Angiotensin II is a very potent chemical formed in the blood by ACE from, angiotensin I. When formed, angiotensin II causes the muscles surrounding blood vessels to contract, thus narrowing the vessels and increasing blood pressure. ACE inhibitors are medications that inhibit the activity of ACE which decreases the production of angiotensin II. As a result, these medications cause the blood vessels to enlarge or dilate, and this reduces blood pressure. This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed.
The causes are most often some combination of clogged “pipes” and excessive salt in the diet. Lifestyle changes, such as appropriate diet and exercise, are among the most effective treatment strategies for high blood pressure. Relaxation, meditation, and otherwise “taking it easy” are not effective solutions, as valuable as such strategies may be for your psychological well-being.
Methyldopa, formerly known under the brand name Aldomet, is one of the oldest blood pressure medications still in use. It was first introduced more than 50 years ago. Methyldopa works in the central nervous system to lower blood pressure. While its general use has declined over the years, methyldopa is considered the first-line of treatment for high blood pressure that develops during pregnancy.
Unfortunately, this seems like a common scenario — medical guidelines recommend more aggressive medication use for minimal potential benefit despite potential harm. A new study published in the Journal of the American Medical Association (JAMA), suggests the blood pressure guidelines go too far for low risk individuals, and the risk of harm outweighs the potential benefits.
When a blood pressure reading is taken, the higher number represents the systolic pressure and the lower number represents the diastolic pressure. For example: 120/80 (120 over 80) in an adult means that the systolic pressure is 120 and the diastolic pressure is 80. As kids grow, their blood pressure increases from a systolic pressure of about 70–90 (as babies) to adult values (when they're teens).
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
4. Find an exercise that works for you (and do it). Moving more can help reverse high blood pressure. One meta-analysis of 65 studies found regular exercise provides both an acute and longer-term reduction in blood pressure. Whether you’re an exercise novice or a conditioned athlete, these four strategies can help you create an effective workout plan to optimize health.
2. Take the right nutrients. Talk with your chiropractor or other healthcare professional about the wide range of well-studied nutrients that, along with dietary and lifestyle modifications, can help normalize your blood pressure. One meta-analysis found magnesium supplements could lower blood pressure. Likewise, researchers find a small but significant decline in blood pressure for people with hypertension who use fish oil. (You can get all of fish oil’s benefits combined with anti-inflammatory flax oil and GLA in our Optimal Omega.)
‘White coat syndrome’ refers to elevated blood pressure due to nervousness or anxiety when clients have their blood pressure taken by a healthcare provider. This occurs in approximately 20% of clients. Key message: have the client take their blood pressure at home with an automatic home blood pressure cuff and compare the findings. Alternatively, you can ask the client to sit quietly and leave the room while an automatic cuff takes a client’s blood pressure. The automatic cuff can be programmed to take three measurements and the blood pressure documented is an average of the three readings.
Caffeine can raise blood pressure by tightening blood vessels and magnifying the effects of stress, says James Lane, PhD, a Duke University researcher who studies caffeine and cardiovascular health. "When you're under stress, your heart starts pumping a lot more blood, boosting blood pressure," he says. "And caffeine exaggerates that effect." (Not sure whether you need to cut back? Here are 6 physical symptoms that mean you're drinking too much coffee.)
Ocean Robbins is the author of 31-Day Food Revolution: Heal Your Body, Feel Great, and Transform Your World (Grand Central Life & Style, February 5, 2019). He is the CEO and co-founder of the 500,000+ member Food Revolution Network. He's served as the adjunct professor for Chapman University. And he's received numerous awards, including the national Jefferson Award for Outstanding Public Service and the Freedom's Flame Award. Ocean Robbins
Hypertension, the medical term for high blood pressure, is known as "the silent killer." More than 80 million Americans (33%) have high blood pressure, and as many as 16 million of them do not even know they have the condition. If left untreated, high blood pressure greatly increases your risk for heart attack and stroke. Hypertension is projected to increase about 8 percent between 2013 and 2030.
Because of the need for emergency care, it is important to recognize the early signs of malignant hypertension. The first giveaway is blood pressure of 180/120. You might have bleeding in the eyes due to rupture of the small blood vessels. Other malignant hypertension symptoms can include chest pain, dizziness, a headache, numbness in your extremities, and confusion.
They may not have been a tempting option to you as a kid, but lima beans are a wonder food for anyone trying to get their blood pressure under control. According to research published in the Journal of the American College of Nutrition, adding beans to your diet can help you get your blood pressure into a healthy range while keeping you full, making you less likely to reach for sugary or salty snacks that can cause your blood pressure to soar.
For some reason, health care providers often think of high blood pressure—or hypertension—as a "man's problem." More men have hypertension than women when they're younger, but once women reach menopause, their risk becomes greater than men's. Overall, about half of Americans with high blood pressure are women—and they're less likely to be diagnosed and treated for it.
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One reason to visit your doctor regularly is to have your blood pressure checked. Routine checks of your blood pressure will help pick up an early rise in blood pressure, even though you might feel fine. If there's an indication that your blood pressure is high at two or more checkups, the doctor may ask you to check your blood pressure at home at different times of the day. If the pressure stays high, even when you are relaxed, the doctor may suggest exercise, changes in your diet, and, most likely, medications.
Hypertension in African-Americans tends to occur earlier in life and tends to be more severe. Plus, some medications that work to lower blood pressure in other ethnicities may have limited effect on African-Americans. Thiazide diuretics (such as HCTZ) or a calcium channel blocker are recommended first choices along with the possible add-on of a second drug from either the ACE inhibitor class or the angiotensin II receptor blocker group.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Be proactive and follow all medical advice received about how to manage hypertension. It is crucial to continue on any prescriptions given to treat hypertension. It is very dangerous to stop taking a medication for hypertension just because the symptoms seem to have lessened. Have frequent medical checkups and stay in touch with the doctor if any new symptoms arise.
“Beware of the American Heart Association’s (AHA) 'Salty Six' — six popular foods that can add high levels of sodium to your diet,” says Rachel Johnson, PhD, a professor of nutrition at the University of Vermont in Burlington and the former chair of the AHA’s nutrition committee. The Salty Six include breads and rolls, cold cuts and cured meats, sandwiches, pizza, soup, and chicken.
Dietary changes: The health care provider might recommend a diet that includes more vegetables (especially leafy green vegetables), fruits, low-fat dairy products, and fiber-rich foods, and fewer carbohydrates, fats, processed foods, and sugary drinks. He or she also might recommend preparing low-sodium dishes and not adding salt to foods. Watch out for foods with lots of hidden salt (like bread, sandwiches, pizza, and many restaurant and fast-food options).
Studies even show that blood pressure measurements outside a doctor’s office are at least as accurate as those in the office (provided the equipment works well). If your results are high, take another reading. Try, try again. If they’re still high, see your healthcare provider and get checked out. Your doctor may order blood and urine tests or an EKG to diagnose other causes for your hypertension.
In “guessing” on the best initial single drug to try, most experts now recommend beginning either with either a thiazide diuretic (usually chlorthalidone or hydrochlorothiazide), a long-acting calcium blocker, or an ACE inhibitor. ARBs are generally thought of as substitutes for ACE inhibitors, and generally, are used only when ACE inhibitors are poorly tolerated.
The drug of choice for hypertensive, pregnant women is one of the oldest high blood pressure medications on the market. Methyldopa, which works to lower blood pressure through the central nervous system, has the lowest risk of harming the mother and developing fetus. Other possible safe options include labetalol, beta blockers, and diuretics. Two classes of drugs which should never be used during pregnancy include the ACE inhibitors and the angiotensin II receptor blockers.
Other exercise options that don’t require a gym membership include body weight exercises, like pushups, squats, and jumping jacks. These exercises can be done at home or outside. For people who like going to the gym or running, these can be good ways to build community, notes Parker. Apps like Fitbit and MapMyRun can be helpful if you like keeping track of your steps, calories burned, weight, or number of miles run.
The flagged medications, which include amlodipine/valsartan and amlodipine/valsartan/hydrochlorothiazide combination tablets, contain a potentially dangerous ingredient called N-nitroso-diethylamine (NDEA). The organic chemical is a known animal carcinogen and a suspected human carcinogen, according to the FDA. It can also be toxic to the liver and other organs.
Start your day with a round of zesty pink grapefruit and see your blood pressure numbers shoot into a healthy range in no time. In addition to being an excellent source of blood pressure-lowering, immune-boosting vitamin C, pink grapefruit is a good source of lycopene, which multiple studies have deemed effective at reducing blood pressure. In fact, a Finnish study published in Neurology reveals that study subjects with the highest concentrations of lycopene in their blood decreased their risk of stroke by 55 percent.
How the heart pumps blood into the arteries with enough force to push blood to the far reaches of each organ from the top of the head to the bottom of the feet. Blood pressure can be defined as the pressure of blood on the walls of the arteries as it circulates through the body. Blood pressure is highest as its leaves the heart through the aorta and gradually decreases as it enters smaller and smaller blood vessels (arteries, arterioles, and capillaries). Blood returns in the veins leading to the heart, aided by gravity and muscle contraction.
For a normal reading, your blood pressure needs to show a top number (systolic pressure) that’s between 90 and less than 120 and a bottom number (diastolic pressure) that’s between 60 and less than 80. The American Heart Association (AHA) considers blood pressure to be within the normal range when both your systolic and diastolic numbers are in these ranges.
Many of us have had our blood pressure measured at the doctor but don’t really understand why it’s important. Find out why (and how) your doctor measures your blood pressure, what’s normal and what’s not, and what to do if you have high blood pressure.How is blood pressure measured?Blood pressure is measured using an instrument called a sphygmomanometer. It consists of an inflatable cuff, an inflating bulb, and a gauge to show the blood pressure.The cuff is wrapped around the upper arm, and inflated to a pressure which temporarily stops the blood from flowing through the brachial artery – the main blood vessel in your arm. At this point, the doctor will not be able to feel a pulse in the arm. The cuff pressure is then raised slightly above this point, and then slowly lowered.As the pressure is lowered, your doctor will listen through a stethoscope for the sound of blood starting to pulse through the brachial artery again. The pressure reading on the sphygmomanometer when the sound of blood is first heard pulsing through the artery is known as the systolic pressure. As the doctor continues to lower the pressure in the cuff, the sounds will disappear. Usually, the point at which the sounds disappear is known as the diastolic pressure.The systolic reading (the first number of the 2) indicates the pressure of blood within your arteries during a contraction of the left ventricle of the heart. The diastolic reading (the second number) indicates the pressure within the arteries when the heart is at rest. Blood pressure is measured in millimetres of mercury (mmHg), for example 120/80 mmHg (known as 120 over 80).What is normal blood pressure?According to the Heart Foundation of Australia, as a general guide:blood pressure below 120/80 mmHg can be classified as 'optimal';blood pressure between 120/80 and 129/84 mmHg is 'normal'; andblood pressure between 130/85 and 139/89 mmHg is classified as 'high-normal'.A person is defined by the Heart Foundation as having high blood pressure (hypertension) if they:have a systolic pressure greater than or equal to 140 mmHg; and/ora diastolic pressure greater than or equal to 90 mmHg.High blood pressure is further classified as mild, moderate or severe as the pressure increases above this level.Low blood pressure, or hypotension, is not as easy to define as it is usually relative to a person’s normal blood pressure reading, and varies between different people. It generally refers to a blood pressure below an average of about 90/60 mmHg.Getting an accurate readingAccording to the Heart Foundation, the diagnosis of high blood pressure should be based on multiple blood pressure measurements taken on separate occasions.It is recommended that you do not smoke or drink caffeine-containing drinks for 2 hours before having your blood pressure monitored, as this can cause an increase in your readings.Self-monitoring of blood pressure in your own environment (home blood pressure monitoring) or ambulatory monitoring of blood pressure is also used to help diagnose high blood pressure.For ambulatory blood pressure monitoring, you wear a portable automatic blood pressure machine for 24 hours while going about your usual daily routine. The portable monitor will measure your blood pressure multiple times during the 24 hours. Your doctor will ask you to record your activities over the 24 hours, plus any symptoms you experience (and when they occur). Variations in blood pressure are normal and may occur depending on where and when the blood pressure is taken.Some people who have raised blood pressure readings taken at the doctor’s surgery actually have acceptable levels outside the surgery, when under normal stress levels. This is known as ‘white-coat’ hypertension.There are also people with ‘reverse white-coat’ hypertension (also known as masked hypertension), who have normal blood pressure when measured in the clinic but high ambulatory blood pressure readings (those recorded during normal daily activities).Keeping on targetYour target blood pressure may vary according to whether you have other conditions that can increase your risk of cardiovascular (heart and blood vessel) disease or conditions that have been caused by high blood pressure.Raised blood pressure is a major risk factor for cardiovascular disease, and the higher your blood pressure, the greater your chance of having heart disease or stroke. For this reason it is important that you have your blood pressure monitored regularly, and that you always take any high blood pressure treatments that have been recommended, including medicines that have been prescribed.Hypertension can also be controlled to a large extent by lifestyle measures such as:losing excess weight;undertaking regular physical activity;quitting smoking; andchanging your diet (reducing your alcohol and salt intake, and following a healthy eating plan).These steps can help to lower your blood pressure and reduce your risk of cardiovascular disease. Last Reviewed: 8 February 2017
If you had previously been diagnosed with high blood pressure, the new guidelines don't affect you too much, says Dr. Conlin, as you still need to continue your efforts to lower it through medication, diet, exercise, and weight loss. "However, based on new information in the guidelines, your doctor may propose treating your blood pressure to a lower level," he says.
You can have high blood pressure, or hypertension, and still feel just fine. That's because high blood pressure often does not cause signs of illness that you can see or feel. But, high blood pressure, sometimes called "the silent killer," is very common in older people and a major health problem. If high blood pressure isn't controlled with lifestyle changes and medicine, it can lead to stroke, heart disease, eye problems, kidney failure, and other health problems. High blood pressure can also cause shortness of breath during light physical activity or exercise.
If your blood pressure reading is 180/120 or higher, wait about five minutes and retake your blood pressure. If you have two readings that are this high, but you aren’t having any other concerning symptoms such as chest pain, back pain, shortness of breath, change in vision, numbness/weakness, or difficulty speaking - you are experiencing hypertensive urgency.
While you shouldn't shrug off the change, there's also no need to panic. "Obviously, nothing happened overnight inside a woman's body or to her health with the release of the guidelines," says Dr. Naomi Fisher, director of hypertension service and hypertension innovation at the Brigham and Women's Hospital Division of Endocrinology, Diabetes, and Hypertension, and associate professor of medicine at Harvard Medical School.
Hypertension causes complications such as heart attack and stroke, and these complications are less likely to occur in women who have undergone menopause than men of the same age. When comparing the complication risks of hypertension between men and women aged between 40 and 70 years, it is seen that men are at a higher risk of developing complications than women.
James, P.A., Oparil, S., Carter, B.L., Cushman, W.C., Dennison-Himmelfarb, C., Handler, J., & Ortiz, E. (2013, December 18). 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth joint national committee. Journal of the American Medical Association. Retrieved from http://jamanetwork.com/journals/jama/fullarticle/1791497