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December 18th, 2018


High Blood Pressure

Incidence

High blood pressure afflicts 75 million adults in the United States and the prevalence dramatically increases in patients older than 60 years. In the African-American population, high blood pressure is more common, more severe, develops earlier in life, and has more long-term serious consequences.

 

Definition

The medical term for high blood pressure is hypertension. but ongoing high blood pressure is really not a matter or "feeling tense." High blood pressure, or hypertension, is the pressure inside of the arteries during heart contraction and between heart contractions. The pressure during contractions is the diastolic pressure, the lower number.

 

Normal blood pressure varies, but normal blood pressure would be 120/80. High blood pressure exists when the systolic number is consistently 140 or above, or the diastolic number is consistently 90 or above, or the person is taking blood pressure medication.

Consequences

High blood pressure is a major risk factor for stroke, myocardial infarction, heart failure, vascular disease, and chronic kidney disease.

 

For every 20-point systolic or 10-point diastolic increase in BP above 115/75, the is a doubling of the death rate for both ischemic heart disease and stroke.

 

Hypertension, within 5 years of its diagnosis, increases the risk of diabetes 2.5 times.

 

African-Americans with hypertension have a 1.5-fold higher risk than hypertensive whites of fatal stroke and a 4.2-fold higher risk of end-stage renal disease.

 

Causes

The causes of most cases of adult hypertension are still unknown.

 

Some cases of high blood pressure are caused by toxins, herbals, and drugs. the most common offenders are alcohol, cocaine, nicotine, ephedra, licorice, some nasal decongestants, cyclosporin, and some of the ibuprofen-type drugs.

 

A common cause of hypertension may be oral contraceptive use. Up to 5% or oral contraceptive users may develop hypertensions. The risk is higher for obese women, those with mild kidney disease or a family history of hypertension, and for those over 35 years of age.

 

Obstructive sleep apnea is another common cause of high blood pressure. These persons have 10 or more episodes per hour of sleeping during which their breathing stops or diminishes to a very low level. Frequently these people exhibit a large neck circumference, unusual snoring, and excessive daytime sleepiness. Treatment of the condition with positive pressure oxygen masks, position adjustments, or dental appliances effectively lowers the blood pressure.

 

Less frequent causes of hypertension are adrenal tumors, kidney disease, underactive thyroid, and overactive thyroid or parathyroid.

 

Treatment

The good news is that hypertension is effectively treatable and that many of the long-term consequences are avoidable. However, hypertension is a chronic condition and treatment and control requires long-term adherence to lifestyle modification and/or medication regimen.

 

Lifestyle Modification

Lifestyle modification is most effective when 2 or more modifications are combined. Modifications to consider are:

  • Weight Loss - A weight reduction of 22 pounds can lower systolic blood pressure by 5-20 points.
  • Reduce Sodium -  Limiting salt to no more than 6 grams (1 teaspoon) daily can lower systolic pressure by 2-8 points.
  • Limit Alcohol -  Limiting alcohol to 1 ounce daily for men or 1/2 ounce daily for women can achieve a systolic blood pressure reduction of 2-4 points. One ounce of alcohol is approximately equal to 24 ounces of beer or 10 ounces of wine.
  • Ensure adequate intake of potassium, calcium, and magnesium.
  • Stop Smoking
  • Exercise - 30 minutes daily of aerobic exercise can reduce systolic blood pressure by 4-9 points.
  • Healthy Diet -  Eating a diet rich in fruits, vegetables, and low-fat dairy products can lower systolic blood pressure by 8-14 points.

Medication

Your physician had more medications than ever from which to choose the right one for your individual blood pressure problem. the right choice depends on your age, the severity of your hypertension, your other medications, your other medical problems, and previous medication intolerances.

 

More than one medication may be appropriate, because the severity of the hypertension, because they work better together, or to reduce side effects from a larger dose of a single drug. Some medications even work better in African-American patients!

 

Conclusion

Hypertension can be a silent killer, stalking you when you don't "fell tense." Learn whether your blood pressure is normal. If it is not, see your doctor. Treat it seriously. Treat it for life and enjoy the healthy years ahead.

 

Thomas Falasca, DO

View this interesting video on high blood pressure - causes, symptoms, and treatment!

 

 

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