We tend not to think about our blood pressure — it’s a normal function of our heart working regularly. However, when blood pressure stays high over an extended period it means the heart is working harder than it should. Since hypertension usually doesn’t have symptoms, we don’t know what is happening unless we measure it. Accurately measuring blood pressure provides a glimpse into what’s happening inside our bodies without needing expensive diagnostic tests.
The cause for hypertension is not always known, although it can develop as a result of other health conditions including: sleep apnea, kidney problems, and thyroid issues. Beyond chronic health conditions, risk factors for hypertension include age, the amount of salt you eat, being overweight or obese, using tobacco, drinking excessively, not exercising, and having too little potassium in your diet.
Recent updates to guidelines from the American Heart Association and the American College of Cardiology changed the definition of high blood pressure or hypertension for most people. High blood pressure is now generally defined as 130 or higher for the first number, or 80 or higher for the second number (previously it was 140/90). However, there are important considerations for older adults in deciding whether to start treatment for high blood pressure, including other health conditions and overall fitness. If your blood pressure is above 130/80, your doctor will evaluate your health to determine what treatment is needed to balance risks and benefits in your particular situation.
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.
Although the guidelines do not change the traditional definition of high blood pressure, they do call for more aggressive treatment of the condition through the use of a combination of blood-pressure lowering medications. In fact, they say that most people with high blood pressure will require two or more drugs to achieve a blood pressure goal of less than 140/90. The blood pressure goal in people with diabetes or kidney disease should be less than 130/80.
It is important to go to your regular check-ups with your doctor. Hypertension is a common condition and, if caught, can be treated with medication to prevent complications. However, if you experience any of the symptoms of hypertension, such as frequent headaches, recurrent dizziness, nosebleeds, shortness of breath, nausea or vomiting, don't wait—speak to your doctor immediately.
However, sometimes a high reading can occur temporarily and then your numbers will return to normal. If your blood pressure measures at this level, your doctor will likely take a second reading after a few minutes have passed. A second high reading indicates that you’ll need treatment either as soon as possible or immediately depending on whether or not you have any of the symptoms described above.
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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.

If your blood pressure readings are consistently high, you and your doctor will probably discuss treatment strategies. Treatment for high blood pressure often begins with lifestyle changes such as a weight loss and exercise program as well as a low sodium diet. In fact, the AHA recommends adopting these strategies as a means of preventing the development of high blood pressure and heart disease. If these strategies are not successful in lowering your blood pressure, medications may be recommended. 

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).

Recognizing heart attack symptoms and signs can help save your life or that of someone you love. Some heart attack symptoms, including left arm pain and chest pain, are well known but other, more nonspecific symptoms may be associated with a heart attack. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Heart attack symptoms and signs in women may differ from those in men. 

Hypertension results from a complex interaction of genes and environmental factors. Numerous common genetic variants with small effects on blood pressure have been identified[34] as well as some rare genetic variants with large effects on blood pressure.[35] Also, genome-wide association studies (GWAS) have identified 35 genetic loci related to blood pressure; 12 of these genetic loci influencing blood pressure were newly found.[36] Sentinel SNP for each new genetic locus identified has shown an association with DNA methylation at multiple nearby CpG sites. These sentinel SNP are located within genes related to vascular smooth muscle and renal function. DNA methylation might affect in some way linking common genetic variation to multiple phenotypes even though mechanisms underlying these associations are not understood. Single variant test performed in this study for the 35 sentinel SNP (known and new) showed that genetic variants singly or in aggregate contribute to risk of clinical phenotypes related to high blood pressure.[36]
Unfortunately, a problem doesn’t always announce itself with a fanfare of trumpets. Even the highest blood pressure can be entirely asymptomatic. Similarly, low blood pressure also known as hypotension can occur in your patient despite no symptoms seemingly being present. This is particularly true if the patient is lying still in an unmonitored bed.
"The implications and potential benefits of such healthier lifestyles could be great, particularly since about 22% of the adult population falls into the prehypertensive category," says Chobanian, who is also dean of the Boston University School of Medicine. "In fact, the blood pressure effects of weight reduction or adoption of the DASH eating plan can be comparable to those achieved with any single blood pressure medication."
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