

Others at risk for developing high blood pressure are the overweight, those with a family history of high blood pressure, and those with high-normal blood pressure. High blood pressure is also more common in the Southeastern United States.

• What are risk factors?

Risk factors are behaviors or conditions that can increase your chances of developing a disease. For instance, high blood pressure is a risk factor for heart disease.

There are other risk factors for heart disease. Most can be modified, though some cannot. The more risk factors you have, the greater your chances of developing heart disease. So it is important to take steps to prevent or control these risk factors.

Heart disease risk factors under your control are:

1. Cigarette smoking
2. High blood cholesterol
3. High blood pressure
4. Diabetes
5. Overweight
6. Physical inactivity

Heart disease risk factors beyond your control are:

1. Age (45 years and older for men and 55 years or older for women)

2. Family history of early heart disease (having a mother or sister who has been diagnosed with heart disease before age 65, or a father or brother diagnosed before age 55.)

Here are some more answers to questions about high blood pressure.

• What causes high blood pressure?

The causes of high blood pressure vary. Most of the time, the cause is not known. It might be due to a narrowing of the arteries, a greater than normal volume of blood, or the heart beating faster or more forcefully than it should. Any of these conditions will cause increased pressure against the artery walls. High blood pressure might also be caused by another medical problem. Although high blood pressure usually cannot be cured, in most cases it can be controlled and prevented.

• How do I know if I have high blood pressure?

High blood pressure often has no signs or symptoms. The only way to find out if you have high blood pressure is to be tested for it. Your doctor can perform a quick, easy, and painless test to see if you have high blood pressure.

• What is systolic pressure?

Systolic pressure is the force of blood in the arteries as the heart beats. It is shown as the top number in a blood pressure reading.

• What is diastolic pressure?

Diastolic pressure is the force of blood in the arteries as the heart relaxes between beats. It's shown as the bottom number in a blood pressure reading.

• How is blood pressure tested?

Having your blood pressure tested is quick, easy, and painless. Blood pressure is measured in millimeters of mercury (mm Hg) and recorded as two numbers — systolic pressure "over" diastolic pressure. For example, the doctor or nurse might say "130 over 80" as a blood pressure reading. An optimal blood pressure is 120/80.

Both numbers in a blood pressure reading are important. For some Americans, systolic blood pressure is especially important.

Some blood pressure testing devices use electronic instruments or digital readouts. In these cases, the blood pressure reading appears on a small screen or is signaled in beeps, and no stethoscope is used.

Focus on Systolic

For middle-aged and older adults, the systolic pressure gives the most accurate diagnosis of high blood pressure. You can find important new information about systolic pressure here.

• What Is Systolic High Blood Pressure?

Blood pressure is typically recorded as two numbers — the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats). Optimal blood pressure is less than 120/80 mm Hg (millimeters of mercury). High blood pressure is 140 and higher for systolic. The diastolic does not need to be high for you to have high blood pressure. When that happens, the condition is called "isolated systolic hypertension," or ISH.

• Is Systolic High Blood Pressure Common?

Yes. It is the most common form of high blood pressure for older Americans. For most Americans, systolic blood pressure increases with age, while diastolic increases until about age 55 and then declines. About 65 percent of hypertensives over age 60 have ISH. You may have ISH and feel fine. As with other types of high blood pressure, ISH often causes no symptoms. To find out if you have ISH — or any type of high blood pressure — see your doctor and have a blood pressure test. The test is quick and painless.

• Is Systolic High Blood Pressure Dangerous?

Any form of high blood pressure is dangerous if not properly treated. If left uncontrolled, it can lead to stroke, heart attack, congestive heart failure, kidney damage, blindness, or other conditions. While it cannot be cured once it has developed, ISH can be controlled.

• Does It Require Special Treatment?

Treatment options for ISH are the same as for other types of high blood pressure, in which both systolic and diastolic pressures are high. ISH is treated with lifestyle changes and/or medications. The key for any high blood pressure treatment is to bring the condition under proper control. Blood pressure should be controlled to less than 140/90. If yours is not, then ask your doctor why. You may just need a lifestyle or drug change, such as reducing salt or adding a second medication.

• Why Is The NHLBI Issuing A Clinical Advisory?

The National Heart, Lung, and Blood Institute (NHLBI) and the National High Blood Pressure Education Program (NHBPEP), which it coordinates, periodically issue clinical practice guidelines to help doctors better diagnose and manage their patients' high blood pressure. The last guidelines were released in 1997. Since then, scientific findings have shown that systolic blood pressure is the best indication of a middle-aged or older patient's need for treatment. The advisory is being issued to give doctors and their patients the latest information as quickly as possible.

Questions To Ask Your Doctor If You Have High Blood Pressure

• What is my blood pressure reading in numbers?

• What is my goal blood pressure?

• Is my blood pressure under adequate control?

• Is my systolic pressure too high (over 140)?

• What would be a healthy weight for me?

• Is there a diet to help me lose weight (if I need to) and lower my blood pressure?

• Is there a recommended healthy eating plan I should follow to help lower my blood pressure (if I don't need to lose weight)?

• Is it safe for me to start doing regular physical activity?

• What is the name of my blood pressure medication? Is that the brand name or the generic name?

• What are the possible side effects of my medication? (Be sure the doctor knows about any allergies you have and any other medications you are taking, including over-the-counter drugs, vitamins, and dietary supplements.)

• What time of day should I take my blood pressure medicine?

• Should I take it with food?

• Are there any foods, beverages or dietary supplements I should avoid when taking this medicine?

• What should I do if I forget to take my blood pressure medicine at the recommended time? Should I take it as soon as I remember or should I wait until the next dosage is due?

See also: Hypertension and Massage

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• Heart Disease Causes and Symptoms
• Heart Disease Nutrition and Diet Alternatives
• Heart Disease Treatment
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