Hypertension is actually of two types, one is called Primary Hypertension or Essential Hypertension, and this type of hypertension develops gradually over the years as a person ages, and it has no known causes. The other type of hypertension is called Secondary Hypertension, and this type is caused by different diseases, and a person’s lifestyle factors, like diet, sedentary lifestyle, alcohol intake etc.
Beta-blockers cause the heart to slow down and so some of their side effects can be traced to that mechanism of action. Dizziness, weakness, fatigue, and fainting are possible. Beta-blockers also affect the respiratory system, so other side effects include shortness of breath, difficulty breathing, and chest pain. Beta-blockers should not be withdrawn suddenly, as that could result in a heart attack or sudden death.
African-Americans tend to develop hypertension earlier in life and often experience more severe blood pressure elevation. It is not known for sure why high blood pressure is more common in this group, but researchers theorize it may include higher rates of obesity and diabetes among African-Americans and a gene that makes African-Americans more sensitive to salt. In people who have this gene, even just one-half teaspoon of salt could elevate blood pressure as much as 5 mmHg. (5)
A person consistently showing blood pressure higher than 140/90 over several readings is considered to have hypertension. Doctors advise these people to make effective lifestyle changes to help lower their blood pressure, such as maintaining a healthy weight, including exercise in their daily routine, limiting salt and alcohol intake, and quitting smoking. The doctors will also recommend medication for hypertension depending on how much higher the BP is as compared to the normal blood pressure range and any other health problems that the patient faces.
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure.
The range of systolic blood pressure for most healthy adults falls between 90 and 120 millimeters of mercury (mm Hg). Normal diastolic blood pressure ranges between 60 and 80 mm Hg. Current guidelines define normal blood pressure range as lower than 120/80. Blood pressures over 130/80 are considered high. High blood pressure increases the risk of damaging the arteries, which leads to the development of:
On physical examination, hypertension may be associated with the presence of changes in the optic fundus seen by ophthalmoscopy. The severity of the changes typical of hypertensive retinopathy is graded from I to IV; grades I and II may be difficult to differentiate. The severity of the retinopathy correlates roughly with the duration or the severity of the hypertension.
In Europe hypertension occurs in about 30-45% of people as of 2013. In 1995 it was estimated that 43 million people (24% of the population) in the United States had hypertension or were taking antihypertensive medication. By 2004 this had increased to 29% and further to 32% (76 million US adults) by 2017. In 2017, with the change in definitions for hypertension, 46% of people in the United States are affected. African-American adults in the United States have among the highest rates of hypertension in the world at 44%. It is also more common in Filipino Americans and less common in US whites and Mexican Americans. Differences in hypertension rates are multifactorial and under study.
Medicines are available if these changes do not help control your blood pressure within 3 to 6 months. Diuretics help rid your body of water and sodium. ACE inhibitors block the enzyme that raises your blood pressure. Other types of medicines— beta blockers, calcium channel blockers, and other vasodilators—work in different ways, but their overall effect is to help relax and widen your blood vessels and reduce the pressure inside the vessel. [See also the free government publication “Medicines to Help You: High Blood Pressure” (PDF) from the US Food and Drug Administration.]
Keeping track of your blood pressure is important. Your doctor can help you learn how to check your blood pressure at home. Each time you check your own blood pressure, record your numbers and the date. Send or take the log of your blood pressure readings with you for appointments with your doctor. Return to Screening for reminders on how to prepare for blood pressure testing.
The portal venous system contains veins coming from the stomach, intestine, spleen, and pancreas. These veins merge into the portal vein, which branches into smaller vessels and travel through the liver. Portal hypertension occurs when there is an increase in the blood pressure within the portal venous system. When the vessels in the liver are blocked due to liver damage, blood cannot flow properly through the liver. This causes high blood pressure in the portal system.
In November, the American Heart Association and the American College of Cardiology issued new guidelines that change how high blood pressure, or hypertension, is diagnosed. Previously, it wasn’t until an adult’s blood pressure reached 140 mmHg or higher systolic (the top, or first, number) or 90 mmHg diastolic (the bottom, or second, number) or higher that high blood pressure was diagnosed. According to the new parameters, high blood pressure should be treated at 130/80 rather than 140/90, as that is the point when our risk for heart attack, stroke, and other consequences for hypertension almost doubles.
You may be directed to seek medical care if blood pressure readings are elevated if done as part of a community health screening. Isolated elevated blood pressure readings do not necessarily make the diagnosis of hypertension. Blood pressure readings vary throughout the day, and your primary care provider may record a different reading than the one that was measured in a screening that sent you in for care.
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.
Tilt-table tests are used to evaluate patients suspected of having postural hypotension or syncope due to abnormal function of the autonomic nerves. During a tilt-table test, the patient lies on an examination table with an intravenous infusion administered while the heart rate and blood pressure are monitored. The table then is tilted upright for 15 minutes to 45 minutes. Heart rate and blood pressure are monitored every few minutes. The purpose of the test is to try to reproduce postural hypotension. Sometimes a doctor may administer epinephrine (Adrenalin, Isuprel) intravenously to induce postural hypotension.
You begin by lying flat on a table. Straps are put around your body to hold you in place. After lying flat for awhile, the table is tilted to raise your body and head — simulating a change in position from lying down to standing up. During this test, your heart rate and blood pressure are monitored to evaluate your body's cardiovascular response to the change in position.
As blood travels throughout your body, it presses against the walls of your blood vessels, just like water in a hose or air in a tire. This is called blood pressure. When your heart beats (contracts), squeezing blood out and pumping it into your arteries, blood pressure peaks. This is called your systolic pressure. Between heartbeats, when your heart relaxes and blood flows back into it, your blood pressure is lower. This is your diastolic pressure.
James, Paul A.; Oparil, Suzanne; Carter, Barry L.; Cushman, William C.; Dennison-Himmelfarb, Cheryl; Handler, Joel; Lackland, Daniel T.; Lefevre, Michael L.; MacKenzie, Thomas D.; Ogedegbe, Olugbenga; Smith, Sidney C.; Svetkey, Laura P.; Taler, Sandra J.; Townsend, Raymond R.; Wright, Jackson T.; Narva, Andrew S.; Ortiz, Eduardo (18 December 2013). "2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults". JAMA. 311 (5): 507–20. doi:10.1001/jama.2013.284427. PMID 24352797.
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017; pii: S0735-1097(17)41519-1. PMID: 29146535 www.ncbi.nlm.nih.gov/pubmed/29146535.