High Blood Pressure

Hypertension - also called high blood pressure - is a major health problem in the world today. 60 million Americans have it - that's about 1 in every 4 adults. It directly contributes to the deaths of at least 250,000 people per year in the United States. For good reason, high blood pressure (hypertension) is called the silent killer - you may have it but feel fine. People usually have no symptoms but the condition contributes to heart attack, stroke, heart failure, kidney failure, dementia and blindness.

Blood pressure measurements typically contain two numbers. The higher number is called systolic blood pressure and represents the pressure of blood pushing against the walls
of your blood vessels as it is pumped through your body. The lower number is called the diastolic pressure and represents the portion of time between beats when the heart muscle is resting and filling with blood.

"Normal" Blood Pressure (mm Hg)
Category	Systolic	Diastolic
Optimal *	under 120	under 80
Normal	under 130	under 85
High Normal	130-139	85-89
High Blood Pressure
Hypertension	Systolic	Diastolic
Stage 1	140-159	90-99
Stage 2	160-179	100-109
Stage 3	over 179	over 109

Note: The blood pressure levels at left apply to adults not taking medicine for blood pressure and who are not suffering from any short-term illnesses.

* With respect to heart disease, optimal blood pressure is below 120/80
mm Hg. However, your doctor should evaluate unusually low readings for clinical significance.

Associated Conditions

Stroke - High blood pressure is the most important risk factor for stroke. Risk varies directly with blood pressure and can increase the chance of stroke up to seven times. Stroke is the third leading cause of death in the United States after diseases of the
heart and all forms of cancer. About 600,000 Americans have strokes each year - in
other terms, someone has a stroke every 53 seconds.

Heart disease - High blood pressure triples a person's chance of developing heart disease and increases the chance of congestive heart failure six times. It contributes to arteriosclerosis, a general term for the thickening and hardening of the arteries - If the arteriosclerosis is advanced, heart disease is likely.

Kidney disease - High blood pressure makes the heart work harder and over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they may stop doing their job of removing wastes and extra fluid from the blood. The extra fluid may then raise blood pressure even more.

After diabetes, high blood pressure is the leading cause of kidney failure, commonly called end-stage renal disease (ESRD). Patients with ESRD must either go on dialysis or receive a new kidney through transplant. Every year, high blood pressure causes more than 15,000 new cases of ESRD in the United States.

Blindness - Studies have shown that high blood pressure seriously increases the risk of vision loss, particularly in type II diabetes. Diabetic patients, who were also hypertensive, were found to be 4 times as likely to suffer damage to the eyes as patients without hypertension.

Risk Factors - Men and Women

While it is not known why most people develop high blood pressure, it is known that certain factors place you at greater risk. You may be at greater risk for high blood pressure if you:

Have a history of hypertension in your family.
Have a pre-existing condition such as diabetes or kidney disease.
Are a male.
Are of African-American descent.
Are over 35 years of age.
Smoke.
Are obese.
Are taking oral contraceptives.
Frequently consume alcoholic beverages.
Lead a sedentary lifestyle.

Risk Factors - Women and Pregnancy

5 to 10 percent of pregnant women will develop high blood pressure during their pregnancy. Certain women are at a higher risk for developing it than others, including:

Women with their first pregnancy who are under age 17 or over age 35.
Women with a family history of high blood pressure.
Women who are pregnant with twins or triplets.
Women with poor diets during pregnancy.
Women who are overweight.
Women who smoke.
Women with other health problems, such as blood vessel conditions, kidney disease, diabetes, etc.

High blood pressure, if it does develop, usually occurs sometime after the 24th week of pregnancy. Blood Pressure normally returns to pre-pregnancy levels for most women
after the baby is born. A few women may continue to experience high blood pressure due to underlying kidney disease, diabetes or other health problems.

A Special Message for African Americans

According to the American Heart Association, If you're African American, there's a good chance that you, a relative or a friend has high blood pressure (hypertension.) It affects about one out of three African Americans. High blood pressure develops earlier in life in blacks than in whites and is usually more severe.

Findings published in the July issue of Hypertension, a journal of the American Heart Association, suggest that the problem begins very early in life. Black children as young as 8 years old tend to have higher blood pressure than whites and are more likely to have insulin resistance, a pre-diabetic condition in which the body fails to efficiently respond to insulin. The findings indicate that preventive measures need to begin earlier than most parents realize and suggests pediatricians should focus on diet and exercise to help boost the health of their patients.

Prevention - Recommendations

Have your blood pressure checked regularly.
Eat nutritious foods, including whole grains and fresh fruits and vegetables.
If your doctor has prescribed medication to help lower your blood pressure, take it as directed.
Maintain your ideal body weight.
Maintain a regular exercise program.
Stop smoking.
Manage stress through relaxation, exercise and development of a positive attitude.
Cut down on added salt and avoid high sodium foods such as chips, processed meats, fast food, cured or smoked products and prepared foods.
Limit your daily cholesterol intake to no more than 100 mg per 1000 calories of food.
Restrict saturated fat to no more than 10 percent of daily calories.
If you dine out frequently, think carefully about your food choices.
French and Mexican food tends to be high in fat; Chinese food often is high in sodium. Always look for fresh ingredients cooked lightly with little sauce.
When reading food labels, beware of the following ingredients, which are other terms for sodium: sodium chloride, salt, MSG, some antacids, soy sauce, baking soda, monosodium, teriyaki sauce, baking powder, Na (chemical symbol for sodium.)

Do it yourself

If your blood pressure is high, you can monitor your own blood pressure at home with an inexpensive blood pressure cuff and gauge, available at most drug stores and medical supply outlets.

Many newer blood pressure testers (electronic sphygmomanometers) are easy to use and have digital readouts. They do not require using a stethoscope or other difficult steps. Check your blood pressure gauge for accuracy every six months by comparing its readings with those of the professional gauge in your doctor's office.

If you have difficulty with your home blood pressure testing equipment, get instruction from a healthcare professional.

Treatment - When Prevention isn't enough

Sometimes your best efforts at prevention aren't enough and you will need to take medication. Don’t be discouraged if you need to take medicine from now on. Sometimes you can take smaller doses after your blood pressure is under control but you may always need some treatment. What's most important is that you continue to follow all the prevention guidelines and take your medicine exactly as directed. Never stop treatment on your own. If you have problems with your medicine or if you have side effects, discuss them with your doctor.

Sources:		Back to Top

1. American Heart Association
2. Mayo Clinic
3. National Heart Lung & Blood Institute

Vision and Health Newsletter courtesy of:

Dr. Philip Smith & Associates
1855 1st Ave #100 San Diego, CA 92101 619-297-4331