High Blood Pressure
High Blood Pressure
Hypertension also commonly known as high blood pressure is a condition where the blood flows with too much force through narrow arteries. This leads to an increase in pressure. If left untreated, hypertension can lead to other health problems such as a heart attack and stroke.
45% of all adults in the U.S. are affected by High blood pressure. The older you get, the higher the risk of high blood pressure. The Center for Disease Control (CDC) breaks down the rates of high blood pressure by race and gender:
- Race: Non-Hispanic black adults (54%) show higher rates than non-Hispanic white adults (46%), non-Hispanic Asian adults (39%), or Hispanic adults (36%)
- Gender: Male-identifying patients (47%), female-identifying patients (43%)
For many people, there is no cause when it comes to high blood pressure. This type is called primary (essential) hypertension, and it develops slowly over time. There is another type called secondary hypertension, which is caused by an underlying condition. Overall the risk factors associated with high blood pressure are:
- Family history
- Obesity/being overweight
- Lack of regular exercise
- Tobacco use
- High-sodium diet
- Low-potassium diet
- Heavy alcohol use
- Recreational drugs (such as cocaine and amphetamines)
- Chronic Conditions (Such as Sleep apnea, Kidney issues, adrenal gland tumors, thyroid issues, and congenital defects blood vessels)
- Prescription and over-the-counter drugs(such as birth control pills, cold medicine, decongestants, and pain relievers)
The Majority of people with high blood pressure do not have symptoms, even when their blood pressure has reached a severe stage.
Some people do report symptoms when they have severe hypertension, such as:
- Shortness of breath
- Chest pain
- Visual Changes
- Blood in urine
There can be a sign of a severe stage of the disease and medical attention straight away.
Primary Care Doctor: Your general doctor can diagnose and treat high blood pressure.
Cardiologist: Cardiologists are doctors who specialize in treating medical conditions that affect the heart and blood vessels. Your Primary Care doctor may refer you to a cardiologist if your high blood pressure is particularly complex or difficult to control.
Nephrologist: Nephrologists are doctors who specialize in treating conditions that affect the kidneys. The kidneys are responsible for releasing hormones that help regulate blood pressure. If your primary care doctor or cardiologist suspects that your kidneys might be an underlying cause of your high blood pressure, then they may refer you to a nephrologist.
Since most people do not see any symptoms or signs of high blood pressure. it is important to get yours checked frequently as part of routine visits with your primary care physician. High blood pressure is easily detected with an arm cuff and pressure measuring device.
Before diagnosing you, your doctor will likely check your three or more times at different appointments. This is because some people show higher readings during a visit to the doctor, possibly being nervous (this is called "white coat hypertension"). If your doctor still suspects you might have hypertension, they may order an additional test, electrocardiograms, and/or an ultrasound of your heart or kidneys.
If you are diagnosed with high blood pressure, it is important to regularly take and record blood pressure readings. Keep a log with date and time, and bring the log with you to your doctor's appointment for review. These are also blood pressure monitors that have extensive memory to keep track for you. This will help your doctor adjust your medication if necessary and track your progress.
There are four main groups of prescription medications typically used to treat high blood pressure.
- Thiazide diuretics: for example hydrochlorothiazide (Microzide)
- Potassium-sparing diuretics: for example triamterene or Spironolactone
- Loop diuretics: like Furosemide (Lasix) or bumetanide (Bumex)
- Combination diuretics: combing above diuretic categories like triamterene + hydrochlorothiazide (Dyazide, Maxzide)
2. Angiotensin-converting enzyme (ACE) inhibitors: lisinopril(Zestril), benazepril (Lotensin), and captopril(Capoten)
3. Angiotensin II receptor blocks (ARBs):candesartan(atacand),losartan(Cozaar), or valsartan (Diovan)
4. Calcium Channel blockers: amlodipine(Norvasc), Nifedipine (Adalat CC or Procardia XL), Diltiazem HCL (Cardizem CD, Cardizem SR, Dilacor XR, Tiazac)
5. Beta-blockers: like atenolol(Tenormin), metoprolol tartrate (Lopressor), metoprolol succinate (Toprol-XL), propranolol (Inderal)
6. Alpha-blockers: like Doxazosin (Cardura), Prazosin (Minipress), Terazosin(Hytrin)
7. Alpha-2 Receptor Agonists: Methyldopa
8. Central Agonists: like clonidine (Catapres), guanfacine (Tenex)
9. Blood vessel dilators (aka Vasodilators): Hydralazine (Apresoline) or oral Minoxidil (used in severe cases where kidney failure is present)
Not all generics are the same. Different people respond better to different versions of the same drug, depending on the manufacture.
There are some lifestyle changes that you can adopt to lower your blood pressure. Try eating low sodium, a healthy diet, and reducing your alcohol and tobacco consumption. Food that is high in salt can cause blood pressure to rise. when we consume too much salt, our body tends to regulate this by retaining more water, which can cause blood pressure to increase. The American Heart Association recommends limiting daily sodium intake to more than 1500 mg per day. Reducing salt intake can mean choosing foods that are labeled "low sodium" or "sodium-free", not adding additional salt to meals, and overall avoiding foods that may be high in salt (i.e frozen processed foods, processed meats, pickled foods, and potato chips).
Alcohol can also increase blood pressure. The Recommendation is to limit alcohol consumption to no more than one drink per day for women and no more than two drinks per day for men. One standard drink is considered either 12 ounces of regular beer (5% alcohol), 5 ounces of wine (12% alcohol), or 1.5 ounces of distilled spirits(40% alcohol).
Regular exercise and maintaining a healthy weight are also important factors for healthy blood pressure levels. It is recommended to engage in at least 150 minutes of moderate-intense aerobic activity per week or 75 minutes of vigorous aerobic activity per week. This can be broken down into smaller sessions over the course of 3-4 days per week. Examples of moderate-intense aerobic activity include biking, brisk walking, swimming, or even dancing. Vigorous-intensity aerobic activity may include running, jump rope, or hiking.
Lastly, do your best to manage stress levels. Techniques such as deep breathing, meditation, and taking walks might help.