High blood pressure

Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. When that pressure becomes too high, it increases your risk of developing serious conditions such as heart attack and stroke.

At Atrium Health Floyd and Harbin Clinic, we work with you to establish heart-healthy habits, including taking medication if needed, to help you get your blood pressure under control.

What causes high blood pressure?

Many factors can affect blood pressure, including:

• Age
• Hormone levels
• The amount of water and salt you have in your body
• The condition of your kidneys, nervous system or blood vessels

You’re more likely to have high blood pressure as you get older. This is because your blood vessels become stiffer as you age. When that happens, your heart works harder and your blood pressure gets higher. High blood pressure increases your chance of having a stroke, heart attack, heart failure, kidney disease or early death.

Essential & secondary hypertension

Most of the time, no cause of high blood pressure is found. This is called essential hypertension.

High blood pressure caused by another medical condition or medicine you’re taking is called secondary hypertension. Secondary hypertension may be due to:

• Chronic kidney disease
• Disorders of the adrenal gland (such as pheochromocytoma or Cushing syndrome)
• Hyperparathyroidism
• Pregnancy or preeclampsia
• Medications such as birth control pills, diet pills, some cold medicines and migraine medicines
• Narrowed artery that supplies blood to the kidney (renal artery stenosis)

Risk factors for high blood pressure

You have a higher risk of having high blood pressure if:

• You are African American
• You are obese
• You are often stressed or anxious
• You drink too much alcohol (more than one drink per day for women and more than two drinks per day for men)
• You consume too much salt
• You have a family history of high blood pressure
• You have diabetes
• You smoke

Measuring your blood pressure

Blood pressure readings are given as two numbers written as a ratio. The top number is called systolic blood pressure. The bottom number is called diastolic blood pressure. One or both numbers can be too high.

• Normal blood pressure: When your blood pressure is lower than 120/80 most of the time
• High blood pressure (hypertension): When your blood pressure is 140/90 or above most of the time
• Prehypertension: When your blood pressure numbers are 120/80 or higher, but below 140/90

If you have heart or kidney problems, or if you’ve had a stroke, your doctor may recommend your blood pressure be even lower than that of people who do not have these conditions.

Stages of high blood pressure

When you have high blood pressure, it will be categorized in one of the following ways:

• Stage 1: 140-159/90-99
• Stage 2: 160-179/100-109
• Stage 3: ≥180/≥110
• Malignant hypertension: Systolic blood pressure above 200 and diastolic blood pressure above 130

Symptoms of high blood pressure (hypertension)

Most of the time, high blood pressure has no symptoms. For most people, high blood pressure is found when they visit their health care provider and have it checked. And, because there are often no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure.

Malignant hypertension is a dangerous form of very high blood pressure. Symptoms include:

• Severe headache
• Nausea or vomiting
• Confusion
• Vision changes
• Nosebleeds

Diagnosis of high blood pressure

Your doctor will measure your blood pressure many times before diagnosing you with high blood pressure. It’s normal for your blood pressure to be different based on the time of day.

All adults should have their blood pressure checked every one to two years if your blood pressure was less than 120/80 mmHg at your most recent reading. If you have high blood pressure, diabetes, heart disease, kidney problems or certain other conditions, have your blood pressure checked every year.

Your doctor will do a physical exam to look for signs of heart disease, eye damage and other changes in your body.

Tests may also be done to look for:

• High cholesterol level
• Heart disease, using tests such as an echocardiogram or electrocardiogram
• Kidney disease, using tests such as a basic metabolic panel and urinalysis or ultrasound of the kidneys

How to check your blood pressure at home

Blood pressure readings taken at home may be a better measure of your current blood pressure than those taken at your health care provider’s office.

To check your blood pressure at home, follow a few guidelines:

• Make sure you use a good quality, well-fitting home blood pressure monitor. It should have the proper sized cuff and a digital readout.
• Practice with your doctor or nurse to make sure you’re taking your blood pressure correctly.
• Bring your home monitor to your appointments so your doctor can make sure it’s working correctly.

Treatment for high blood pressure

The goal of treatment is to reduce your blood pressure so you have a lower risk of complications. You and your health care provider should set your blood pressure goal.

If you have prehypertension, your health care provider will recommend lifestyle changes to bring your blood pressure down to a normal range. Medicine is rarely used for prehypertension.

You can do many things to help control your blood pressure at home, including:

• Eat a heart-healthy diet, including potassium and fiber.
• Drink plenty of water.
• Participate in at least 30 minutes of aerobic exercise a day.
• If you smoke, quit.
• Limit how much alcohol you drink to one drink a day for women and two drinks a day for men.
• Limit the amount of sodium (salt) you consume. Aim for less than 1,500 mg per day.
• Reduce stress. Try to avoid things that cause you stress. Try things like meditation or yoga to lower your stress levels.
• Stay at a healthy body weight.

Your health care provider can help you find programs for losing weight, stopping smoking and exercising. You can also get a referral from your health care provider to a dietician, who can help you plan a diet that’s healthy for you.

How low your blood pressure should be and at what level you need to start treatment is individualized, based on your age and any medical problems you have.

Medications for high blood pressure

There are many different medicines to treat high blood pressure. Often, a single blood pressure drug may not be enough to control your blood pressure, and you may need to take two or more medications.

It’s important that you take the medicines prescribed to you. If you have side effects, your doctor can substitute a different medicine.