Orlando F. Mills, MD, MPH

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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 a measurement of the force of the blood against the arteries. High blood pressure occurs when your blood moves through your arteries at a higher pressure than normal. High blood pressure is also called hypertension.

 

What do the numbers mean?

Blood pressure is really two measurements.  The first number, or the number “on top,” is the systolic blood pressure.  This is a measurement of the pressure of your blood against the arteries when your heart is squeezing blood out. The second number, or the number “on the bottom,” is the diastolic blood pressure.  This is a measurement of the pressure of your blood against the arteries when your heart is filling with blood or relaxing.

 

Example: Your doctor tells you that your blood pressure is 120/80.  This means that your systolic pressure is 120mmHg (millimeters of mercury). The diastolic pressure is 80mmHg.

 

Normal blood pressure is when your blood pressure is lower than 120/80 most of the time.


Pre-hypertension is when your blood pressure is higher than 120/80, but lower than 140/90.

The term pre-hypertension was chosen because patients with blood pressures in this range are at increased risk of progressing to hypertension and developing cardiovascular complications.

 

Hypertension – is when your blood pressure is usually over 140/90.  There are two stages of high blood pressure.

Stage 1: systolic 140 to 159 mmHg OR diastolic 90 to 99 mmHg

Stage 2: systolic ≥160 mmHg OR diastolic ≥100 mmHg

 

What causes changes in blood pressure?

• The amount of salt and water in your body

• The condition of your kidneys, blood vessels, or nervous system

• Hormone levels


Often, there is no cause found for high blood pressure. This is called essential hypertension.


High blood pressure may be caused by caffeine intake, chocolate intake, salt intake, kidney disease, pregnancy, birth control pills, diet pills, and cold or migraine medicines.

 

You may have been told that your blood pressure is like to be high as you get older. This is due to blood vessels stiffening with age, which in turn raises blood pressure.

Other risk factors for high blood pressure include:

  1. High stress & anxiety
  2. Obesity
  3. African American heritage
  4. Alcohol – more than 1 drink/day for women or 2 drinks/day for men
  5. Salty diet
  6. Family history
  7. Personal history of diabetes
  8. Smoking
  9. Caffeine in diet including caffeinated coffee and chocolate

 

What are the risks of high blood pressure?

Blood pressure that is poorly controlled can be very dangerous for your body. It puts you at risk for stroke, kidney disease, heart attack, heart failure, bleeding from the aorta, the heart’s main artery, poor blood supply to the legs, and visual problems.

A person is considered to have high blood pressure after three to six elevated blood pressure measurements over several months. These definitions apply to adults who are healthy and not using medication for high blood pressure.

 

How is high blood pressure treated?

Treatment begins with lifestyle changes.  If these changes don't work, you may also need to take medicine.

 

Lifestyle changes

  1. Do not smoke or use any tobacco
  2. Lose weight if you're overweight
  3. Exercise. Work up to 30 minutes five times per week. 
  4. Take in non-caffeinated foods and drinks including coffee & chocolate
  5. Limit the salt (sodium) in your diet
  6. Limit alcohol intake
  7. Relaxation techniques such as listening to music, taking a walk, or talking to a friend. 

 

Reducing sodium intake:  Reducing sodium in your diet lowers blood pressure!  You should try to read food labels and keep your sodium intake to less than 1500 mg per day.

 

What about medicine?

Anti-hypertensive medicines help to reduce your blood pressure to normal levels. 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 to Dr. Mills.  

 

What are the medication side effects?

Side effects 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 depression. In men, some anti-hypertensive drugs can cause sexual problems. Talk to Dr. Mills about any changes or problems you notice while on medications.

 

Dr. Mills may ask you to record your blood pressure and bring it to the office at your next visit. If you are purchasing a blood pressure machine for home, keep in mind that a properly fitting arm cuff will give the most accurate reading. Make sure the cuff is on correctly, the batteries are working or the machine is plugged in. You can also bring it with you to your next visit. 

Always take your blood pressure medications before you come for your office visit.

 

Resources:American Academy of Family Physicians: www.aafp.org

Medline Plus: http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm

American Heart Association: www.heart.org