Dr. Rachel Bond, associate director of the Women's Heart Health Program at Lenox Hill Hospital in New York City, who was not involved with the guidelines, said she agreed with the new updates. "I believe this will allow for earlier detection [of high blood pressure], and allow for more lifestyle modification to prevent the long-term detrimental effects of untreated high blood pressure," Bond said.
First-line medications for hypertension include thiazide-diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), and angiotensin receptor blockers (ARBs). These medications may be used alone or in combination (ACE inhibitors and ARBs are not recommended for use in combination); the latter option may serve to minimize counter-regulatory mechanisms that act to restore blood pressure values to pre-treatment levels. Most people require more than one medication to control their hypertension. Medications for blood pressure control should be implemented by a stepped care approach when target levels are not reached.
There are many popular medical myths about high blood pressure. For example, many physicians believe that high blood pressure is an “inevitable consequence of aging;” that the “only viable treatment option for high blood pressure patients is medication”; that high blood pressure patients must take their medications “for the rest of their lives”; and, worst of all, that high blood pressure medications are “safe and effective.”
When a direct cause for high blood pressure can be identified, the condition is described as secondary hypertension. Among the known causes of secondary hypertension, kidney disease ranks highest. Hypertension can also be triggered by tumors or other abnormalities that cause the adrenal glands (small glands that sit atop the kidneys) to secrete excess amounts of the hormones that elevate blood pressure. Birth control pills -- specifically those containing estrogen -- and pregnancy can boost blood pressure, as can medications that constrict blood vessels.
When discussing blood pressure issues, the healthcare professional may ask questions about past medical history, family history, and medication use, including prescriptions, over-the-counter medications, herbal remedies, and food additives. Other questions may include lifestyle habits, including activity levels, smoking, alcohol consumption, and illegal drug use.
Events in early life, such as low birth weight, maternal smoking, and lack of breastfeeding may be risk factors for adult essential hypertension, although the mechanisms linking these exposures to adult hypertension remain unclear. An increased rate of high blood urea has been found in untreated people with hypertension in comparison with people with normal blood pressure, although it is uncertain whether the former plays a causal role or is subsidiary to poor kidney function. Average blood pressure may be higher in the winter than in the summer. Periodontal disease is also associated with high blood pressure.
The medical world experienced yet another guideline update in 2018 telling doctors more medication is better. This guideline for treating hypertension was put out by the American College of Cardiology and the American Heart Association, and effectively lowered the definition of hypertension from 140/90 down to 130/80. The organizations also recommended drug treatment for all individuals with blood pressure greater than 140/90, regardless of underlying risk.
Johns Hopkins researchers have identified the genes responsible for aortic ballooning and the sequence of events leading to aortic aneurysms. Dr. Hal Dietz currently conducts clinical trials of therapies for people with inherited aortic aneurysms to improve health and quality of life for these patients.Learn more about Dr. Deitz and his aortic ballooning therapies.
High blood pressure often runs in families. Much of the understanding of the body systems involved in high blood pressure has come from genetic studies. Research has identified many gene variations associated with small increases in the risk of developing high blood pressure. New research suggests that certain DNA changes during fetal development may also lead to the development of high blood pressure later in life.
^ Jump up to: a b c d e f James, PA.; Oparil, S.; Carter, BL.; Cushman, WC.; Dennison-Himmelfarb, C.; Handler, J.; Lackland, DT.; Lefevre, ML.; et al. (Dec 2013). "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 (JNC 8)". JAMA. 311 (5): 507–20. doi:10.1001/jama.2013.284427. PMID 24352797.
Pulse pressure (the difference between systolic and diastolic blood pressure) is frequently increased in older people with hypertension. This can mean that systolic pressure is abnormally high, but diastolic pressure may be normal or low a condition termed isolated systolic hypertension. The high pulse pressure in elderly people with hypertension or isolated systolic hypertension is explained by increased arterial stiffness, which typically accompanies aging and may be exacerbated by high blood pressure.
Meditate or take slow, steady deep breaths to calm the nervous system, relax and your dilate blood vessels. Breathing exercises help calm your sympathetic nervous system and your fight-or-flight response. This technique also encourages blood flow to your body’s tissues and causes your diaphragm to move up and down, which eases blood flow to your heart.
Sodium (salt) sensitivity: Some people have high sensitivity to sodium (salt), and their blood pressure increases if they use salt. Reducing sodium intake tends to lower their blood pressure. Americans consume 10-15 times more sodium than they need. Fast foods and processed foods contain particularly high amounts of sodium. Many over-the-counter medicines also contain large amounts of sodium. Read food labels and learn about salt content in foods and other products as a healthy first step to reducing salt intake. Fast food restaurants also make the salt and calorie content of their food available to consumers at their restaurants,
Often, hypertension can improve with lifestyle changes. In some cases, high blood pressure can go down to normal levels with only lifestyle modifications, particularly if you have stage 1 hypertension (systolic blood pressure of 130 mmHg to 159 mmHg, or diastolic blood pressure 80 mmHg to 99 mmHg), or if you have elevated blood pressure (systolic blood of 120 mmHg to 129 mmHg and diastolic less than 80 mmHg).
Hypertension Stage 1 is when blood pressure consistently ranges from 130-139 systolic or 80-89 mm Hg diastolic. At this stage of high blood pressure, doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD), such as heart attack or stroke.
In hypertensive emergency, there is evidence of direct damage to one or more organs. The most affected organs include the brain, kidney, heart and lungs, producing symptoms which may include confusion, drowsiness, chest pain and breathlessness. In hypertensive emergency, the blood pressure must be reduced more rapidly to stop ongoing organ damage, however, there is a lack of randomized controlled trial evidence for this approach.
If you’re feeling overwhelmed about how to make changes to your diet or if you’re trying to lose weight, you may want to consider working with a registered dietitian-nutritionist (RDN). Some people work with an RDN if they have a health condition like type 2 diabetes. In fact, high blood pressure is a risk factor for type 2 diabetes. This is partly because they share similar modifiable risk factors, like being overweight or obese, following an unhealthy diet, and having a lack of physical activity.
How do you check your own blood pressure? It is common to have your blood pressure checked at the doctor's office, but there are many cases where it is important to monitor it at home. It is easy to check blood pressure with an automated machine, but it can also be done manually at home. Learn how to check your own blood pressure and what the results mean. Read now
Are there any alternatives to Flomax? Flomax is a drug that is often used to treat benign prostatic hyperplasia (BPH). It is an alpha-blocker and it affects the hormones adrenaline and noradrenaline. There may be side effects, and other drugs may be used. Home remedies can also help relieve symptoms. Find out more about Flomax and other treatment options. Read now
In general, lower doses of blood pressure medicine are as effective as higher doses and cause fewer side effects. So, when trying to find effective single-drug therapy, doctors usually begin with a low dose. They may decide to increase the dose a bit if the initial dose is ineffective—but it is rarely useful to “push” the dose of a single-drug therapy into the higher dosage ranges. Instead, if a drug fails to work at a relatively low dose, it is time to switch to a low dose of a different drug.
If your blood pressure is always on the low side and you do not have any of the above symptoms, there is usually no cause for concern. Similarly, if you have a single at-home blood pressure reading that is abnormally low without any symptoms, you probably do not need to see your doctor. It is normal for your blood pressure to rise and fall over time, and your body is usually able to get your blood pressure back to normal.
What is a normal blood pressure? Blood pressure is essential to life because it forces the blood around the body, delivering all the nutrients it needs. Here, we explain how to take your blood pressure, what the readings mean, and what counts as low, high, and normal. The article also offers some tips on how to maintain healthy blood pressure. Read now