Medical matters: How you can recognize and treat high blood pressure

Blood pres­sure is the meas­ure­ment of force against the walls of your ar­ter­ies as your heart pumps blood through your body. The meas­ure­ment is giv­en in two dif­fer­ent num­bers: the top or high­er num­ber known as the systol­ic and the bot­tom or lower num­ber known as the dia­stol­ic. The systol­ic is the highest pres­sure and the dia­stol­ic the low­est pres­sure dur­ing each heart­beat.

Nor­mal blood pres­sure is less than 120/80 (or “120 over 80”), while pre­hyper­tens­ive is great­er than 120/80 but less than 140/90. If blood pres­sure is great­er than 140/90, it is con­sidered hy­per­ten­sion or high blood pres­sure.

Stage 1 hy­per­ten­sion is a systol­ic pres­sure between 140 and 159 or a dia­stol­ic between 90 and 99. A systol­ic pres­sure of 160 or great­er qual­i­fies as Stage 2 hy­per­ten­sion, as does a dia­stol­ic pres­sure of 100 or great­er.

There are many causes for hy­per­ten­sion such as fam­ily his­tory or ge­net­ics, obesity, ex­cess­ive al­co­hol in­take, dia­betes, smoking, high salt con­sump­tion, eth­ni­city and age. As a per­son ages, the ar­ter­ies get stiffer and the body can­not reg­u­late the pres­sure as well as it used to do. Less com­mon causes in­clude ad­ren­al gland dis­orders, kid­ney dis­ease and nar­row­ing of ar­ter­ies that sup­ply the kid­neys. This is known as sec­ond­ary hy­per­ten­sion.

The signs of high blood pres­sure vary. A pa­tient can walk in­to the of­fice with a pres­sure of 200/110 and have ab­so­lutely no symp­toms. These pa­tients gen­er­ally have had hy­per­ten­sion for a long peri­od of time, and their body has be­come ac­climated to this pres­sure. This is why hy­per­ten­sion is known as a “si­lent killer.” Pa­tients who are symp­to­mat­ic com­monly com­plain of bad head­aches, blurred vis­ion, nosebleeds and con­fu­sion.

Hy­per­ten­sion af­fects the body in many ways. It puts people at high­er risk for heart at­tack, stroke, kid­ney dis­ease, ret­in­al dis­ease, con­gest­ive heart fail­ure, car­di­omy­opathy, car­di­ac ar­rhythmi­as and dis­sec­tion or rup­ture of aor­tic an­eurysms. The risks are even great­er for pa­tients who have oth­er health is­sues such as dia­betes, vas­cu­lar dis­ease and cho­les­ter­ol dis­orders.

Hy­per­ten­sion can be treated through life­style changes and/or med­ic­a­tion. A pre-hy­per­tens­ive pa­tient would be ad­vised to lose weight, de­crease salt in­take (in­clud­ing table salt and foods that con­tain high levels of so­di­um), ex­er­cise aer­obic­ally, quit smoking, re­duce stress and re­duce al­co­hol in­take. In gen­er­al, if a pa­tient’s blood pres­sure ex­ceeds 150/90, the doc­tor will pre­scribe med­ic­a­tion along with life­style changes, es­pe­cially if the pa­tient is over age 60.

Many pa­tients fear that if they start tak­ing med­ic­a­tion, they will be tak­ing it for the rest of their lives. This may be true in some cases, par­tic­u­larly if the hy­per­ten­sion is hered­it­ary. If a pa­tient is obese, smokes, lives on a fast food diet, uses a lot of salt and drinks al­co­hol ex­cess­ively, but the pa­tient mod­i­fies that life­style and the blood pres­sure de­creases enough, med­ic­a­tions can be dis­con­tin­ued. A home blood pres­sure mon­it­or is a good idea to let the doc­tor know how a pa­tient’s blood pres­sure is at home.

A per­son’s most im­port­ant step is to get to a doc­tor for a well­ness ex­am. The pa­tient may have high blood pres­sure and not even know it. If a per­son has any symp­toms such as severe head­aches or blurred vis­ion, he or she should vis­it a doc­tor as soon as pos­sible or go to an acute care fa­cil­ity (ur­gent care or emer­gency room) for an eval­u­ation.

People who fol­low a healthy life­style in­cor­por­at­ing diet, ex­er­cise and not smoking live longer, health­i­er lives. ••

Dr. Mi­chael Lo­Bi­anco is a fam­ily phys­i­cian with EPIC Phys­i­cians Group, 8019 Frank­ford Ave., in Holmes­burg.

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