65. High Blood Pressure: Get It Down, Keep It Down

High blood pressure isn’t like a toothache, a bruise, or constipation.  Nothing hurts, looks discolored, or fails to work. Usually, people with high blood pressure experience no discomfort or outward signs of trouble.  For this reason, you should get your blood pressure checked at every office visit, at least every two years, or as advised by your doctor. Directly or indirectly, high blood pressure accounts for nearly a million deaths a year.  Uncontrolled high blood pressure increases the odds that you’ll have a heart attack, a stroke, or kidney failure.

Many who have high blood pressure don’t know it. Worse yet, nine out of ten people who know their blood pressures are unhealthfully high are doing nothing to try to control it. And for 95 percent of those affected, there is no known cause.

The amazing part is, high blood pressure is one of the easiest health problems to control.

Have your blood pressure checked more than once on several occasions. If your blood pressure is generally pretty good and suddenly registers high, don’t be alarmed. Anxiety and other strong emotions, physical exertion, drinking a large amount of coffee, or digesting a recently consumed meal can temporarily elevate normal blood pressure with no lasting effects. If, after several readings, your doctor is convinced you do indeed have high blood pressure, follow his or her advice. Here’s a multipoint plan to control high blood pressure.

  1. If you’re overweight, lose weight. Stay at a healthy weight.

  2. Don’t smoke. Avoid secondhand smoke.

  3. Limit alcohol to two drinks or less a day (one drink for females and persons age 65 and older).

  4. Follow the “DASH” (Dietary Approaches to Stop Hypertension) diet. Access www.nhlbi.nih.gov for information on the DASH diet.

  5. Get regular exercise. Try to do at least 30 minutes of exercise a day.

  6. Take medicine as prescribed. And, don’t skip your pills because you feel fine. Discuss bothersome side effects with your doctor.

  7. Learn to handle stress by practicing relaxation techniques and rethinking stressful situations. (See chapter 6, Success over Stress, for more details.)

  8. If you’re a woman, talk to your doctor about oral contraceptives and blood pressure. Many other birth control methods are available.

  9. Monitor your blood pressure using a home testing device as recommended by your doctor.

How’s Your Blood Pressure?

Blood pressure is normally measured with a blood pressure cuff placed on the arm. The numbers on the gauge measure your blood pressure in millimeters of mercury (mm Hg). The first (top) number measures the systolic pressure. This is the maximum pressure exerted against the arterial walls while the heart is beating. The second (bottom) number records the diastolic pressure, the pressure between heartbeats, when the heart is being refilled. The results are then recorded as systolic/diastolic pressure (120/80, for example). The term hypertension means high blood pressure.

The accompanying table gives the normal and abnormal ranges for both systolic and diastolic blood pressures for adults age 18 or older. To accurately determine your blood pressure, an average of two or more readings should be taken on two or more separate occasions. The risk of stroke, heart attack, and kidney disease increases when blood pressure is in the high range. So have your blood pressure checked at every office visit or at least every two years, and follow your physician’s advice if it is abnormal.

Chapter 2
  1. Major Medical Conditions:

  2. Prevention, Detection, and Treatment

Note: For persons with high blood pressure, blood pressure goal is less than 140/90 mm Hg. For Afican Americans and persons with diabetes or kidney disease, the goal is less than 130/80 mm Hg.