Understanding High-Blood Pressure

High blood pressure increases your chance (or risk) for getting heart disease and/or kidney disease, and for having a stroke. It is especially dangerous because it often has no warning signs or symptoms. Regardless of race, age, or gender, anyone can develop high blood pressure. It is estimated that one in every four American adults has high blood pressure. Once high blood pressure develops, it usually lasts a lifetime. You can prevent and control high blood pressure by taking action. In this section you will learn more about what high blood pressure is and what it does inside the body.

What Is High Blood Pressure?

Blood pressure is the force of blood against the walls of arteries. Blood pressure rises and falls during the day. When blood pressure stays elevated over time, it is called high blood pressure or hypertension. Blood pressure is typically recorded as two numbers the systolic pressure (as the heart beats, i.e., contracts to pump blood) over the diastolic pressure (as the heart relaxes between beats). A consistent blood pressure reading of 140/90 mm Hg or higher is considered high blood pressure, another term for hypertension.

What is systolic blood pressure?

Systolic pressure is the force of blood in the arteries as the heart beats. It is shown as the top number in a blood pressure reading. High blood pressure is 140 and higher for systolic pressure. Diastolic pressure does not need to be high for you to have high blood pressure. When that happens, the condition is called “isolated systolic hypertension,” or ISH.

Is isolated systolic high blood pressure common?

Yes. It is the most common form of high blood pressure for older Americans. For most Americans, systolic blood pressure increases with age, while diastolic increases until about age 55 and then declines. About 65 percent of hypertensives over age 60 have ISH. You may have ISH and feel fine. As with other types of high blood pressure, ISH often causes no symptoms. To find out if you have ISH or any type of high blood pressure see your doctor and have a blood pressure test. The test is quick and painless.

Is isolated systolic high blood pressure dangerous?

Any form of high blood pressure is dangerous if not properly treated. Both numbers in a blood pressure test are important, but, for some, the systolic is especially meaningful. That’s because, for those persons middle aged and older, systolic pressure gives a better diagnosis of high blood pressure.

If left uncontrolled, high systolic pressure can lead to stroke, heart attack, congestive heart failure, kidney damage, blindness, or other conditions. While it cannot be cured once it has developed, ISH can be controlled.

Clinical studies have proven that treating a high systolic pressure saves lives, greatly reduces illness, and improves the quality of life. Yet, most Americans do not have their high systolic pressure under control.

Does high blood pressure require special treatment?

Treatment options for ISH are the same as for other types of high blood pressure, in which both systolic and diastolic pressures are high. ISH is treated with lifestyle changes and/or medications. The key for any high blood pressure treatment is to bring the condition under proper control. Blood pressure should be controlled to less than 140/90 mm Hg. If yours is not, then ask your doctor why. You may just need a lifestyle or drug change, such as reducing salt in your diet or adding a second medication.

What is diastolic blood pressure?

Diastolic pressure is the force of blood in the arteries as the heart relaxes between beats. It’s shown as the bottom number in a blood pressure reading. The diastolic blood pressure has been and remains, especially for younger people, an important hypertension number. The higher the diastolic blood pressure the greater the risk for heart attacks, strokes and kidney failure. As people become older, the diastolic pressure will begin to decrease and the systolic blood pressure begins to rise and becomes more important. A rise in systolic blood pressure will also increase the chance for heart attacks, strokes, and kidney failure. Your physician will use both the systolic and the diastolic blood pressure to determine your blood pressure category and appropriate prevention and treatment activities.

Why Is High Blood Pressure Important?

High blood pressure is dangerous because it makes the heart work too hard. It also makes the walls of the arteries hard. High blood pressure increases the risk for heart disease and stroke, the first- and third-leading causes of death for Americans. High blood pressure can also cause other problems, such as heart failure, kidney disease, and blindness.

What Causes High Blood Pressure?

The causes of high blood pressure vary. Causes may include narrowing of the arteries, a greater than normal volume of blood, or the heart beating faster or more forcefully than it should. Any of these conditions will cause increased pressure against the artery walls. High blood pressure might also be caused by another medical problem. Most of the time, the cause is not known. Although high blood pressure usually cannot be cured, in most cases it can be prevented and controlled.

Who Can Develop High Blood Pressure?

High blood pressure is common. More than 50 million American adults – 1 in 4 – have high blood pressure. It is very common in African Americans, who may get it earlier in life and more often than whites. Many Americans tend to develop high blood pressure as they get older, but this is not a part of healthy aging. About 60% of all Americans age 60 and older have high blood pressure. Others at risk for developing high blood pressure are the overweight, those with a family history of high blood pressure, and those with high-normal blood pressure (130-139/85-89 mm Hg).

African Americans

High blood pressure occurs more often among African Americans than whites. It begins at an earlier age and is usually more severe. Further, African Americans have a higher death rate from stroke and kidney disease than whites. The good news is, treatment can control high blood pressure. In addition, lifestyle changes can prevent and control high blood pressure. These include losing weight if overweight (losing 10 lbs can help), increasing physical activity (walking 30 minutes per day can help), following a healthy eating plan, that emphasizes fruits, vegetables, and low-fat dairy foods, choosing and preparing foods with less salt and sodium, and if you drink alcoholic beverages, drinking in moderation. If lifestyle changes alone are not effective in keeping your blood pressure controlled, there are many blood pressure medications to help you.

A diet that has been found to be effective in lowering blood pressure is called Dietary Approaches to Stop Hypertension (DASH). In January 2016 the DASH diet was ranked the best diet for the 6th year in a row by U.S. News and World Report. It is not only good for lowering blood pressure, but effective for weight loss, lowering cholesterol and managing/preventing diabetes.

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