Hypertension (High Blood Pressure)
Hypertension, or high blood pressure, is a common condition where the force of blood against your artery walls is consistently too high. Often called the "silent killer" because it typically has no symptoms but can lead to serious health problems like heart disease and stroke. Blood pressure is measured in millimeters of mercury (mmHg) and recorded as two numbers: systolic pressure (when the heart beats) over diastolic pressure (when the heart rests). Normal blood pressure is below 120/80 mmHg, while hypertension is diagnosed at 130/80 mmHg or higher.
Causes
- Genetics - Family history can play a significant role in developing hypertension.
- Age - Blood pressure tends to rise as you get older due to stiffening of arteries.
- Obesity - Excess weight increases the strain on your heart and circulatory system.
- Physical inactivity - Lack of exercise can contribute to weight gain and higher heart rate.
- Tobacco use - Smoking or chewing tobacco raises blood pressure temporarily and damages artery walls.
- High sodium diet - Too much salt can cause your body to retain fluid, increasing blood pressure.
- Low potassium intake - Potassium helps balance sodium in cells; low levels may contribute to hypertension.
- Excessive alcohol consumption - Regular, heavy drinking can damage your heart over time.
- Stress - High levels of stress can temporarily increase blood pressure.
- Chronic kidney disease - Kidneys help regulate blood pressure; kidney damage can raise it.
- Sleep apnea - This sleep disorder is linked to hypertension.
- Thyroid or adrenal disorders - Hormone conditions can trigger blood pressure increases.
- Certain medications - Some prescription and over-the-counter drugs can raise blood pressure.
Signs and Symptoms
- Most people with hypertension have no symptoms, even at severely elevated levels.
- Headaches - Particularly in the morning and located at the back of the head.
- Shortness of breath - Especially with activity or when lying flat.
- Nosebleeds - Occurring without obvious cause.
- Visual changes - Blurred vision or seeing spots.
- Dizziness or lightheadedness - Particularly when standing up quickly.
- Chest pain - In severe cases or during hypertensive crisis.
- Facial flushing - Redness in the face, especially during blood pressure spikes.
- Blood in urine - In severe cases, potentially indicating kidney damage.
- Fatigue - Persistent tiredness that doesn't improve with rest.
Diagnosis
Blood Pressure Measurement
Multiple readings taken over time using a sphygmomanometer. A diagnosis of hypertension is typically made after elevated readings on at least two separate occasions.
Ambulatory Blood Pressure Monitoring
A device worn for 24 hours that takes blood pressure readings at regular intervals, providing a more comprehensive picture of blood pressure variations throughout the day and night.
Home Blood Pressure Monitoring
Regular self-monitoring with a home blood pressure device to track patterns and treatment effectiveness.
Physical Examination
Checking for signs of organ damage or secondary causes of hypertension, including heart, eye, and neurological exams.
Laboratory Tests
Blood and urine tests to check kidney function, electrolyte levels, cholesterol, and blood sugar, which can identify causes or complications of hypertension.
Electrocardiogram (ECG)
Records the electrical activity of your heart to detect abnormalities in heart rhythm or signs of heart muscle damage from sustained high blood pressure.
Echocardiogram
Uses sound waves to create images of your heart to assess for enlargement or other changes due to hypertension.
Renal Ultrasound
Imaging of the kidneys to look for structural abnormalities that might cause hypertension.
Treatment Options
Lifestyle Modifications
Often the first line of treatment, including weight loss, regular physical activity, adopting a heart-healthy diet (like DASH - Dietary Approaches to Stop Hypertension), reducing sodium intake, limiting alcohol, quitting smoking, and managing stress.
Diuretics
Often called "water pills," these medications help your kidneys remove excess sodium and water from your body, reducing blood volume and pressure.
ACE Inhibitors
Angiotensin-converting enzyme inhibitors relax blood vessels by preventing the formation of a hormone called angiotensin II, which narrows blood vessels.
Angiotensin II Receptor Blockers (ARBs)
Block the action of angiotensin II directly, relaxing blood vessels to lower blood pressure.
Calcium Channel Blockers
Prevent calcium from entering the cells of the heart and blood vessel walls, causing blood vessels to relax and open wider.
Beta-Blockers
Reduce the workload on your heart and open blood vessels by blocking the effects of epinephrine (adrenaline).
Home Remedies
DASH Diet
The Dietary Approaches to Stop Hypertension eating plan emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy while limiting foods high in saturated fat and sugar.
Sodium Reduction
Limit daily sodium intake to 1,500-2,300 mg. Read food labels, cook at home more often, use herbs and spices instead of salt, and minimize processed food consumption.
Regular Physical Activity
Aim for at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, swimming, or cycling. Even small increases in activity can help reduce blood pressure.
Weight Management
Even a small weight loss (just 5-10% of your current weight) can significantly reduce blood pressure in overweight individuals.
Stress Reduction
Practice stress management techniques such as deep breathing, meditation, yoga, or tai chi. Consider activities you enjoy that help you relax.
Alcohol Moderation
Limit alcohol consumption to no more than one drink per day for women and two for men. Excessive alcohol intake can raise blood pressure and reduce medication effectiveness.
Self-Monitoring
Regularly monitor your blood pressure at home and keep a log to share with your healthcare provider. This helps track treatment effectiveness and encourages better adherence.
Preventive Care
- Maintain a healthy weight - Aim for a body mass index (BMI) between 18.5 and 24.9.
- Exercise regularly - At least 30 minutes of moderate physical activity most days of the week.
- Eat a healthy diet - Rich in fruits, vegetables, whole grains, and low-fat dairy, with reduced saturated and total fat.
- Reduce sodium - Aim for less than 2,300 mg per day (about 1 teaspoon of salt), or 1,500 mg if you already have hypertension.
- Limit alcohol - No more than one drink per day for women and two for men.
- Avoid tobacco - Don't smoke and avoid secondhand smoke.
- Manage stress - Practice relaxation techniques and find healthy ways to cope with stress.
- Monitor your blood pressure - Regular checks, especially if you have risk factors.
- Get adequate sleep - Aim for 7-8 hours of quality sleep each night.
- Take medications as prescribed - If you're already on blood pressure medication, take it exactly as directed.
- Regular check-ups - Follow your doctor's recommendations for routine health screenings.
- Consider family history - Be especially vigilant about prevention if hypertension runs in your family.
Surgical Options
Renal Denervation
An innovative procedure for resistant hypertension that uses radiofrequency ablation to reduce the activity of nerves in the renal arteries that contribute to high blood pressure. This minimally invasive procedure is typically considered when multiple medications have failed to control blood pressure adequately.
Learn More About This ProcedureBariatric Surgery
For patients with severe obesity and hypertension, weight-loss surgery can significantly improve blood pressure control by addressing the underlying weight issue. Studies show many patients experience improved or resolved hypertension following successful bariatric procedures.
Learn More About This ProcedureSchedule a Consultation
If you're experiencing symptoms of hypertension (high blood pressure), our expert team is here to help you find the right treatment approach for your specific needs.