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Hypertension

What is high blood pressure?

Imagine that your arteries are pipes that carry blood from your heart to the rest of your body. Blood pressure is the force of blood against the walls of arteries. Blood pressure rises and falls during the day. When blood pressure stays elevated (>140/90 mm Hg) over time, it is called high blood pressure or hypertension.

Blood pressure is typically recorded as two numbers - the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats).

High blood pressure is dangerous because it makes the heart work too hard. It risk for heart disease and stroke. High blood pressure can also cause other problems, such as heart failure, kidney disease, and blindness.

What causes hypertension?

The causes of high blood pressure vary. Causes may include narrowing of the arteries, a greater than normal volume of blood, or the heart beating faster or more forcefully than it should. Any of these conditions will cause increased pressure against the artery walls. High blood pressure might also be caused by another medical problem. Most of the time, the cause is not known. Although high blood pressure usually cannot be cured, in most cases it can be prevented and controlled.

Tips for having your blood pressure taken

  • Don't drink coffee or smoke cigarettes 30 minutes before having your blood pressure measured.
  • Before the test, sit for five minutes with your back supported and your feet flat on the ground. Rest your arm on a table at the level of your heart.
  • Wear short sleeves so your arm is exposed.

How is it treated?

Treatment begins with changes you can make in your lifestyle to help lower your blood pressure and reduce your risk of heart disease (see table below). These things alone may work. If these changes don't work, you may also need to take medicine. Even if you must take medicine, making some changes in your lifestyle can help lower how much medicine you must take.

Lifestyle changes

  • Don't smoke cigarettes or use any tobacco product.
  • Lose weight if you're overweight.
  • Exercise regularly.
  • Limit how much sodium you eat.
  • Limit how much alcohol you drink.
  • 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?

Losing weight if you're overweight helps lower blood pressure in most people. 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 people who have high blood pressure should limit the sodium they eat each day to less than 2,300 mg (about 1 teaspoon of table salt).

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 things like bread and cheese.

What about caffeine?

Caffeine in coffee as well as in other drinks, such as tea and sodas, only raises blood pressure temporarily. So you should be able to continue to have drinks that contain caffeine, unless you are sensitive to it or have heart disease and your doctor tells you not to have any.

Do I need to quit drinking alcohol altogether?

In some people, alcohol causes the blood pressure to rise quite a lot. In other people, it doesn't. If you drink alcohol, limit it to no more than 2 drinks per day. One drink is a can of beer, a glass of wine or 1 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 medicines can be used to treat high blood pressure. 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. Don't stop taking the medicine without talking with your family doctor. If you do, you raise your risk of having a stroke or heart attack.

What are the possible side effects of medicine?

Different drugs have different side effects for different people. Side effects of antihypertensive drugs can include feeling dizzy when you stand up after lying down or sitting, lowered levels of potassium in your blood, problems sleeping, drowsiness, dry mouth, headaches, bloating, constipation and cough. In men, some antihypertensive drugs can cause problems with having an erection.

Talk to your family doctor about any changes you notice. If one medicine doesn't work for you or causes side effects, you have other options. Let your doctor help you find the right medicine for you

Questions To Ask Your Doctor If You Have High Blood Pressure

  • What is my blood pressure reading in numbers?
  • What is my goal blood pressure?
  • Is my blood pressure under adequate control?
  • Is my systolic pressure too high (over 140?)
  • What would be a healthy weight for me?
  • Is there a diet to help me lower my blood pressure?
  • Are there any foods, beverage or dietary supplements I should avoid?
  • Is it safe for me to start doing regular physical activity?
  • What is the name of my blood pressure medication?
  • What are the possible side effects of my medications?
  • What time of day should I take my blood pressure medicine?