Hypertension is high blood pressure, a very common condition in older adults. Blood pressure is the physical force exerted by the blood as it pushes against the walls of the arteries. Blood pressure readings are written in two numbers separated by a line. The top number represents the systolic blood pressure and the bottom number represents the diastolic pressure. The systolic blood pressure is the pressure in the arteries as the heart contracts pushing the blood forward. The diastolic pressure is the pressure in the arteries as the heart relaxes.
Normal blood pressure is below 120/80, blood pressure between 120/80 and 139/89 is prehypertension and blood pressure 140/90 or above is considered hypertension. An elevated blood pressure means that the heart must work harder to pump blood. High blood pressure can also damage the walls of the arteries. Over time, hypertension increases the risk of heart disease, kidney disease, and stroke. It is estimated that one in three adults in America are affected by hypertension.
High blood pressure is more common in older people. At age 45, more men have hypertension than women. By age 65, this is reversed and more women are affected. People with diabetes have a greater risk of hypertension than those without diabetes. Having a close family member with high blood pressure also increases your risk of developing it. About 60% of all people with diabetes also have hypertension.
Hypertension may not produce any symptoms, even if you have had it for years. That’s why it is sometimes referred to as a "silent killer." It’s estimated that 1 out of every 5 people with high blood pressure aren’t aware that they have this major risk factor for strokes and heart attacks. If not properly treated, high blood pressure can damage the heart and circulation, lungs, brain, and kidneys without causing noticeable symptoms. Symptoms of extremely high blood pressure include the following:
Blood pressure is given as a reading of two numbers, such as 110/70. The higher number (systolic) is the pressure when the heart beats. The diastolic, or lower number shows the pressure between the heartbeats, while the relaxed heart is refilling with blood. Normal blood pressure readings are lower than 120/80. The cause of most hypertension is unknown. Occasionally, conditions of the kidney or adrenal gland are the cause of high blood pressure.
There are several factors that may cause high blood pressure, but the exact cause is unknown. The following factors may increase one’s risk for high blood pressure:
Prehypertension means that your blood pressure falls just above the normal level, corresponding to a systolic pressure between 120 and 139 or a diastolic pressure of 80 to 89. Lifestyle changes can help many people with prehypertension lower their blood pressure.
Factors that increase your blood pressure can cause prehypertension. Medications such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers, and some prescription drugs may cause a temporary rise in blood pressure. The build up of fatty deposits in the arteries (atherosclerosis) can also lead to prehypertension. Other conditions that may lead to prehypertension include the following:
If prehypertension is accompanied by diabetes, kidney disease, or cardiovascular disease, your doctor may suggest blood pressure medication as well lifestyle changes. If prehypertension is your only condition, lifestyle changes can help prevent blood pressure from rising. The following are lifestyle changes that may help lower blood pressure:
If your blood pressure measurements are 140/90 or higher, for either of the two numbers. At this level of blood pressure you may not have any symptoms. When blood pressure reaches 180/110 or higher, a serious condition known as a malignant hypertension may occur. This can lead to stroke, kidney damage, heart attacks, or loss of consciousness.
Malignant Hypertension Causes
High blood pressure is the main cause of malignant hypertension. Skipping doses of blood pressure medications can also lead to malignant hypertension. The following are medical conditions that may cause malignant hypertension:
Malignant Hypertension Symptoms
The primary symptoms of malignant hypertension is a blood pressure of 180/120 or higher and signs of organ damage. Other symptoms of malignant hypertension include bleeding and swelling of blood vessels in the retina, anxiety, nosebleeds, severe headache, and shortness of breath. Malignant hypertension may cause brain swelling, but this symptom is very rare.
Malignant Hypertension Treatment
Malignant hypertension is a medical emergency and requires immediate treatment. Blood pressure medications will be given through an IV, in hopes of lowering blood pressure within minutes. Oral medication will be given once blood pressure has been lowered to a safe level.
Abnormally elevated pressure in the pulmonary circulation is referred to as pulmonary hypertension. This condition affects the arteries in the lungs and the right side of the heart.
Pulmonary Hypertension Causes
Pulmonary hypertension is caused by changes in the cells that line the pulmonary arteries. These changes cause the walls of the arteries to become stiff and thick, extra tissue may also form. This can reduce or block blood flow through the blood vessels. Increased blood pressure is then caused because it is harder for blood to flow. Pulmonary hypertension can be an associated condition with scleroderma, sarcoidosis, pulmonary embolism, and dermatomyositis.
Pulmonary Hypertension Symptoms
Symptoms of pulmonary hypertension may not present themselves for months or years. Later on, symptoms become worse. Symptoms of pulmonary hypertension may include:
Pulmonary Hypertension Treatment
Pulmonary hypertension cannot be cured, but treatments are available to improve symptoms and slow the progression. The following are treatments available for pulmonary hypertension:
Atrial septostomy (open-heart surgery) and transplantation are surgical treatments that may control pulmonary hypertension, if medications are unsuccessful.
Sodium, a chemical found in salt, raises blood pressure by promoting the retention of fluid by the body. This increases the workload on the heart. The American Heart Association recommends an upper daily limit for sodium consumption of 1,500 mg. Checking food labels and menus can help you calculate how much sodium you are consuming. Processed foods are particularly high in sodium and make up about 75% of our sodium intake. Among these, lunch meats and canned soups have some of the highest levels of dietary sodium.
Stress leads to temporary elevations of blood pressure, but there is no proof that stress causes ongoing high blood pressure. Stress may have an indirect effect on blood pressure since it can influence other risk factors for heart disease. People who are under stress tend to engage more in unhealthy habits like poor nutrition, alcohol use, and smoking, all of which can play a role in the development of high blood pressure and heart disease.
Being overweight increases the risk of getting hypertension and increases the workload required of your heart. Diets designed to control blood pressure are often designed to reduce calories as well. Most of these diets require decreasing consumption of fatty food and sugars while increasing your intake of lean protein, fiber, fruits, and vegetables. A weight loss of just 10 pounds can make a difference in your blood pressure.
Drinking too much alcohol is a risk factor for high blood pressure. The American Heart Association guidelines recommend the consumption of no more than two alcoholic drinks per day for men and no more than one drink a day for women. One drink is defined as one 12-ounce beer, 4 ounces of wine, 1.5 ounces of 80-proof spirits, or 1 ounce of 100-proof spirits. Adults who consume more than three drinks in one sitting temporarily increase their blood pressure. However, binge drinking can lead to long-term increased blood pressure
Caffeine can bring on the jitters, but there is no evidence that it can cause long-term hypertension. However, especially for those not accustomed to caffeine, a caffeinated beverage might bring on a temporary rise in blood pressure. It is possible that caffeine could block a hormone that helps keep arteries widened, which causes blood pressure to rise. It is also possible that caffeine causes adrenal glands to release more adrenaline, causing blood pressure to increase. The exact reason why caffeine causes increased blood pressure is unknown.
Women who do not have high blood pressure before pregnancy may develop gestational hypertension or preeclampsia during pregnancy. Gestational hypertension is high blood pressure that develops in pregnancy. Gestational hypertension generally develops after week 20 of pregnancy. If not properly managed, it may develop into preeclampsia.
Preeclampsia is elevated blood pressure and the leakage of protein into the urine by the kidneys. Preeclampsia can be dangerous to both mother and baby. High blood pressure during pregnancy may lead to decreased blood flow to the placenta, placental abruption, premature delivery, or future cardiovascular disease. After the baby is born, high blood pressure during pregnancy usually returns to normal levels.
Certain medications contain ingredients that can elevate blood pressure. Cold and flu medications that contain decongestants are one example of drugs that raise blood pressure. Other kinds of medicines that can raise blood pressure are steroids, diet pills, birth control pills, non-steroidal anti-inflammatory drugs (NSAIDs), pain relief medications, and some antidepressants. Talk to your doctor about the medications or supplements you are taking that might affect your blood pressure
Although it's most common in older adults, hypertension can also affect children. The normal blood pressure for a child is dependent upon the child’s age, gender, and height. Your doctor can tell if your child’s blood pressure is abnormal. Children are at higher risk for hypertension if they are overweight, African-American, or if they have a family history of the condition. Children with high blood pressure may benefit from the DASH diet and taking medications. Children with high blood pressure should also maintain a healthy weight and avoid tobacco smoke.
Dietary changes can help control blood pressure. One diet designed to promote lower blood pressure is known as the DASH diet. This stands for Dietary Approaches to Stop Hypertension. The DASH diet recommends eating more vegetables, fruits, whole grains, low-fat dairy products, poultry, nuts, and fish. Red meat, saturated fats, and sweets should be avoided. The DASH diet can lower blood pressure within 2 weeks. It can also help to reduce your intake of sodium. The following is the DASH diet suggested daily intake:
On the DASH diet, nuts, seeds, and dry beans should be limited to 4-5 servings per week. Sweets should be limited to less than 5 servings per week.
Exercise is another lifestyle factor that can lower blood pressure. It’s recommended that adults get about 150 minutes per week of moderate exercise. This can include cardiovascular exercises such as walking, bicycling, gardening, or other aerobic exercise. Muscle-strengthening activities are recommended at least twice a week and stretching makes you more flexible and helps prevent injuries.
If diet and exercise are not sufficient to lower blood pressure, the first medications recommended are often diuretics or so-called "water pills." These reduce sodium and fluid levels in the body to lower blood pressure. (Torsamolex tablet)
Taking diuretics means you will urinate more frequently. Sometimes, diuretics deplete potassium levels as well, which can lead to muscle weakness, leg cramps, and tiredness. Other side effects of diuretics can include elevated blood sugars in people with diabetes. Less commonly, erectile dysfunction can occur.
Dandelion, ginger, parsley, hawthorn, and juniper may have a diuretic effect that can reduce sodium and water retention, which helps lower blood pressure. It is very important to consult with your doctor before taking any natural diuretics. Certain herbs and supplements may actually worsen your medical problems.
Beta-blockers are another drug used to treat hypertension. They block the effects of the sympathetic nervous system on the heart. This reduces the workload of the heart by requiring less blood and oxygen, which slows the heart rate. They can be used to treat other conditions as well, including abnormal heart rate (arrhythmia) (Nevilob Plus tablet) (Nevilob tablet)
Side effects of beta-blockers can include:
ACE (angiotensin converting enzyme) inhibitors are another class of antihypertensive drugs. They reduce the body’s levels of angiotensin II, a substance that narrows blood vessels. This means that arteries are more open (dilated) and the blood pressure is lower. ACE inhibitors can be used alone, or with other medications such as diuretics. Side effects of ACE inhibitors can include skin rash, dry cough, dizziness, and elevated potassium levels. Women who are pregnant, planning to get pregnant, or breastfeeding should not take ACE inhibitors.
Angiotensin receptor blockers prevent the actions of angiotensin II on the arteries. This means the arteries stay more open and blood pressure is lowered. ARBs can take a few weeks to work.
Side effects can include dizziness, muscle cramps, insomnia, and elevated potassium levels. As with ACE inhibitors, women who are pregnant, planning to get pregnant, or breastfeeding should not take ARBs.
Calcium channel blockers are drugs that reduce the movement of calcium into cells of the heart and vessels. This reduces the strength of heart contractions and relaxes the arteries, allowing them to remain more open, lowering blood pressure. Side effects of calcium channel blockers can include heart palpitations, dizziness, swollen ankles, and constipation. Calcium channel blockers can be taken alone or with other blood pressure medications. They should be taken with food or milk. Because of potential interactions, those taking calcium channel blockers should avoid alcohol and grapefruit juice
There are even more medication types that can lower blood pressure. Some of these are alpha blockers, vasodilators, and central alpha agonists. Your doctor may prescribe these medications if other medications have been ineffective or if you have another condition along with hypertension. Side effects can include fast pulse, palpitations, dizziness, diarrhea, or headaches.
It has been shown that meditation and other relaxation techniques can help lower blood pressure. Yoga, tai chi, and breathing exercises can also help reduce blood pressure. It’s best when these are combined with changes in diet and exercise. Tell your doctor if you are taking any herbal remedies, since some of these preparations can actually raise blood pressure or interact with your blood pressure medications. The following are supplements that may lower blood pressure:
Hypertension often lasts a lifetime, so following a careful management plan is essential. Keeping your blood pressure under control can lower your risk of heart disease, stroke, and kidney failure and can improve your quality of life. The following are tips to manage your blood pressure: