The Hype About Hypertension: Understanding High Blood Pressure.

For your body, the heart and blood vessels function a lot like the plumbing in your home. The heart acts as a pump, the arteries are the pipes, and the blood is like water flowing through the house. Blood pressure is the measurement of how hard blood pushes against the walls of the arteries as it travels through the body.

While everyone needs some pressure to keep the blood flowing, too much pressure can strain our system over time. For most adults, an optimal blood pressure reading is 120/80. The Centers for Disease Control and Prevention reports almost half of U.S. adults have blood pressure that’s higher than that, called hypertension. 

Over time, high blood pressure can damage and weaken blood vessels, significantly raising your risk of stroke, heart disease, kidney disease or even heart failure if left untreated.

Hypertension can be caused by factors beyond your control, such as congenital heart disease present at birth or narrowing of the arteries (stenosis). Age is also a risk factor—an estimated 74% of people 60 and older live with high blood pressure. 

In some cases, the cause is unclear, while in other cases lifestyle factors may contribute to high blood pressure, including:
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• A lack of exercise

• Chronic stress

• Consuming too much alcohol

• Eating too much sodium (table salt)

• Excess body weight

• Smoking

The good news is high blood pressure is very treatable. Your watchful eye paired with your doctor’s guidance can usually result in safe control of blood pressure. Simple lifestyle adjustments and effective medications may be all it takes to optimize your numbers and reduce your risk.

How do I know if my blood pressure is high?

Stable hypertension, or high blood pressure that’s consistent, is a silent condition that doesn’t have unique symptoms. You may not know there’s a problem. Regular at-home monitoring can help you and your doctor track trends and pinpoint concerns.

How to measure your blood pressure at home.

Measure your blood pressure at home using a monitor with an inflatable cuff that wraps around your upper arm. These devices are usually available at your local drugstore or pharmacy. Blood pressure cuffs can produce more reliable readings than wrist monitors. Check your blood pressure when you’re calm and relaxed. Be sure to sit with your feet flat on the floor and your arms rested.

Blood pressure is measured in millimeters of mercury, or mmHg. The top number, or systolic number, measures the peak of blood pressure when your heart pumps. The bottom number, or diastolic number, measures the blood pressure when your heart is relaxed. 

Adults have five measurement thresholds:
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• Optimal: Less than 120/80 mmHg 

• Elevated: 120-129/ less than 80 mmHg

• Hypertension stage 1: 130-139/80-89 mmHg

• Hypertension stage 2: 140/90 mmHg or higher

• Hypertensive crisis: 180/120 mmHg or higher

Hypertensive crisis requires immediate, same-day attention from a doctor. If you see high readings like these at home, rest calmly for five minutes, then check again. If your measurement remains high, contact a healthcare professional for guidance right away.

Keep a record of your home blood pressure numbers and share them with your doctor. This history can help identify patterns of high blood pressure and inform treatment options. Together, you can help prevent a serious cardiovascular problem down the road. 

When is the best time to measure my blood pressure?

Morning is a great time to take your blood pressure. If you take morning medications, monitor your blood pressure about an hour later. Keep your back supported, and don’t cross your legs while measuring.

Don’t take your blood pressure right after eating a meal, exercising, or handling a stressful situation. Give yourself time to settle. If you get an elevated or high reading, wait five minutes and try again to be sure it’s an accurate measurement. Listening to relaxing music or deep breathing exercises can help.

Be sure to follow your doctor’s guidance on the frequency of monitoring that’s right for your unique health needs.

What are the treatments for high blood pressure?

If you’re diagnosed with hypertension, talk with your doctor about healthy lifestyle changes you could make, including:
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• Achieving a healthy weight

• Brisk 30-minute walks

• Heart-healthy eating like the Mediterranean Diet

• Stress management

• Table salt substitutes, such as potassium salt

When necessary, medications may be prescribed to support lifestyle adjustments. Medications like Lisinopril and Losartan are common, safe treatments for high blood pressure. If your doctor prescribes medicines to help manage hypertension, be sure to take them faithfully. Sticking to the treatment plan will help your doctor recognize what’s working or if there’s a secondary cause for your high blood pressure.

Even with a healthy lifestyle and a medication plan that’s followed precisely, some patients still can’t get their high blood pressure to budge. This is called resistant hypertension, and it requires specialized treatment.

An innovative treatment for resistant hypertension.

As many as 19% of patients have resistant hypertension that doesn’t respond to medication. 

If you’ve adjusted your lifestyle and taken your medications but your numbers still won’t come down, you may have “resistant hypertension.” A new, minimally invasive option called renal denervation may help.

Nerves in the kidneys communicate information about blood pressure with the brain. Eliminating signals from these nerves can help. Renal denervation is a minimally invasive procedure to alter nerves inside the kidneys, modestly lowering blood pressure over time.

Related: Read “Minimally Invasive Therapy for High Blood Pressure: A New Tool to Manage Resistant Hypertension.”

Together we can take control of your blood pressure.

Today is a great day to schedule an appointment with your primary care doctor or cardiologist to check in and discuss your blood pressure numbers. No concern is too small when it comes to your heart, and optimizing your blood pressure is an effective way to take control of your heart health.