Blood pressure is recorded as two numbers and written as a ratio: the top number, called the systolic pressure, is the pressure as the heart beats. The bottom number, called the diastolic pressure, is the measurement as the heart relaxes between beats. According to guidelines announced in November 2017 by the American Heart Association (AHA), people's blood pressure measurements fall into the following categories:

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.


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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.
Anyone can develop hypotension, but certain groups of people are more likely to experience it, and there are different types. For instance, orthostatic (positional) hypotension, which occurs when you stand up after sitting or lying down, is more common in older adults. Typically, “your body has certain compensatory mechanisms to prevent your blood pressure from falling when you stand up,” explains Willie Lawrence, MD, an interventional cardiologist at Research Medical Center in Kansas City, Missouri, and a spokesperson for the American Heart Association. But, he adds, “orthostatic hypotension is a problem for some people because these reflexes that should occur, don’t occur.”

High blood pressure is a common and dangerous condition. Having high blood pressure means the pressure of the blood in your blood vessels is higher than it should be. But you can take steps to control your blood pressure and lower your risk of heart disease and stroke. About 1 of 3 U.S. adults—or about 75 million people—have high blood pressure.1 Only about half (54%) of these people have their high blood pressure under control.1 Many youth are also being diagnosed with high blood pressure.2 This common condition increases the risk for heart disease and stroke, two of the leading causes of death for Americans.3 Get more quick facts about high blood pressure, or learn more about high blood pressure in the United States.
Your doctor can help you measure and track your blood pressure to confirm whether it’s too high. You may need to start taking medications if your blood pressure doesn’t improve after one month of following a healthy lifestyle, especially if you’re already at high risk for heart disease. If you’re at lower risk, your doctor may want to follow up in three to six months after you’ve adopted more healthy habits.
Patient-activated event recorder: If the episodes of bradycardia or tachycardia are infrequent, a 24-hour Holter recording may not capture these sporadic episodes. In this situation, a patient can wear a patient-activated event recorder for up to 4 weeks. The patient presses a button to start the recording when he or she senses the onset of an abnormal heart rhythm or symptoms possibly caused by low blood pressure. The doctor then analyzes the recordings later to identify the abnormal episodes.

This means whether your parent’s needs are mild or complex, you can work with the elderly home health care services provider to devise a course of care, management, support, and assistance that will help them to stay safe, healthy, comfortable, and happy throughout their later years. Through a highly personalized approach to their care, this home health care provider can help your loved one live the quality of life they desire and deserve, remain as independent as possible, and find meaning and fulfillment in this chapter in their life.
An electrocardiogram is known by the acronyms "ECG" or "EKG" more commonly used for this non-invasive procedure to record the electrical activity of the heart. An EKG generally is performed as part of a routine physical exam, part of a cardiac exercise stress test, or part of the evaluation of symptoms. Symptoms evaluated include palpitations, fainting, shortness of breath, dizziness, fainting, or chest pain.
Hypertension with certain specific additional signs and symptoms may suggest secondary hypertension, i.e. hypertension due to an identifiable cause. For example, Cushing's syndrome frequently causes truncal obesity, glucose intolerance, moon face, a hump of fat behind the neck/shoulder (referred to as a buffalo hump), and purple abdominal stretch marks.[23] Hyperthyroidism frequently causes weight loss with increased appetite, fast heart rate, bulging eyes, and tremor. Renal artery stenosis (RAS) may be associated with a localized abdominal bruit to the left or right of the midline (unilateral RAS), or in both locations (bilateral RAS). Coarctation of the aorta frequently causes a decreased blood pressure in the lower extremities relative to the arms, or delayed or absent femoral arterial pulses. Pheochromocytoma may cause abrupt ("paroxysmal") episodes of hypertension accompanied by headache, palpitations, pale appearance, and excessive sweating.[23]
The kidney can respond to changes in blood pressure by increasing or decreasing the amount of urine that is produced. Urine is primarily water that is removed from the blood. When the kidney makes more urine, the amount (volume) of blood that fills the arteries and veins decreases, and this lowers blood pressure. If the kidneys make less urine, the amount of blood that fills the arteries and veins increases and this increases blood pressure. Compared with the other mechanisms for adjusting blood pressure, changes in the production of urine affect blood pressure slowly over hours and days. (The other mechanisms are effective in seconds.)

In the 19th and 20th centuries, before effective pharmacological treatment for hypertension became possible, three treatment modalities were used, all with numerous side-effects: strict sodium restriction (for example the rice diet[152]), sympathectomy (surgical ablation of parts of the sympathetic nervous system), and pyrogen therapy (injection of substances that caused a fever, indirectly reducing blood pressure).[152][158]

The guidelines also redefined the various categories of hypertension. It eliminated the category of prehypertension, which had been defined as systolic blood pressure of 120 to 139 mm Hg or diastolic pressure (the lower number in a reading) of 80 to 89 mm Hg. Instead, people with those readings are now categorized as having either elevated pressure (120 to 129 systolic and less than 80 diastolic) or Stage 1 hypertension (130 to 139 systolic or 80 to 89 diastolic).

High blood pressure, or hypertension, most commonly occurs without any symptoms and has for this reason been referred to as the "silent killer." Uncomplicated hypertension can persist for years, even decades, without causing symptoms. However, when complications of the condition begin to develop due to damage to the vascular system, symptoms can occur. Symptoms of complicated hypertension (high blood pressure) can include dizziness, shortness of breath, headache, and blurred vision. Other possible symptoms are nosebleeds, blood in the urine, fatigue, chest pain, and a pounding sensation in the neck, chest, or ears.
Adrenal insufficiency, for example, due to Addison's disease, can cause low blood pressure. Addison's disease is a disorder in which the adrenal glands (small glands next to the kidneys) are destroyed. The destroyed adrenal glands can no longer produce sufficient adrenal hormones (specifically cortisol) necessary to maintain normal bodily functions. Cortisol has many functions, one of which is to maintain blood pressure and the function of the heart. Addison's disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and, sometimes, darkening of the skin.

On physical examination, hypertension may be associated with the presence of changes in the optic fundus seen by ophthalmoscopy.[22] The severity of the changes typical of hypertensive retinopathy is graded from I to IV; grades I and II may be difficult to differentiate.[22] The severity of the retinopathy correlates roughly with the duration or the severity of the hypertension.[20]
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