Friday, January 30, 2015

Hypertension

Hypertension Overview
High blood pressure or hypertension increases the risk of heart disease and stroke. Hypertension risk factors include obesity, drinking too much alcohol, smoking, and family history. Beta-blockers are a common treatment for hypertension.

Overview & Facts
High blood pressure, also known as hypertension, affects millions -- even children and teens.

High Blood Pressure Basics
Hypertension, or high blood pressure, is a common condition that will catch up with most people who live into older age.

What Is High Blood Pressure?
High blood pressure, also known as hypertension, is the most common cardiovascular disease.
Blood pressure refers to the force of blood pushing against artery walls as it courses through the body. Like air in a tire or water in a hose, blood fills arteries to a certain capacity. Just as too much air pressure can damage a tire or too much water pushing through a garden hose can damage the hose, high blood pressure can threaten healthy arteries and lead to life-threatening conditions such as heart disease and stroke.






Hypertension is the leading cause of stroke and a major cause of heart attack.
How Is Blood Pressure Measured?
A blood pressure reading appears as two numbers. The first and higher of the two is a measure of systolic pressure, or the pressure in the arteries when the heart beats and fills them with blood. The second number measures diastolic pressure, or the pressure in the arteries when the heart rests between beats.

Who Gets Hypertension?
High blood pressure is more likely in people who:
  • ·         Have a family history of high blood pressure, heart disease, or diabetes
  • ·         Are over age 55
  • ·         Are overweight
  • ·         Are not physically active
  • ·         Drink excessively
  • ·         Smoke
  • ·         Eat foods high in salt
  • ·         Use certain medications such as NSAIDs (ibuprofen, aspirin, e.g.), decongestants, and illicit drugs such as cocaine


What Causes High Blood Pressure?
What Does the Systolic Blood Pressure Number Mean?
When your heart beats, it contracts and pushes blood through the arteries to the rest of the body. This force creates pressure on the arteries. This is called systolic blood pressure.
·         A normal systolic blood pressure is below 120.
·         A systolic blood pressure of 120 to 139 means you have prehypertension, or borderline high blood pressure. Even people with prehypertension are at a higher risk of developing heart disease.
·         A systolic blood pressure number of 140 or higher is considered to be hypertension, or high blood pressure.

What Does the Diastolic Blood Pressure Number Mean?
The diastolic blood pressure number or the bottom number indicates the pressure in the arteries when the heart rests between beats.
·         A normal diastolic blood pressure number is less than 80.
·         A diastolic blood pressure between 80 and 89 indicates prehypertension.
·         A diastolic blood pressure number of 90 or higher is considered to be hypertension or high blood pressure.


Diagnosis & Tests
Diagnosis
Hypertension, or high blood pressure, is often called a "silent disease" because you usually don't know that you have it. There may be no symptoms or signs. Nonetheless, it damages the body and eventually may cause problems like heart disease.
Therefore, it's important to regularly monitor your blood pressure, especially if it has ever been high or above the "normal" range, or if you have a family history of hypertension. Because hypertension can cause heart disease, you may also need to be tested for heart disease.

Measuring Blood Pressure
You can get your blood pressure measured by a health care provider, at a pharmacy, or you can purchase a blood pressure monitor for your home.
Blood pressure is most often measured with a device known as a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve.
Blood pressure is measured in two ways: systolic and diastolic.
  • ·         Systolic blood pressure is the maximum pressure during a heartbeat.
  • ·         Diastolic blood pressure is the lowest pressure between heartbeats.


Your doctor will also conduct a physical exam.
If you're diagnosed with high blood pressure, your doctor may recommend other tests, such as:
  • ·         Electrocardiogram (EKG or ECG): A test that measures the electrical activity, rate, and rhythm of your heartbeat via electrodes attached to your arms, legs, and chest. The results are recorded on graph paper.
  • ·         Echocardiogram: This is a test that uses ultrasound waves to provide pictures of the heart's valves and chambers so the pumping action of the heart can be studied and measurement of the chambers and wall thickness of the heart can be made.

Tests
Tests for High Blood Pressure
The only way to tell whether you have high blood pressure is to have it measured with a blood pressure cuff (sphygmomanometer).
  • This device consists of a gauge and a rubber cuff that is placed around your arm and inflated.
  • Having your blood pressure measured is painless and takes just a few minutes.
  • Blood pressure (BP) is classified as follows by the American Heart Association:
Normal BP:
  • Under age 60: Systolic less than 140 mm Hg; diastolic less than 90
  • Age 60 years and older:  Systolic less than 150 mm Hg; diastolic less than 90 mm Hg
High BP:
  • Under age 60: Systolic greater than 140 mm Hg; diastolic greater than 90 mm Hg
  • Age 60 years and older: Systolic greater than 150 mm Hg; diastolic greater than 90 mm Hg
Tests may be ordered by your health care provider to check for causes of high blood pressure and to assess any organ damage from high blood pressure or its treatment. These tests may include the following:
  • Blood tests, including measurement of electrolytes, blood urea nitrogen, and creatinine levels (to assess kidney involvement)
  • Lipid profile for levels of various kinds of cholesterol
  • Special tests for hormones of the adrenal gland or thyroid gland
  • Urine tests for electrolytes and hormones
  • A noninvasive, painless eye examination with an ophthalmoscope will look for ocular damage.
  • Ultrasound of the kidneys, CT scan of the abdomen, or both may be done to assess damage or enlargement of the kidneys and adrenal glands
Treatment & Care
Treating high blood pressure can take a multi-pronged approach including diet changes, medication, and exercise. Learn about hypertension treatment options here.

Treatment

Drugs to Treat High Blood Pressure

There are several types of drugs used to treat high blood pressure, including:
·         Angiotensin-converting enzyme (ACE) inhibitors
·         Angiotensin II receptor blockers (ARBs)
·         Diuretics
·         Beta-blockers
·         Calcium channel blockers
·         Alpha-blockers
·         Alpha-agonists
·         Renin inhibitors
·         Combination medications

High Blood Pressure and Smoking
Smoking makes you more likely to get high blood pressure and heart disease. Put quitting at the top of your to-do list to help lower your blood pressure. It could save your life.

The nicotine in cigarette smoke is a big part of the problem. It raises your blood pressure and heart rate, makes your arteries more narrow and hardens their walls, and also makes your blood more likely to clot. It stresses your heart and sets you up for a heart attack or stroke.

If you don't smoke but you spend time with people who do, you're still at risk. Their secondhand smoke makes you more likely to get the same life-threatening health problems that smokers get, including high blood pressure, heart disease, and many types of cancer.

How to Quit Smoking
There's no single method that works for everyone. You need to prepare and get support. Here's how to start:
1.      Pick a date to stop smoking and tell your doctor about it.
2.      Write down your reasons for quitting. Read the list every day, before and after you quit.

Here are some other tips:
·         Before you quit, write down when you smoke, why you smoke, and what you are doing when you smoke. You will learn what triggers you to smoke.
·         Stop smoking in certain situations first (such as during your work break or after dinner).
·         Make a list of things you can do instead of smoking. Be ready to do something else when you want to smoke.
·         Join a quit-smoking group or program.
·         Don't carry a lighter, matches, or cigarettes. Keep all of these smoking reminders out of sight.
·         If you live with someone who smokes, ask that person not to smoke around you.
·         Keep your hands busy. Doodle, play with a pencil or straw, or work on a computer.
·         Take a walk or read a book instead of taking a cigarette break.
·         Eat low-calorie, healthful foods (such as carrot or celery sticks, sugar-free hard candies) or chew sugar-free gum when you crave cigarettes.
·         Drink plenty of fluids, but limit alcoholic and caffeinated beverages. They can trigger urges to smoke.
·         Exercise. It will help you relax. Consider starting a fitness program before you quit.

Heart Disease and Stress: What's the Link?
Having too much stress, for too long, is bad for your heart. 
If you're often stressed, and you don't have good ways to manage it, you are more likely to have heart disease, high blood pressure, chest pain, or irregular heartbeats.

The stress itself can be a problem. It raises your blood pressure, and it's not good for your body to constantly be exposed to stress hormones. Studies also link stress to changes in the way blood clots, which makes a heart attack more likely.

You may also want to:
·         Change what you can to lower your stress.
·         Accept that there are some things you cannot control.
·         Before you agree to do something, consider whether you can really do it. It's OK to say "no" to requests that will add more stress to your life.
·         Stay connected with people you love.


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