What is Hypertension?
Hypertension, or high blood pressure, occurs when the force of blood pushing against the walls of the arteries is consistently too high. The heart works harder to pump blood through the arteries, which can lead to damage over time. Blood pressure is measured in millimeters of mercury (mmHg) and is expressed as two numbers: systolic pressure (the force when the heart beats) over diastolic pressure (the force when the heart rests between beats).
Normal Blood Pressure: Less than 120/80 mmHg
Elevated Blood Pressure: Systolic between 120-129 and diastolic less than 80
Stage 1 Hypertension: Systolic between 130-139 or diastolic between 80-89
Stage 2 Hypertension: Systolic 140 or higher or diastolic 90 or higher
Hypertensive Crisis: Systolic over 180 and/or diastolic over 120, requiring immediate medical attention
Hypertension is often called the "silent killer" because it typically has no noticeable symptoms. Many people are unaware they have high blood pressure until it causes complications such as heart disease, stroke, kidney damage, or vision problems. Regular blood pressure checks are essential for early detection.
Certain factors increase the risk of developing hypertension, including:
Family history of high blood pressure
Age (risk increases with age)
Excess weight
Lack of physical activity
Smoking or excessive alcohol use
High-sodium diet
Stress
Chronic conditions such as diabetes or kidney disease
How is Hypertension Treated?
The goal of hypertension treatment is to lower blood pressure to a healthy range and reduce the risk of complications. Nearly half of all adults in the US have hypertension, but only 1 in 4 have the condition under control. While lifestyle modifications are recommended for all hypertensive patients, medications are additionally recommended for 80% of cases.
Lifestyle Modifications
For many patients, lifestyle changes are the first line of treatment for managing high blood pressure. These modifications can have a significant impact on improving heart health and lowering blood pressure naturally.
Healthy Diet: A heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, is rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy. Reducing sodium intake is crucial for lowering blood pressure.
Regular Exercise: Physical activity helps strengthen the heart and improve circulation, which lowers blood pressure. Aim for at least 150 minutes of moderate exercise per week, such as brisk walking, swimming, or cycling.
Weight Loss: If you are overweight, losing even a small amount of weight can help reduce blood pressure. Your provider can guide you on safe and sustainable weight management strategies.
Limit Alcohol and Quit Smoking: Reducing alcohol consumption and quitting smoking can have immediate and long-term benefits for lowering blood pressure and improving overall cardiovascular health.
Stress Management: Chronic stress can contribute to elevated blood pressure. Techniques such as deep breathing, meditation, and yoga can help manage stress effectively.
Medications
If lifestyle changes alone are not enough to control high blood pressure, your healthcare provider may prescribe medications. The type of medication depends on the severity of hypertension and any other health conditions you may have.
Diuretics: Also known as “water pills,” diuretics help the kidneys remove excess sodium and water from the body, lowering blood pressure.
ACE Inhibitors and ARBs: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) relax blood vessels by blocking hormones that cause blood vessels to constrict.
Calcium Channel Blockers: These medications prevent calcium from entering the muscle cells of the heart and arteries, helping to relax and widen blood vessels.
Beta Blockers: Beta blockers reduce the workload on the heart by slowing the heart rate and reducing the force of heartbeats.
Other Medications: In some cases, other medications like vasodilators or alpha-blockers may be prescribed to help control blood pressure.
It is important to take medications exactly as prescribed and to have regular follow-ups with your provider to monitor your blood pressure and adjust treatment as needed.
At-Home Monitoring
At-home monitoring of blood pressure is an important component of hypertension management, and often argued more accurate and reliable than readings collected at the clinic. Regularly checking blood pressure with a home monitor provides consistent data to healthcare providers to identify changes early, assess the effectiveness of therapy, and ensure that the condition is not being over- or undertreated.
Healthcare providers can offer guidance on proper measurement techniques and recommend how frequently readings should be taken, ensuring that at-home monitoring contributes to improved overall management of hypertension.
Finding the Right Provider
Managing hypertension requires ongoing care and support, which is why finding the right healthcare provider is essential. A skilled provider can help you understand your condition, guide you through treatment options, and monitor your progress.
When looking for a provider, consider the following:
Experience with Hypertension Management: Choose a provider with expertise in managing high blood pressure and preventing related complications. As lifestyle modification is a big part of hypertension treatment, pick a provider who not only has expertise in the latest medications, but also knowledge of nutrition, diet, movement, weight loss, tobacco cessation, and stress management.
Personalized Care: Since hypertension affects such a broad population, every person with the condition is different. The right provider will be genuinely interested in getting to know you, so that they can customize your treatment plan based on your specific health needs, activity level, lifestyle, and personal preferences.
Education and Support: Managing hypertension is an ongoing process. Your provider should offer education on how to monitor your blood pressure at home, make necessary lifestyle changes, and recognize any warning signs of complications.
Remote Monitoring: You should not be alone in managing your condition. Find a proactive provider who is equipped to remotely monitor your numbers wherever you are, so that they can detect issues early before they develop into potentially serious health issues.
Accessibility and Communication: Look for a provider who is easily accessible for regular checkups and questions. Open communication is key to managing your blood pressure effectively.
