For older people, often the first number (systolic) is 130 or higher, but the second number (diastolic) is less than 80. This problem is called isolated systolic hypertension, which is due to age-related stiffening of the major arteries. It is the most common form of high blood pressure in older people and can lead to serious health problems (stroke, heart disease, eye problems, and kidney failure) in addition to shortness of breath during light physical activity, lightheadedness upon standing too fast, and falls. Isolated systolic hypertension is treated in the same way as regular high blood pressure (130 or higher for the first number, or 80 or higher for the second number) but may require more than one type of blood pressure medication. If your doctor determines that your systolic pressure is above a normal level for your age, ask how you can lower it.
Blood pressure is measured with a blood pressure cuff (sphygmomanometer). This may be done using a stethoscope and a cuff and gauge or by an automatic machine. It is a routine part of the physical examination and one of the vital signs often recorded for a patient visit. Other vital signs include pulse rate, respiratory rate (breathing rate), temperature, and weight.
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.
Some high blood pressure medications can, in fact, lead to weight gain. Common offenders include older beta blockers such as propranolol (Inderal) and atenolol (Tenormin). There could be several reasons for this -- including the fact that the medications can make patients feel tired and thus less likely to exercise. Minoxidil tablets (Loniten) -- used only when other antihypertensive medications have failed -- can also cause weight gain. Weight gain is also listed as a common side effect of doxazosin (Cardura). Diuretics are more likely to cause weight loss.

There is no treatment available for the causes of portal hypertension. However, treatment can prevent or manage the complications. Diet, medication (nonselective beta-blockers), endoscopic therapy, surgery, and radiology procedures can all help in treating or preventing symptoms of portal hypertension. If these treatments are unsuccessful in treating symptoms, transjugular intrahepatic portosystemic shunt (TIPS) or distal splenorenal shunt (DSRA) are two procedures that may reduce pressure in the portal veins. Maintaining a healthy lifestyle may help to prevent portal hypertension.
Diuretics can lead to an increase in potassium loss, known as hypokalemia, which, in turn can affect muscular function -- including the muscles of the heart. There is also an increased risk for gout with diuretics -- as well as the possibility of weakness, thirst, dehydration, and increased urination. Changes in blood sugar levels are also possible. Skin reactions, some severe, are possible with thiazide diuretics (such as hydrochlorothiazide). Potassium-sparing diuretics, such as spironolactone (Aldactone) may cause breast enlargement in males.
Stress reduction techniques such as biofeedback or transcendental meditation may be considered as an add-on to other treatments to reduce hypertension, but do not have evidence for preventing cardiovascular disease on their own.[125][126][127] Self-monitoring and appointment reminders might support the use of other strategies to improve blood pressure control, but need further evaluation.[128]
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).
Blood pressure changes throughout the day and varies from person to person. Various factors affect blood pressure, including your body position, breathing rhythm, stress level, physical activity, medications, what you eat or drink, and the time of the day (blood pressure is usually lowest at night when you sleep and rises when you wake up). In healthy individuals, your body responds and adapts to these changes to keep your blood pressure within a normal range. This ensures that vital organs, such as your brain and kidneys, receive a constant blood flow and nutrient supply.
This study is exploring whether use of losartan, a medicine commonly used to lower blood pressure, is effective at treating abnormal nighttime blood pressure in children and young adults who have sickle cell disease. To participate in this study, you or your child must be 5 to 25 years old and have high blood pressure and a certain type of sickle cell disease: hemoglobin SS or Sβ0 thalassemia. This study is located in Birmingham, Alabama.
Recurrent headaches: Headaches are fairly common among people with or without hypertension. Some people with hypertension notice changes or worsening of headaches when medications are skipped or when the blood pressure becomes higher than usual. Headaches associated with hypertension can be mild, moderate, or severe and can be of a throbbing nature. 

For an accurate diagnosis of hypertension to be made, it is essential for proper blood pressure measurement technique to be used.[76] Improper measurement of blood pressure is common and can change the blood pressure reading by up to 10 mmHg, which can lead to misdiagnosis and misclassification of hypertension.[76] Correct blood pressure measurement technique involves several steps. Proper blood pressure measurement requires the person whose blood pressure is being measured to sit quietly for at least five minutes which is then followed by application of a properly fitted blood pressure cuff to a bare upper arm.[76] The person should be seated with their back supported, feet flat on the floor, and with their legs uncrossed.[76] The person whose blood pressure is being measured should avoid talking or moving during this process.[76] The arm being measured should be supported on a flat surface at the level of the heart.[76] Blood pressure measurement should be done in a quiet room so the medical professional checking the blood pressure can hear the Korotkoff sounds while listening to the brachial artery with a stethoscope for accurate blood pressure measurements.[76][77] The blood pressure cuff should be deflated slowly (2-3 mmHg per second) while listening for the Korotkoff sounds.[77] The bladder should be emptied before a person's blood pressure is measured since this can increase blood pressure by up to 15/10 mmHg.[76] Multiple blood pressure readings (at least two) spaced 1–2 minutes apart should be obtained to ensure accuracy.[77] Ambulatory blood pressure monitoring over 12 to 24 hours is the most accurate method to confirm the diagnosis.[78]

There are a number of factors that likely work together to cause high blood pressure. A family history of high blood pressure can make you more likely to develop the condition, so genetics likely plays a role. High salt intake (too much salt in the diet) or salt sensitivity occurs in some people, which can lead to hypertension, particularly in the elderly, African Americans, people who are obese, or people with chronic kidney (renal) disease.
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]
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.

Low blood pressure is diagnosed by a doctor when they check your blood pressure with a sphygmomanometer. For people who experience low blood pressure without other symptoms, it may only require regular monitoring by a doctor during routine exams, and medical treatment may not be necessary. If certain signs suggest an underlying condition, your doctor may recommend one or more of the following tests to diagnose a cause for your hypotension:
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.
When blood pressure is measured, there are two numbers for each reading: for example, "120 over 80" is written as 120/80. This is because each heartbeat sends a pressure wave through the bloodstream. The higher number (systolic blood pressure) is the peak of the wave, when your heart contracts (the loud "thump" when you listen to your heartbeat). The lower number (diastolic blood pressure) is the lower "dip" or trough of the wave, when your heart relaxes.
You can also have symptoms of low blood pressure when someone with hypertension comes down from very high pressures. For instance, 120/80 mm Hg may be normal for everyone else, but if your patient lives at 190/100 mm Hg, they are going to feel the difference. For this reason, the objective sign of a pressure must be combined with the subjective symptoms the patient reports.
Postural hypotension occurs most frequently in people who are taking drugs to control high blood pressure (hypertension). It can also be related to pregnancy, strong emotions, hardening of the arteries (atherosclerosis), or diabetes. The elderly are particularly affected, especially those who have high blood pressure or autonomic nervous system dysfunction.
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.
Wear a blood pressure monitor. This monitor is attached to you. You will be asked to wear it for 24 hours. The monitor is usually programmed to take blood pressure readings every 15 to 30 minutes all day and night while you go about your normal activities. The doctor will evaluate the results. In some cases, home blood pressure monitors may also be used to evaluate the effectiveness of your treatment.
Moderate or severe bleeding can quickly deplete an individual's body of blood, leading to low blood pressure or orthostatic hypotension. Bleeding can result from trauma, surgical complications, or from gastrointestinal abnormalities such as ulcers, tumors, or diverticulosis. Occasionally, the bleeding may be so severe and rapid (for example, bleeding from a ruptured aortic aneurysm) that it causes shock and death rapidly. 

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.

You will work with your provider to come up with a treatment plan. It may include only the lifestyle changes. These changes, such as heart-healthy eating and exercise, can be very effective. But sometimes the changes do not control or lower your high blood pressure. Then you may need to take medicine. There are different types of blood pressure medicines. Some people need to take more than one type.
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.[10] High blood pressure typically does not cause symptoms.[1] Long-term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral vascular disease, vision loss, chronic kidney disease, and dementia.[2][3][4][11]

This study is assessing whether a low-sodium and low-calorie eating pattern, along with aerobic exercise, can improve blood pressure in patients who do not respond to high blood pressure medicines. To participate you must be at least 35 years and have high blood pressure that does not respond to medicines. Please note that this study is in Durham, North Carolina.

A blood pressure reading contains two numbers: systolic pressure and diastolic pressure. Systolic pressure is the top or first number in your blood pressure reading; it indicates the pressure within your arteries when your heart pumps out blood. Diastolic pressure is the bottom number, and shows the pressure in your arteries while your heart is filling with blood.
Hypertension clinical guidelines from the American Heart Association are comprehensive guidelines for healthcare professionals for the detection and treatment of high blood pressure in a wide range of patients. Included in the 2018 hypertension clinical guidelines are proper methods for measuring blood pressure, risk factors for hypertension, and hypertension treatment for different populations.

The authors bring several evidence-based yet progressive concepts into the guidelines, the first of which is that high blood pressure should be treated using a team approach. This makes sense, as science supports more and better patient education around self-monitoring, nutrition, and lifestyle changes, as well as stress management. Telehealth is emphasized as a cost-effective method of ongoing monitoring that is more convenient for patients than frequent office visits.
Much is being made of the fact that the new definitions of high blood pressure will mean roughly half of all US citizens will be considered to have high blood pressure, but when you really look at the numbers, as cardiologists already have, not that many more people will actually be advised to take medications. Although the public has good reason to be suspicious of “big pharma,” that’s not what this is about.
With low blood pressure, the patient may feel faint or lose consciousness. This is due to lack of blood flow to the brain, and usually laying the patient supine will help them come round. This is also known as a blackout, and it could be accompanied by a dizzy feeling and light-headedness. Generally, your patient will report trouble focusing, difficulty keeping upright and lack of coordination.
The most widely used classification of blood pressure readings currently is given in the table below. Stratification of the blood pressure readings into different categories is important because of increasing severity of high blood pressure readings and different approach to the treatment of these conditions. Another table below the first one gives the blood pressure chart with different categories of the blood pressure, symptoms and the treatment.

It occurs more often in older people who are taking a lot of medication. However, it can cause symptoms in younger people. There may be underlying medical conditions such as joint hypermobility syndrome, diabetes, parkinson’s disease, addison’s disease or autonomic failure. Dehydration, hunger, low body weight and deconditioning (being out of shape/unfit) can reduce blood pressure.
Healthcare professionals use a stethoscope and a manual sphygmomanometer to measure your blood pressure. Typically they take the reading above your elbow. The sphygmomanometer has a bladder, cuff, bulb, and a gauge. When the bulb is pumped it inflates the bladder inside the cuff, which is wrapped around your arm. This inflation will stop the blood flow in your arteries. The stethoscope is used to listen for sound of the heartbeat, and no sound indicates that there is no flow. As the pressure is released from the bladder, you will hear the sound of the blood flowing again. That point becomes systolic reading. The diastolic reading is when you hear no sound again, which means that the blood flow is back to normal.
You will work with your provider to come up with a treatment plan. It may include only the lifestyle changes. These changes, such as heart-healthy eating and exercise, can be very effective. But sometimes the changes do not control or lower your high blood pressure. Then you may need to take medicine. There are different types of blood pressure medicines. Some people need to take more than one type.
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]
Your doctor may diagnose you with high blood pressure when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher. Based on research, your doctor may also consider you to have high blood pressure if you are an adult or child age 13 or older who has consistent systolic readings of 130 to 139 mm Hg or diastolic readings of 80 to 89 mm Hg and you have other cardiovascular risk factors.
Health issues may happen; however, when a person's blood pressure suddenly drops and their brain is deprived of an adequate blood supply. The condition may lead to lightheadedness or dizziness. A sudden drop in blood pressure usually happens in a person who has risen from a prone or sitting position to a standing one. When this occurs it is referred to as, 'orthostatic hypotension,' or, 'postural hypotension.' Another type of low blood pressure may happen when a person stands for extended periods of time; it is referred to as, 'neurally mediated hypotension.'
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.)
High blood pressure is a major risk factor for cardiovascular disease. Without treatment, you can have a transient ischemic attack (TIA) or stroke, heart attack, enlarged heart, heart failure, peripheral vascular disease (such as poor circulation and pain in your legs), aneurysms, kidney disease, and broken blood vessels in your eyes. Treatment includes making changes recommended by your healthcare provider.
Not only the degree of obesity is important, but also the manner in which the body accumulates extra fat. Some people gain weight around their belly (central obesity or "apple-shaped" people), while others store fat around their hips and thighs ("pear-shaped" people). "Apple-shaped" people tend to have greater health risks for high blood pressure than "pear-shaped" people.
You can also have symptoms of low blood pressure when someone with hypertension comes down from very high pressures. For instance, 120/80 mm Hg may be normal for everyone else, but if your patient lives at 190/100 mm Hg, they are going to feel the difference. For this reason, the objective sign of a pressure must be combined with the subjective symptoms the patient reports.
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. 

Moderate or severe bleeding can quickly deplete an individual's body of blood, leading to low blood pressure or orthostatic hypotension. Bleeding can result from trauma, surgical complications, or from gastrointestinal abnormalities such as ulcers, tumors, or diverticulosis. Occasionally, the bleeding may be so severe and rapid (for example, bleeding from a ruptured aortic aneurysm) that it causes shock and death rapidly.
Dietary changes can help control blood pressure. One diet designed to promote lower blood pressure is known as the DASH diet. This stands for Dietary Approaches to Stop Hypertension. The DASH diet recommends eating more vegetables, fruits, whole grains, low-fat dairy products, poultry, nuts, and fish. Red meat, saturated fats, and sweets should be avoided. The DASH diet can lower blood pressure within 2 weeks. It can also help to reduce your intake of sodium. The following is the DASH diet suggested daily intake:
Blood pressure readings fall into four general categories, ranging from normal to stage 2 high blood pressure (hypertension). The level of your blood pressure determines what kind of treatment you may need. To get an accurate blood pressure measurement, your doctor should evaluate your readings based on the average of two or more blood pressure readings at three or more office visits.
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