Hypertension
Blood pressure normally goes up and down, depending on your activities and emotions. However, when your blood pressure is consistently high, you have a condition known as hypertension.
For most adults, a normal blood pressure is about 120 over 80. Hypertension is usually defined as consistently having a systolic pressure (top number) of 140 or more, and/or a diastolic pressure (bottom number) of 90 or more.
Hypertension is very common. However, it rarely causes symptoms in itself and only about 50 percent of people know they have it. Unfortunately, even mild hypertension increases the likelihood of heart attack and stroke; hypertension may be at least partly responsible for 25 percent of all deaths from cardiovascular disease. For this reason, it is called "the silent killer."
In 85 percent to 90 percent of cases, hypertension is "essential" or "primary" — meaning doctors are not certain of the exact cause. In a minority of cases, hypertension is caused by other conditions, such as diabetes, kidney disease and side effects of certain over-the-counter or prescription medications.
Certain behaviours increase the likelihood of developing hypertension. They include smoking, obesity, a high-fat or high-salt diet, drug abuse, drinking alcohol in excess, and lack of exercise. Men and, in particular, black (African American) men are more likely to become hypertensive than women and, in particular, white (Caucasian) women. Getting older, as well as having a family history of hypertension, in addition increase your chances of developing the condition.
What you can do
Detecting hypertension
The best way to detect hypertension is to have your blood pressure checked at regular intervals — at least every two years for adults. If you are at risk of developing hypertension or heart disease (if you have high cholesterol, diabetes or a family history of heart disease, for example), have your blood pressure checked once a year. Primary health care pharmacies are able to take your blood pressure.
Although extremely high blood pressure occasionally produces symptoms such as headache, irregular heart beat, dizziness, nosebleeds or a general feeling of illness, do not wait for the symptoms to surface before having your blood pressure checked. The earlier hypertension is detected, the easier it is to treat.
A single elevated blood pressure reading does not necessarily mean you have hypertension. Blood pressure fluctuates in response to time of day, recent activity, pain, and even factors such as having just smoked a cigarette or drunk a cup of coffee. Usually, doctors require more than one reading taken on different occasions to diagnose hypertension.
Once you have been diagnosed, your doctor is likely to do some routine blood and urine tests and an electrocardiogram (ECG).
Making important changes
Many people with mild hypertension are able to lower their blood pressure sufficiently by making some lifestyle changes. For individuals with moderate-to-severe hypertension, certain behaviour changes may greatly enhance the effects of drug therapy. Modifications that often help include:
Managing with medication
The goal of medical treatment is to control blood pressure while creating as few side effects as possible. Medications your doctor may prescribe include diuretics (drugs that remove fluid from the body by increasing urination), and drugs that work directly on the blood vessels, heart and chemicals in the blood.
Complying with treatment
It is critically important that you comply with the treatment programme your doctor prescribes, including behaviour modification strategies and drug therapy. If you have trouble with any part of the programme — including experiencing any unexpected symptoms or side effects after beginning a new medication — discuss this with your doctor; it's quite likely he or she will be able to recommend alternatives that work better for you.
Long-term, follow-up care is very important for people with hypertension. Your doctor will decide how often follow-up visits should be scheduled based on the severity of your hypertension, treatment response and other factors.
Call your doctor if . . .
Your systolic pressure is higher than 140, or your diastolic pressure is higher than 90. Do not attempt to diagnose hypertension yourself; only your doctor can do this after taking into account the various factors that affect blood pressure readings, your individual circumstances and other relevant issues.
In addition, you should call your doctor right away if your systolic pressure is higher than 180, or your diastolic pressure is higher than 110. Seek immediate care if your systolic pressure is 210 or higher, or your diastolic pressure is 120 or higher.
Also seek immediate care if you experience symptoms of stroke such as...
For most adults, a normal blood pressure is about 120 over 80. Hypertension is usually defined as consistently having a systolic pressure (top number) of 140 or more, and/or a diastolic pressure (bottom number) of 90 or more.
Hypertension is very common. However, it rarely causes symptoms in itself and only about 50 percent of people know they have it. Unfortunately, even mild hypertension increases the likelihood of heart attack and stroke; hypertension may be at least partly responsible for 25 percent of all deaths from cardiovascular disease. For this reason, it is called "the silent killer."
In 85 percent to 90 percent of cases, hypertension is "essential" or "primary" — meaning doctors are not certain of the exact cause. In a minority of cases, hypertension is caused by other conditions, such as diabetes, kidney disease and side effects of certain over-the-counter or prescription medications.
Certain behaviours increase the likelihood of developing hypertension. They include smoking, obesity, a high-fat or high-salt diet, drug abuse, drinking alcohol in excess, and lack of exercise. Men and, in particular, black (African American) men are more likely to become hypertensive than women and, in particular, white (Caucasian) women. Getting older, as well as having a family history of hypertension, in addition increase your chances of developing the condition.
What you can do
Detecting hypertension
The best way to detect hypertension is to have your blood pressure checked at regular intervals — at least every two years for adults. If you are at risk of developing hypertension or heart disease (if you have high cholesterol, diabetes or a family history of heart disease, for example), have your blood pressure checked once a year. Primary health care pharmacies are able to take your blood pressure.
Although extremely high blood pressure occasionally produces symptoms such as headache, irregular heart beat, dizziness, nosebleeds or a general feeling of illness, do not wait for the symptoms to surface before having your blood pressure checked. The earlier hypertension is detected, the easier it is to treat.
A single elevated blood pressure reading does not necessarily mean you have hypertension. Blood pressure fluctuates in response to time of day, recent activity, pain, and even factors such as having just smoked a cigarette or drunk a cup of coffee. Usually, doctors require more than one reading taken on different occasions to diagnose hypertension.
Once you have been diagnosed, your doctor is likely to do some routine blood and urine tests and an electrocardiogram (ECG).
Making important changes
Many people with mild hypertension are able to lower their blood pressure sufficiently by making some lifestyle changes. For individuals with moderate-to-severe hypertension, certain behaviour changes may greatly enhance the effects of drug therapy. Modifications that often help include:
- Losing weight (if needed)
- Reducing dietary fats, especially saturated fats
- Getting regular exercise (always consult with your doctor before beginning an exercise programme)
- Restricting or eliminating alcohol consumption (more than 60ml. of alcohol per day can elevate your blood pressure)
- Avoiding the use of tobacco
- Reducing dietary salt intake is recommended, but the value is debatable
Managing with medication
The goal of medical treatment is to control blood pressure while creating as few side effects as possible. Medications your doctor may prescribe include diuretics (drugs that remove fluid from the body by increasing urination), and drugs that work directly on the blood vessels, heart and chemicals in the blood.
Complying with treatment
It is critically important that you comply with the treatment programme your doctor prescribes, including behaviour modification strategies and drug therapy. If you have trouble with any part of the programme — including experiencing any unexpected symptoms or side effects after beginning a new medication — discuss this with your doctor; it's quite likely he or she will be able to recommend alternatives that work better for you.
Long-term, follow-up care is very important for people with hypertension. Your doctor will decide how often follow-up visits should be scheduled based on the severity of your hypertension, treatment response and other factors.
Call your doctor if . . .
Your systolic pressure is higher than 140, or your diastolic pressure is higher than 90. Do not attempt to diagnose hypertension yourself; only your doctor can do this after taking into account the various factors that affect blood pressure readings, your individual circumstances and other relevant issues.
In addition, you should call your doctor right away if your systolic pressure is higher than 180, or your diastolic pressure is higher than 110. Seek immediate care if your systolic pressure is 210 or higher, or your diastolic pressure is 120 or higher.
Also seek immediate care if you experience symptoms of stroke such as...
- Sudden weakness or numbness of the face or an extremity
- Sudden change in vision
- Trouble talking or understanding speech
- Sudden severe headache