High Blood Pressure (Hypertension)

Blood pressure is the pressure created by the heart as it pumps blood through the arteries and the circulatory system.

What blood pressure numbers mean

• Top number (Systolic)= Pressure while heart is beating.
• Bottom number (Diastolic)= Pressure while heart is resting between beats.

Normal Blood Pressure

• Blood Pressure of < 130/ 80

High Blood Pressure (hypertension)
What High Blood Pressure Does to the Body
High blood pressure puts you at a higher risk for the following:

• Stroke
• Congestive heart failure
• Kidney failure
• Heart attack
• Heart rhythm problems
• Aneurysm

Symptoms of High Blood Pressure
High blood pressure usually has NO SYMPTOMS!! Because of this it is sometimes referred to as “The Silent Killer”.

How to tell if you might have high blood pressure:

• Headache
• Blurry vision
• Chest Pain
• Frequent urination at night

Causes of High Blood Pressure
Blood pressure develops when certain nerve impulses cause arteries to become larger (dilate) or smaller (contract). If vessels are wide open blood flows easily. If vessels narrow pressure inside increases causing hypertension. The cause of vessels narrowing is unknown in 90 to 95% of cases. This is called Primary Hypertension. In 5 to 10% of cases, the cause of vessel narrowing comes from another condition. This is called Secondary Hypertension. Some common conditions that can cause secondary hypertension are:

• Kidney Abnormalities
• Narrowing of certain arteries
• Rare tumors
• Adrenal gland abnormalities
• Pregnancy

Risk Factors of High Blood PressureRisk Factors You Can’t Control

Uncontrollable risk factors are inherent to you and cannot be changed. They include:

• Heredity
• Age
• Men between age 35 and 50
• Women after menopause

Risk Factors You Can Control
Controllable risk factors are lifestyle choices that increase the risk of high blood pressure. They include:

• Increased salt intake
• Obesity
• Alcohol consumption
• Stress
• Lack of exercise

​Women and High Bood Pressure
Women are particularly at risk for hypertension due to the following:

• Birth Control Pill
• Pregnancy
• Overweight
• After Menopause

What You Can Do to Reduce the Risk of Hypertension
High blood pressure is a lifelong disease. It can be controlled, but not cured. Controlling blood pressure will reduce the risk of stroke, heart attack, heart failure and kidney disease. The following lifestyle changes will help you reduce your risk:

• Lose weight if your overweight
• Get regular physical activity
• Avoid excessive alcohol
• Stop smoking
• Manage your stress
• Decrease salt intake
• Eat for heart health
• Discuss the use of oral contraceptives with your doctor
• Discuss the use of some medications with your doctor
• Follow the Ten Commandments for Blood Pressure Control

The Ten Commandments for Blood Pressure Control

1. Know your blood pressure. Have it checked regularly.
2. Know what your weight should be. Keep it at that level or below.
3. Don’t use excessive salt in cooking or at meals. Avoid salty foods.
4. Eat a low-fat diet
5. According to AHA regulations, don’t smoke cigarettes or use tobacco products.
6. Take your medicine exactly as prescribed. Don’t run out of pills even for a single day.
7. Keep your appointments with the doctor.
8. Follow your doctors advice about exercise.
9. Make certain family members have their blood pressure checked regularly.
10. Live a normal life in every other way!

Medication for High Blood Pressure

1. Diuretics — Rid the body of excess fluids and salt.
2. Beta-blockers — Reduce the heart rate and the work of the heart.
3. Calcium antagonists — Reduce heart rate and relax blood vessels.
4. Angiotensin II receptor blockers (ACE) — Interfere with the bodies production of angiotensin, a chemical that causes the arteries to constrict (narrow).
5. Vasodialators — Cause the muscle in the wall of the blood vessels to relax, allowing the vessel to dialate (widen).
6. Sympathetic nerve inhibitors — Sympathetic nerves go from the brain to all parts of the body, including the arteries. They cause arteries to constrict raising blood pressure. These drugs reduce blood pressure by inhibiting these nerves from constricting blood vessels.

​Blood Pressure Measurement
Blood pressure is measured using a sphygmomanometer. There are two numbers in a bood pressure reading.

• Systolic pressure= pressure when 1st sound is heard
• Diastolic pressure= pressure when last sound is heard

In order to get an accurate measurement, the size of the blood pressure cuff should be appropriate.

• Small — children and small adults
• Average
• Large — overweight and large adults

​American Heart Association Recommended Blood Pressure Levels

Copyright Akwa Wellness

Home Blood Pressure Monitoring
​Mercury sphygmomanometer

• Standard for BP monitoring
• No calibration
• May be bulky
• Need a second person to use machine
• May be difficult for hearing impaired or patients with arthritis

Aneroid equipment

• Inexpensive, lightweight and portable
• Two person operation/need stethoscope
• Delicate mechanism, easily damaged
• Needs calibration with mercury sphygmomanometer

Automatic equipment

• Contained in one unit
• Portable with easy-to-read digital display
• Expensive, fragile
• Must be calibrated
• Requires careful cuff placement​

Drs. Christiaan Janssens MBA
CRO Akwa Wellness

Sources and References:
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James, Paul A.; Oparil, Suzanne; Carter, Barry L.; Cushman, William C.; Dennison-Himmelfarb, Cheryl; Handler, Joel; Lackland, Daniel T.; Lefevre, Michael L.; MacKenzie, Thomas D.; Ogedegbe, Olugbenga; Smith, Sidney C.; Svetkey, Laura P.; Taler, Sandra J.; Townsend, Raymond R.; Wright, Jackson T.; Narva, Andrew S.; Ortiz, Eduardo (18 December 2013). “2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults”. JAMA. 311 (5): 507–20.
Lackland, DT; Weber, MA (May 2015). “Global burden of cardiovascular disease and stroke: hypertension at the core”. The Canadian journal of cardiology. 31 (5): 569–71. Mendis, Shanthi; Puska, Pekka; Norrving, Bo (2011). Global atlas on cardiovascular disease prevention and control (PDF) (1st ed.). Geneva: World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization. p. 38. ISBN 9789241564373. Hernandorena, I; Duron, E; Vidal, JS; Hanon, O (July 2017). “Treatment options and considerations for hypertensive patients to prevent dementia”. Expert Opinion on Pharmacotherapy (Review). 18 (10): 989–1000. Poulter, NR; Prabhakaran, D; Caulfield, M (22 August 2015). “Hypertension”. Lancet. 386 (9995): 801–12. doi:10.1016/s0140–6736(14)61468–9.Carretero OA, Oparil S; Oparil (January 2000). “Essential hypertension. Part I: definition and etiology”. Circulation. 101 (3): 329–35. doi:10.1161/01.CIR.101.3.329. “How Is High Blood Pressure Treated?”. National Heart, Lung, and Blood Institute. 10 September 2015. Campbell, NR; Lackland, DT; Lisheng, L; Niebylski, ML; Nilsson, PM; Zhang, XH (March 2015). “Using the Global Burden of Disease study to assist development of nation-specific fact sheets to promote prevention and control of hypertension and reduction in dietary salt: a resource from the World Hypertension League”. Journal of clinical hypertension (Greenwich, Conn.). 17 (3): 165–67.Naish, Jeannette; Court, Denise Syndercombe (2014). Medical sciences (2 ed.). p. 562. ISBN 9780702052491. Lau, DH; Nattel, S; Kalman, JM; Sanders, P (August 2017). “Modifiable Risk Factors and Atrial Fibrillation”. Circulation (Review). 136 (6): 583–96. James, PA.; Oparil, S.; Carter, BL.; Cushman, WC.; Dennison-Himmelfarb, C.; Handler, J.; Lackland, DT.; Lefevre, ML.; et al. (Dec 2013). “2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)”. JAMA. 311 (5): 507–20. Musini, VM; Tejani, AM; Bassett, K; Wright, JM (7 October 2009). “Pharmacotherapy for hypertension in the elderly”. The Cochrane Database of Systematic Reviews (4): CD000028. Sundström, Johan; Arima, Hisatomi; Jackson, Rod; Turnbull, Fiona; Rahimi, Kazem; Chalmers, John; Woodward, Mark; Neal, Bruce (February 2015). “Effects of Blood Pressure Reduction in Mild Hypertension”. Annals of Internal Medicine. 162: 184–91. Xie, X; Atkins, E; Lv, J; Bennett, A; Neal, B; Ninomiya, T; Woodward, M; MacMahon, S; Turnbull, F; Hillis, GS; Chalmers, J; Mant, J; Salam, A; Rahimi, K; Perkovic, V; Rodgers, A (30 January 2016). “Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis”. Lancet. 387 (10017): 435–43Diao, D; Wright, JM; Cundiff, DK; Gueyffier, F (Aug 15, 2012). “Pharmacotherapy for mild hypertension”. The Cochrane Database of Systematic Reviews. 8: CD006742. Garrison, SR; Kolber, MR; Korownyk, CS; McCracken, RK; Heran, BS; Allan, GM (8 August 2017). “Blood pressure targets for hypertension in older adults”. The Cochrane Database of Systematic Reviews.

Websites:

http://newsroom.cumc.columbia.edu/blog/2018/02/14/understanding-the-new-blood-pressure-treatment-guidelines/https://www.medicalnewstoday.com/articles/159283.phphttps://www.health.harvard.edu/topics/blood-pressurehttps://www.healthyhorns.utexas.edu/HT/HT_highbloodpressure.html​http://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017

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