TELMISAT AM

MANAGING HYPERTENSION

What Is Blood Pressure?

Blood is carried from the heart to all parts of your body by vessels called arteries. Blood pressure is the force of the blood pushing against the walls of the arteries. Each time the heart beats (about 60-70 times a minute at rest), it pumps out blood into the arteries. Your blood pressure is at its highest when the heart beats, pumping the blood. This is called systolic (sis-TOL-ik) pressure. When the heart is at rest, between beats, your blood pressure falls. This is the diastolic (di-a-STOL-ik) pressure.

Blood pressure is always given in these two numbers, the systolic and diastolic pressures. Both are important. Usually they are written one above or before the other, that is, as 120/80 mmHg (measured in millimeters of mercury, a unit for measuring pressure). When the two measurements are written down, the systolic pressure is the first or top number, and the diastolic pressure is the second or bottom number (for example, 120/80). If your blood pressure is 120/80, you would say that it is "120 over 80."

Blood pressure changes during the day. It is lowest as you sleep and rises when you get up. It also can rise when you are excited, nervous or active.

Nevertheless, for most of your waking hours, your blood pressure remains fairly constant when you are sitting or standing still. That level should be lower than 120/80 mmHg. When the level stays high, i.e., 140/90 mmHg or higher, you have high blood pressure. With high blood pressure, the heart works harder, your arteries take a beating, and your chances of a stroke, heart attack, and kidney problems are greater.

What Is Normal Blood Pressure?

A blood pressure reading below 120/80 mmHg is considered normal. In general, lower is better. However, very low blood pressure can sometimes be a cause for concern and should be checked out by a doctor.

Doctors classify blood pressures under 140/90 mmHg as either normal or pre-hypertension.

• Normal blood pressure is lower than 120/80 mmHg
• Pre-hypertension is blood pressure between 120 and 139 for the top number, or between 80 and 89 for the bottom number. For example, blood pressure readings of 138/82, 128/89, or 130/86 are all in the pre-hypertension range. If your blood pressure is in the pre-hypertension range, you are a likely candidate for high blood pressure unless you take action to prevent it.

What Is High Blood Pressure?

High blood pressure is a condition where the blood pressure reading is 140/90 mmHg or higher. Both numbers are important.

High blood pressure is called the silent killer because it usually has no symptoms. In some cases, people may not be aware of the condition until they have trouble with their heart, brain, or kidneys. When high blood pressure is not detected and treated, it could cause:

• The heart to get larger, which may lead to heart failure
• Small bulges (aneurysms (AN-u-risms)) to form in the blood vessels. Common locations for aneurysms are the main artery from the heart (aorta); arteries in the brain, legs, and intestines; and the artery leading to the spleen.
• Blood vessels in the kidney to narrow, which may cause kidney failure.
• Arteries throughout the body to "harden" faster, especially those in the heart, brain, kidneys, and legs. This could cause a heart attack, stroke, kidney failure or amputation of part of the leg.
• Blood vessels in the eyes to burst or bleed, which may cause vision change and could result in blindness.

There is an exception to the above definition of high blood pressure. A blood pressure of 130/80 mmHg or higher is considered high blood pressure in people with diabetes and chronic kidney disease.

What Causes High Blood Pressure?

For most people with high blood pressure, a single specific cause is not known. This is called essential or primary high blood pressure. Research is ongoing to find the causes of essential high blood pressure.

In some cases, high blood pressure is the result of another medical problem or due to the side-effects of certain medication. When the cause is known, this is called secondary high blood pressure.

Who Is At Risk of Getting High Blood Pressure?

To pre-empt high blood pressure, have a healthy diet, maintain a healthy weight, and get enough exercise.

Your chances of developing high blood pressure are also higher if you:

• Are overweight
• Are a man over the age of 45
• Are a woman over the age of 55
• Have a family history of high blood pressure
• Have pre-hypertension (that is, blood pressure in the 120-139/80-89 mmHg range).

Other factors that could raise blood pressure are:

• Eating too much salt
• Drinking too much alcohol
• Not getting enough potassium in your diet
• Not getting enough exercise
• Taking certain medicines
• Getting stressed often
• Smoking (smoking could cause a temporary rise in blood pressure).

How Do You Know Whether You Have High Blood Pressure?

Only your doctor can tell you whether you have high blood pressure. Most doctors would check your blood pressure several times on different days before deciding that you have the condition. A diagnosis of high blood pressure is given if repeated readings are 140/90 mmHg or higher; or 130/80 mmHg or higher, if you have diabetes or chronic kidney disease.

It is a quick and easy process to have your blood pressure tested. Your doctor or nurse would use some type of a gauge, a stethoscope (or electronic sensor), and a blood pressure cuff, also called a sphygmomanometer (sfig-mo-ma-NOM-e-ter).

Blood pressure readings are usually taken when you are sitting or lying down, and relaxed. To ensure optimum reading before getting your blood pressure checked;

• do not drink coffee or smoke for 30 minutes prior to the test
• wear short sleeves
• go to the bathroom before the reading. A full bladder can change your blood pressure reading
• sit quietly for 5 minutes before the test.

• sit with your back supported and your feet flat on the floor
• rest your arm on a table at the level of your heart
• take two readings, at least 2 minutes apart, and average the results.

In some cases, the blood pressure is high only when a person visits the doctor's office. This condition is called ‘white coat hypertension’. If your doctor suspects this, you may be asked to check and record your blood pressure at home with a home monitor. Another way to check blood pressure away from the doctor's office is by using an ambulatory blood pressure monitor. This device is worn for 24 hours and can take blood pressure every 30 minutes.

• following the DASH (Dietary Approaches to Stop Hypertension) Eating Plan, which includes cutting down on salt and sodium and eating healthy foods such as fruits, vegetables, and low-fat dairy products
• losing excess weight and staying at a healthy weight
• being physically active (for example, walking 30 minutes every day)
• quitting smoking
• limiting alcohol intake.

Occasionally, the blood pressure stays very high even when a person makes healthy lifestyle changes. In such cases, it is necessary to add medicine(s) to help lower blood pressure. Medicines will control your blood pressure, but they cannot cure it. You will need to take blood pressure medication on an ongoing basis, with regular checks, to ascertain correct dosages at any given time.

How Can High Blood Pressure Be Prevented?

You could take the following steps to prevent high blood pressure:

• Maintain a healthy weight.
• Be physically active
• Follow a healthy meal plan with emphasis on fruits, vegetables, and low-fat dairy foods
• Reduce salt and sodium intake.
• Quit smoking. Moderate your alcohol intake, if you drink.

• Keep track of your blood pressure. Learn to take your own blood pressure at home or have it checked regularly by a health care professional. Record each reading and date.
• Talk to your healthcare provider about the names and dosages of your blood pressure medicines and how to take them.
• Talk to your doctor, if you think you are having other problems (side effects) from taking your medicine. Another medicine may be more suitable, or the problem may not be related to the medicine.
• Refill your blood pressure medicines before they run out.
• Take your blood pressure medicines exactly as directed. Do not skip days or cut pills in half.
• Keep your follow-up appointments with your health-care provider.
• Choose healthier habits, for example, eat a heart healthy diet, exercise regularly, and do not smoke.
• Talk to your doctor or healthcare provider about your treatment, and other lifestyle changes that you need to make in order to lower your high blood pressure.

Remember, high blood pressure has no symptoms.