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.