What is high blood pressure?

High blood pressure, also called hypertension, is a condition in which the pressure of blood flowing through your arteries is  consistently too high.

A blood pressure reading is recorded as two numbers.   The number on the top is called the systolic blood pressure.   This is a measure of the pressure on your artery walls when your heart beats.   The bottom number is called the diastolic blood pressure.   The diastolic pressure is a measure of the pressure on your artery walls  between heart beats, when  your heart is resting.

As we age,  increased stiffness in our arteries and the  build up of plaque contributes to an increase in the systolic blood pressure. Both systolic and diastolic readings are important when evaluating blood pressure and an elevation in either one can lead to a diagnosis of hypertension.

The American Heart Association has 5 categories of hypertension:


Normal  is less than 120 on top and 80 on the bottom.


Elevated blood pressure is when multiple readings  range from 120-129  on top and less than 80 on bottom.

Hypertension Stage 1 is when blood pressure consistently ranges from 130-139 on top or 80-89 on bottom.

Hypertension Stage 2 is when blood pressure consistently ranges  140 or higher on top or 90  or higher on bottom.

A hypertensive crisis  is when your blood pressure readings suddenly go above 180 on top or 120 on bottom.

What are the signs of high blood pressure?

Dizziness, fatigue, headaches, ringing in your ears,  feeling light headed,  or facial flushing may be signs of high blood pressure.   However, hypertension is also known as “the silent killer” because most of the time people do not experience any signs or symptoms of high blood pressure.

Is high blood pressure dangerous?

High blood pressure is dangerous if it goes untreated over a period of time.   Damage to vessels can decrease the blood flow to your heart muscle and cause a heart attack.  Vessels in your brain may  burst open, this a called stroke.  The elevated pressure can cause your heart to work too hard, causing the heart muscle to enlarge.  When this happens your heart does not work as efficiently as it does when it is  a healthy size.   Damage to the vessels of your kidneys prevents your kidneys from filtering your blood properly.   Damage to vessels in the back of your eyes can lead to vision loss.   Erectile dysfunction or changes in libido can also be caused by uncontrolled high blood pressure.

How can I control my blood pressure?

Maintain a healthy weight.  If you are overweight work on eating fewer calories and get moving!

Follow a heart health diet.   This means your diet should consist mainly of  fruits and vegetables, whole grains,  nuts and legumes, low fat dairy products and lean proteins.  Avoid or limit things such as saturated and trans fats, sodium, red meat and processed foods.  Sugary foods and drinks,  caffeine and alcohol should also be limited.

Stay active!  Engage in at least 30 minutes of brisk cardiovascular exercise 5 days per week.  Try a variety of activities that get your heart pumping!   Try brisk walking, dancing, swimming, playing basketball, bicycling, or hiking.  Finding something you enjoy will increase the likelihood  that you maintain your exercise regimen.

Stop smoking! Smoking increases the plaque build up in your arteries. Smoking even one cigarette causes an immediate, temporary elevation in your blood pressure.  Smoking is a leading cause of preventable death in the United States.

Manage stress.  When faced with a stressful situation our bodies release cortisol and adrenaline.   These stress hormones are responsible for our “fight or flight” response.   When this occurs,  your heart rate goes up and blood vessels constrict, to redirect blood flow from your extremities and increase circulation to your vital organs.   Constriction of blood  vessels increases your blood pressure.   Learn to manage your time, say “no” and prioritize commitments, practice stress reducing  techniques (such as yoga or meditation), participate in regular exercise, and make time to engage in activities you enjoy.

Avoid products that are known to increase  blood pressure such as decongestants  (commonly found in cold and allergy medications), amphetamines, recreational drugs,  caffeine, and alcohol.   Some prescription medications (such as some anti-inflammatories, birth control pills, anti-depressants) can cause high blood pressure and should be used with caution.

Talk to  your healthcare provider.   Your provider may suggest some changes to your lifestyle to help control your blood pressure.  If your blood pressure remains elevated despite  lifestyle modifications, medications may be prescribed.   There are many different types of blood pressure medications.  Blood pressure medications are divided into different classes based on how they work. Some work on reducing the water in your body,  some dilate your blood vessels, others help your heart beat stronger. It is not uncommon for blood pressure medications from different classes to be taken together to achieve  control.

It is very important that blood pressure medications be taken exactly as prescribed.   Make sure your provider knows all of the medications  (both prescribed and over the counter) and supplements that you are taking.  If you are experiencing any side effects from your medications talk to your healthcare provider before stopping or altering the dose of your medication.

Working with your healthcare provider

Controlling your blood pressure requires you to have a committed relationship with your healthcare provider.   Avoid “doctor shopping”.  Develop a trusting relationship with your doctor or nurse practitioner.  Be patient and know that blood pressure medications take time to control your blood pressure.   Does adjustments  or medication changes may  be needed.   Make  follow up appointments with your healthcare provider as directed.  Get lab work done when requested.   Let your provider know if you are having trouble affording your medication.   Refill your medication before you run out. Monitor your blood pressure and home and bring your readings to your  appointments.   Help your healthcare provider help you.   Working together your blood pressure can be controlled!






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