Hypertension

Basic Facts

  • Hypertension, or high blood pressure, is sometimes called “the silent killer” because there are rarely any symptoms.
  • Hypertension is a primary factor in causing hardening of the arteries throughout the body (called, atherrosclerosis). It increases the risk for heart disease, stroke, aortic aneurysm rupture, peripheral arterial disease, kidney failure, and blindness.
  • Approximately 43 million Americans have high blood pressure, but nearly 1 in 3 of them don’t know it.
    Hypertension is elevated blood pressure that is consistently above normal ranges. Hypertension can go undetected for years while it causes irreparable organ damage, even leading to sudden death from a stroke or heart attack.
  • Blood pressure is a measure of the force of blood that is pushing against the inside of artery walls. The more blood the heart pumps and the more resistance in the arteries, the greater the blood pressure.
  • Blood pressure is measured in millimeters of mercury (mm Hg) as two numbers, and written like a fraction. Normal blood pressure is considered below 120/80 mm Hg. Pressure that consistently equals or exceeds 140/90 mm Hg diastolic is considered high. Diastolic blood pressure that reaches 120 mm Hg requires urgent treatment to prevent heart failure or other complications.
  • People with systolic blood pressure between 120 and 139 or diastolic blood pressure between 80 and 89 are considered prehypertensive and should modify lifestyle factors such as diet and exercise to prevent cardiovascular disease.
  • Hypertension adversely affects the heart, the blood vessels, and other organs and can lead to the following health problems:
    • Congestive heart failure
    • Atherosclerosis
    • Tissue death or failure of organs such as the kidneys
    • Stroke
    • Aneurysms (bulges in arteries that are subject to rupture)

Symptoms

Hypertension has no obvious symptoms. Symptoms only occur after complications have already developed. These symptoms may include one or more of the following:

  • Blurred vision
  • Dizziness
  • Headaches
  • Facial flushing

Symptoms of severe hypertension may include:

  • Nausea
  • Irregular or rapid heartbeat
  • Vomiting
  • A buzzing noise in the ear
  • Shortness of breath
  • Blurred vision

Causes & Risk Factors

In 85 – 90 percent of cases, there is no known cause for hypertension. This kind of hypertension is known as ‘primary.’ There are a number of risk factors that may contribute to primary hypertension, including:

  • Age
  • Heredity
  • Race (for example, African Americans are more likely to develop hypertension than white Americans)
  • Sex (until the age of 55 males are more likely to develop hypertension; over 55, women are more likely to develop it)
  • Smoking
  • Being overweight
  • Insufficient exercise or physical activity

When hypertension occurs because of a medical condition or medication, it is referred to as ‘secondary.’ Factors that may contribute to secondary hypertension include:

  • Blockage of artery blood flow to the kidneys
  • Kidney disease
  • A tumor of the adrenal gland
  • A congenital defect of the aorta
  • Pregnancy
  • A hormonal disorder
  • Hyperthyroidism
  • Use of alcohol, oral contraceptives, or corticosteroids

Diagnosis

In order to diagnose hypertension, physicians will require tests to be done. The first test that will be performed, is a measurement of the patient’s blood pressure. Blood pressure is measured using a sphygmomanometer—an inflatable arm cuff attached to a pressure gauge—and a stethoscope. To measure blood pressure, the cuff is wrapped around the upper arm and the stethoscope is placed at or near the inside of the elbow. The cuff is inflated until the pressure gauge reading is at least 30 mm Hg higher than the expected systolic blood pressure. As the cuff is slowly deflated, the pulse becomes audible and then stops briefly before returning. The pressure reading at which the pulse is first heard is the systolic pressure. The reading at which the pulse ceases to be audible is the diastolic pressure.

If hypertension is diagnosed, additional tests are commonly ordered to determine if organ damage has occurred because of the condition. These tests include:

  • Electrocardiography (ECG)
  • Echocardiography
  • Urine analysis
  • Blood analysis
  • Chest x ray
  • Eye examination

Treatment Options

Though not entirely curable, hypertension can be treated successfully through lifelong lifestyle modifications and, when appropriate, medication.

For mild hypertension, positive lifestyle changes are usually enough to reduce blood pressure. Some recommended lifestyle changes include:

  • Quit smoking
  • Lose weight
  • Moderate alcohol intake
  • Exercise regularly
  • Eat a healthy diet

If lifestyle changes do not reduce blood pressure sufficiently (or if high blood pressure is severe or complicated by medical conditions such as heart disease or diabetes) medications may be prescribed. The most commonly prescribed antihypertensive medications are:

  • Diuretics
  • Beta-blockers
  • ACE (angiotensin-converting enzyme) inhibitors
  • Angiotensin II receptor blockers
  • Calcium channel blockers

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Medical Review Date: November 16, 2009 / Copyright © 2012 NorthPoint Domain, Inc. All rights reserved. This material cannot be reproduced in digital or printed form without the express consent of NorthPoint Domain, Inc. Unauthorized copying or distribution of NorthPoint Domain’s Content is an infringement of the copyright holder’s rights.

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