What is high blood pressure?
Blood pressure is the force that pushes blood through the blood vessels in your body. In people who have high blood pressure, blood is pushed through the blood vessels with greater force than normal. Another word for high blood pressure is "hypertension."
Blood pressure is recorded as two numbers separated by a slash, like 120/80. The first number is called systolic (say: "sis-tol-ik") pressure; it is the force when the heart pumps. The second number is the diastolic (say: "die-uh-stol-ik") pressure; it is the force when the heart relaxes between beats.
Knowing both of your blood pressure readings can help your doctor tell if you have high blood pressure. Your doctor will want you to keep your normal blood pressure lower than 140/90. If you have diabetes, your doctor will want you to keep your blood pressure lower than 130/80.
What causes high blood pressure?
Your doctor can help you find out what might be causing your high blood pressure. The following are some common factors that can lead to high blood pressure:
A diet high in fat and cholesterol
Not exercising regularly or not exercising hard enough
Being overweight
A family history of high blood pressure
Tobacco use
Stress
Some birth control medicines
Kidney and hormone problems
Why do I have to control my blood pressure?
High blood pressure can damage many parts of the body. If you have high blood pressure, you have a higher risk for stroke, heart disease, heart attacks and kidney failure. Control of your blood pressure can reduce these risks.
You and your doctor will work together to find the best way to lower your blood pressure. Your doctor usually will ask you to change your diet and start exercising more. You may need to lose weight. Your doctor may talk to you about taking medicines to lower your blood pressure.
How can I check my blood pressure?
High blood pressure usually has no symptoms. The only way you can find out that your blood pressure is too high is to check it with a pressure monitor. The higher your blood pressure is, the more often you need to check it.
When you first start treatment to lower your blood pressure, your doctor may want you to come to the office regularly. Your blood pressure will be checked at the office.
You may also be asked to check your blood pressure at home and keep track of your numbers for your doctor. High quality automated arm blood pressure cuffs for home use can be purchased for about $40 to $60. Your doctor may want you to check your blood pressure several times in a day. Another option is to have you use an ambulatory blood pressure monitor.
What is an ambulatory blood pressure monitor?
It's a small machine, about the size of a portable radio. You wear it on a belt. The blood pressure cuff on the monitor can be worn under your clothes without anyone seeing it. The picture to the right shows a person wearing an ambulatory blood pressure monitor.
This machine lets your doctor find out what your blood pressure was every 15 to 30 minutes of a normal day.The information collected by this machine can help you and your doctor see if your blood pressure treatment is working.
Your doctor may want you to use an ambulatory blood pressure monitor for one or more of the following reasons:
If you have "borderline" high blood pressure
If you and your doctor can't keep your blood pressure under control
If you have blood pressure problems caused by your other medicines
If you have changed your medicine
If you are pregnant and have high blood pressure
If you have fainting spells
The monitor may help your doctor find out if you are a person who only has high blood pressure when you are at the doctor's office. This is called "white-coat hypertension." If you have this kind of hypertension, you may not need to take medicine.
What happens when I wear the monitor?
The small blood pressure cuff that is connected to the monitor will automatically check your blood pressure about every 30 minutes, even while you are sleeping. You also will be asked to keep a diary of your day's activities, so your doctor will know when you were active and when you were resting. Some people feel a little sore from the frequent pressure checks. Some people get a rash, but it usually goes away without treatment.
After 24 hours of monitoring, you will take the machine and your diary to the doctor's office. The blood pressure information is transferred from the monitor to a computer. The computer helps the doctor make sense of the information. Your doctor will review the information with you and decide if your treatment program is working or if you need to make changes to it.
High Blood Pressure During Pregnancy
What is blood pressure?
Blood pressure is the pressure in the arteries in your body. It is the force with which the blood moves through the blood vessels. Doctors and nurses measure blood pressure by putting a cuff around your upper arm. Then they listen to your blood flow with a stethoscope. High blood pressure is also called "hypertension."
What causes high blood pressure during pregnancy?
There are three types of high blood pressure in pregnant women:
Chronic hypertension: High blood pressure that develops before the 20th week of pregnancy or is present before the woman becomes pregnant. Sometimes a woman has high blood pressure for a long time before she gets pregnant, but she doesn't know it until her first prenatal check-up.
Gestational hypertension: Some women just get high blood pressure near the end of pregnancy. They don't have any other associated symptoms.
Pregnancy-Induced Hypertension (PIH), also called
Toxemia or Preeclampsia: This condition can cause serious problems for both the mother and the baby if left untreated. PIH develops after the 20th weeks of pregnancy. Along with high blood pressure, it causes protein in the urine, blood changes and other problems.
Why is high blood pressure during pregnancy a problem?
High blood pressure during pregnancy can cause problems for you and your baby:
Chronic hypertension: High blood pressure can make your baby grow too slowly, not get enough nutrients or oxygen. This can hurt your baby's health. Women who have chronic hypertension are also more likely to develop PIH, which can be very dangerous.
Gestational hypertension: This condition does not cause any problems for you or your baby, but it can increase the risk that you will develop high blood pressure later in life. Gestational hypertension can also turn into PIH.
PIH: High blood pressure is not the main problem, but it is one of the main signs of this health condition. PIH can cause headaches, blurred vision, vision loss, abdominal pain and dizziness. It can cause slow growth of the baby, low birth weight and premature delivery. If you get PIH with seizures (called eclampsia), you and your baby are at risk of dying.
How is high blood pressure treated in pregnant women?
The treatment will depend on the reason for the high blood pressure:
Chronic hypertension: If you are already taking medicine for high blood pressure, your doctor may want you to keep taking that medicine. If that medicine is not safe for the baby, your doctor might want you to change to another medicine or to stop taking medicine while you are pregnant. Your doctor will pay special attention to how your baby is growing. You might have ultrasound exams more often. You might have some other tests near the end of your pregnancy to make sure that your baby is healthy. Your doctor will monitor you closely for signs of PIH.
Gestational hypertension: This condition doesn't need any treatment. But it can be hard to tell this condition from early or mild preeclampsia, so your doctor will monitor you very closely to make sure your high blood pressure does not turn into PIH.
PIH: How your doctor treats this condition depends on how close you are to your due date and how you and your baby are doing. The only treatment that stops PIH is to deliver the baby. If your baby is born very early, it may have serious health problems. But your doctor may want your baby to be delivered early if you or the baby are very sick. If your doctor thinks it is safe for the pregnancy to continue to full term, he or she will monitor you and your baby very closely until delivery. You will see your doctor often and get blood tests. Your baby will also get some tests to make sure he or she is healthy. You might need to stay home from work and rest in bed.
What happens to high blood pressure after delivery?
Chronic hypertension: Your blood pressure will probably stay high after you have your baby. You will have to keep taking medicine for high blood pressure, watch your diet and exercise.
Gestational hypertension: Your blood pressure will go back to normal within a few weeks after you have your baby, but you are more likely to develop chronic high blood pressure later in life.
PIH: Your blood pressure will go back to normal within a few weeks after you have your baby.
High Blood Pressure: Things You Can Do to Help Lower Yours
What is high blood pressure?
Arteries are like hoses that carry blood from your heart to the rest of your body. If you put a crimp in a hose, pressure builds up inside it. High blood pressure (also called hypertension) occurs when your blood moves through your arteries at a higher pressure than normal.
What do the numbers mean?
Blood pressure is really two measurements, separated by a slash when written, such as 120/80. You may also hear someone say a blood pressure is "120 over 80."
The first number is the systolic blood pressure. This is the peak blood pressure when your heart is squeezing blood out. The second number is the diastolic blood pressure. It's the pressure when your heart is filling with blood--relaxing between beats.
A normal blood pressure is less than 120/80. High blood pressure is 140/90 or higher. If your blood pressure is between 120/80 and 140/90, you have what is called "prehypertension," which means that if you don’t take important steps, your blood pressure can turn into high blood pressure.
How is high blood pressure diagnosed?
Blood pressure is measured by placing a blood pressure cuff around your arm, inflating the cuff and listening for the flow of blood. Your doctor will measure your blood pressure at more than one visit to see if you have high blood pressure.
How often should I have my blood pressure checked?
After age 18, have your blood pressure checked at least once every 2 years. Do it more often if you have had high blood pressure in the past.
What problems does high blood pressure cause?
Both high blood pressure and prehypertension damage your blood vessels. This in turn raises your risk of stroke, kidney failure, heart disease and heart attack.
Does it have any symptoms?
Not usually. This is why it's so important to have your blood pressure checked regularly.
How is it treated?
Treatment begins with changes you can make to your lifestyle to help lower your blood pressure and reduce your risk of heart disease (see below). If these changes don't work, you may also need to take medicine.
Even if you need to take medicine, making some changes in your lifestyle can help reduce the amount of medicine you must take.
Lifestyle changes
Don't smoke cigarettes or use any tobacco product.
Lose weight if you're overweight.
Exercise regularly.
Eat a healthy diet that includes lots of fruits and vegetables and is low in fat.
Limit your sodium, alcohol and caffeine intake.
Try relaxation techniques or biofeedback.
How do tobacco products affect blood pressure?
The nicotine in cigarettes and other tobacco products causes your blood vessels to constrict and your heart to beat faster, which temporarily raises your blood pressure. If you quit smoking or using other tobacco products, you can significantly lower your risk of heart disease and heart attack, as well as help lower your blood pressure.
What about losing weight and exercising?
If you're overweight, losing weight usually helps lower blood pressure. Regular exercise is a good way to lose weight. It also seems to lower high blood pressure by itself.
Is sodium really off limits?
Not everyone is affected by sodium, but sodium can increase blood pressure in some people. Most Americans with healthy blood pressure should limit the sodium in their diet to 2,300 mg per day. African Americans, older Americans and people with high blood pressure should limit the sodium in their diet to 1,500 mg per day. Your doctor may tell you to limit your sodium even more.
Don't add salt to your food. Check food labels for sodium. While some foods obviously have a lot of sodium, such as potato chips, you may not realize how much sodium is in food like bread, canned vegetables, soups and cheese. Also be aware that some medicines contain sodium.
Do I need to quit drinking alcohol altogether?
In some people, alcohol causes blood pressure to rise quite a lot. In other people, it doesn't. If you drink alcohol, limit it to no more than 1 drink per day for women or 2 drinks per day for men. One drink is a can of beer, a glass of wine (4-5 oz.), or 1 shot (jigger) of liquor. If your blood pressure increases with alcohol, it's best not to drink any alcohol.
Does stress affect my blood pressure?
Stress may affect blood pressure. To help combat the effects of stress, try relaxation techniques or biofeedback. These things work best when used at least once a day. Ask your family doctor for advice.
What about medicine?
Many different types of medicine can be used to treat high blood pressure (see the box below). These are called antihypertensive medicines.
The goal of treatment is to reduce your blood pressure to normal levels with medicine that's easy to take and has few, if any, side effects. This goal can almost always be met.
If your blood pressure can only be controlled with medicine, you'll need to take the medicine for the rest of your life. You may need to take more than one medicine to help control your blood pressure. Don't stop taking the medicine without talking with your family doctor or you may increase your risk of having a stroke or heart attack.