High Blood Pressure F.A.Q.

The Answer:

Blood pressure is the force of blood against the walls of arteries. Blood pressure is recorded as two numbers—the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats). The measurement is written one above or before the other, with the systolic number on top and the diastolic number on the bottom. For example, a blood pressure measurement of 120/80 mmHg (millimeters of mercury) is expressed verbally as "120 over 80."

Normal blood pressure is less than 120 mmHg systolic and less than 80 mmHg diastolic.

The Answer:

Blood pressure is the force of blood against the walls of arteries. Blood pressure rises and falls during the day. When blood pressure stays elevated over time, it is called high blood pressure.

The medical term for high blood pressure is hypertension. High blood pressure is dangerous because it makes the heart work too hard and contributes to atherosclerosis (hardening of the arteries). It increases the risk of heart disease and stroke, which are the first- and third-leading causes of death among Americans. High blood pressure also can result in other conditions, such as congestive heart failure, kidney disease, and blindness.

A blood pressure level of 140/90 mmHg or higher is considered high. About two-thirds of people over age 65 have high blood pressure. If your blood pressure is between 120/80 mmHg and 139/89 mmHg, then you have prehypertension. This means that you don't have high blood pressure now but are likely to develop it in the future. You can take steps to prevent high blood pressure by adopting a healthy lifestyle.

Those who do not have high blood pressure at age 55 face a 90 percent chance of developing it during their lifetimes. So high blood pressure is a condition that most people have at some point in their lives.

Both numbers in a blood pressure test are important, but for people who are 50 or older, systolic pressure gives the most accurate diagnosis of high blood pressure. Systolic pressure is the top number in a blood pressure reading. It is high if it is 140 mmHg or above.

The Answer:

Systolic pressure is the force of blood in the arteries as the heart beats. It is shown as the top number in a blood pressure reading. High blood pressure is 140 and higher for systolic pressure. Diastolic pressure does not need to be high for you to have high blood pressure. When that happens, the condition is called "isolated systolic hypertension," or ISH.

The Answer:

Yes.  It is the most common form of high blood pressure for older Americans.  For most Americans, systolic blood pressure increases with age, while diastolic increases until about age 55 and then declines.  About 65 percent of hypertensives over age 60 have ISH.  You may have ISH and feel fine.  As with other types of high blood pressure, ISH often causes no symptoms.  To find out if you have ISH — or any type of high blood pressure — see your doctor and have a blood pressure test.  The test is quick and painless.

The Answer:

Any form of high blood pressure is dangerous if not properly treated. Both numbers in a blood pressure test are important, but, for some, the systolic is especially meaningful. That's because, for those persons middle aged and older, systolic pressure gives a better diagnosis of high blood pressure.

If left uncontrolled, high systolic pressure can lead to stroke, heart attack, congestive heart failure, kidney damage, blindness, or other conditions. While it cannot be cured once it has developed, ISH can be controlled.

Clinical studies have proven that treating a high systolic pressure saves lives, greatly reduces illness, and improves the quality of life. Yet, most Americans do not have their high systolic pressure under control.

The Answer:

Treatment options for ISH are the same as for other types of high blood pressure, in which both systolic and diastolic pressures are high.  ISH is treated with lifestyle changes and/or medications.  The key for any high blood pressure treatment is to bring the condition under proper control.  Blood pressure should be controlled to less than 140/90 mmHg.  If yours is not, then ask your doctor why.  You may just need a lifestyle or drug change, such as reducing salt in your diet or adding a second medication.

The Answer:

Diastolic pressure is the force of blood in the arteries as the heart relaxes between beats. It's shown as the bottom number in a blood pressure reading.

The diastolic blood pressure has been and remains, especially for younger people, an important hypertension number. The higher the diastolic blood pressure the greater the risk for heart attacks, strokes and kidney failure. As people become older, the diastolic pressure will begin to decrease and the systolic blood pressure begins to rise and becomes more important. A rise in systolic blood pressure will also increase the chance for heart attacks, strokes, and kidney failure. Your physician will use both the systolic and the diastolic blood pressure to determine your blood pressure category and appropriate prevention and treatment activities.

The Answer:

High blood pressure is dangerous because it makes the heart work too hard.  It also makes the walls of the arteries hard.  High blood pressure increases the risk for heart disease and stroke, the first- and third-leading causes of death for Americans.  High blood pressure can also cause other problems, such as heart failure, kidney disease, and blindness.

The Answer:

As people get older, arteries throughout the body "harden," especially those in the heart, brain, and kidneys. High blood pressure is associated with these "stiffer" arteries. This, in turn, causes the heart and kidneys to work harder.

The Answer:

High blood pressure is the most important risk factor for stroke. Very high pressure can cause a break in a weakened blood vessel, which then bleeds in the brain. This can cause a stroke. If a blood clot blocks one of the narrowed arteries, it can also cause a stroke.

The Answer:

High blood pressure can eventually cause blood vessels in the eye to burst or bleed. Vision may become blurred or otherwise impaired and can result in blindness.

The Answer:

Heart Attack: High blood pressure is a major risk factor for heart attack. The arteries bring oxygen-carrying blood to the heart muscle. If the heart cannot get enough oxygen, chest pain, also known as "angina," can occur. If the flow of blood is blocked, a heart attack results.

Congestive Heart Failure: High blood pressure is the number one risk factor for congestive heart failure (CHF). CHF is a serious condition in which the heart is unable to pump enough blood to supply the body's needs.

The Answer:

The kidneys act as filters to rid the body of wastes. Over time, high blood pressure can narrow and thicken the blood vessels of the kidneys. The kidneys filter less fluid, and waste builds up in the blood. The kidneys may fail altogether. When this happens, medical treatment (dialysis) or a kidney transplant may be needed.

The Answer:

The causes of high blood pressure vary. Causes may include narrowing of the arteries, a greater than normal volume of blood, or the heart beating faster or more forcefully than it should. Any of these conditions will cause increased pressure against the artery walls. High blood pressure might also be caused by another medical problem. Most of the time, the cause is not known. Although high blood pressure usually cannot be cured, in most cases it can be prevented and controlled.

The Answer:

High blood pressure is common. About 65 million American adults — nearly 1 in 3 — have high blood pressure. It is very common in African Americans, who may get it earlier in life and more often than whites. Many Americans tend to develop high blood pressure as they get older, but this is not a part of healthy aging. Middle-aged Americans face a 90% chance of developing high blood pressure during their lives. Others at risk for developing high blood pressure are the overweight, those with a family history of high blood pressure, and those with prehypertension (120–139/80–89 mmHg).

African Americans: High blood pressure occurs more often among African Americans than whites. It begins at an earlier age and is usually more severe. Further, African Americans have a higher death rate from stroke and kidney disease than whites. The good news is, treatment can control high blood pressure. In addition, lifestyle changes can prevent and control high blood pressure. These include losing weight if overweight (losing 10 lbs can help), increasing physical activity (walking 30 minutes per day can help), following a healthy eating plan, that emphasizes fruits, vegetables, and lowfat dairy foods, choosing and preparing foods with less salt and sodium, and if you drink alcoholic beverages, drinking in moderation. If lifestyle changes alone are not effective in keeping your blood pressure controlled, there are many blood pressure medications to help you.

The Answer:

High blood pressure often has no signs or symptoms. The only way to find out if you have high blood pressure is to be tested for it. Using the familiar blood pressure cuff, your doctor or nurse can easily tell if your blood pressure is high.

The Answer:

You can find out if you have high blood pressure by having your blood pressure checked regularly. Most doctors will diagnose a person with high blood pressure on the basis of two or more readings, taken on several occasions. A consistent blood pressure reading of 140/90 mmHg or higher is considered high blood pressure, another term for hypertension.

Some people experience high blood pressure only when they visit the doctor's office. This condition is called "white-coat hypertension." If your doctor suspects this, you may be asked to monitor your blood pressure at home or asked to wear a device called an ambulatory blood pressure monitor. This device is usually worn for 24 hours and can take blood pressure every 30 minutes. In this section you will learn more about diagnosing high blood pressure.

The Answer:

Having your blood pressure tested is quick and easy. Blood pressure is measured in millimeters of mercury (mmHg) and recorded as two numbers systolic pressure "over" diastolic pressure. For example, the doctor or nurse might say "130 over 80" as a blood pressure reading.

Both numbers in a blood pressure reading are important. As we grow older, systolic blood pressure is especially important.

To test your blood pressure, your doctor will use a familiar device with a long name. It is called a sphygmomanometer (pronounced sfig’-mo-ma-nom-e-ter), and may look something like this:

Some blood pressure testing devices use electronic instruments or digital readouts. In these cases, the blood pressure reading appears on a small screen or is signaled in beeps, and no stethoscope is used.

Remember these useful tips for having your blood pressure taken:

• Don't drink coffee or smoke cigarettes 30 minutes before having your blood pressure measured.
• Before the test, sit for five minutes with your back supported and your feet flat on the ground. Rest your arm on a table at the level of your heart.
• Wear short sleeves so your arm is exposed.
• Go to the bathroom prior to the reading. A full bladder can change your blood pressure reading.
• Get two readings, taken at least two minutes apart, and average the results.
• Ask the doctor or nurse to tell you the blood pressure reading in numbers.

The Answer:

Tests at home can be done with the familiar blood pressure cuff and a stethoscope, or with an electronic monitor, such as a digital readout monitor. Also, be sure that the person who will use the device reads the instructions before taking blood pressure readings. Your doctor, nurse, or pharmacist can help you check the device and teach you how to use it. You also may ask for their help in choosing the right one for you. Blood pressure devices can be bought at various places, such as discount chain stores and pharmacies.

The Answer:

When systolic and diastolic blood pressures fall into different categories, the higher category should be used to classify blood pressure level. For example, 160/80 mmHg would be stage 2 hypertension (high blood pressure).

The Answer:

You can take steps to prevent high blood pressure by adopting a healthy lifestyle. These steps include maintaining a healthy weight; being physically active; following a healthy eating plan, that emphasizes fruits, vegetables, and lowfat dairy foods; choosing and preparing foods with less salt and sodium; and, if you drink alcoholic beverages, drinking in moderation.

The Answer:

So far, research has shown that potassium does lower blood pressure. Studies have not indicated that calcium and magnesium supplements prevent high blood pressure. Here's the latest:

Potassium helps to prevent and control high blood pressure. Be sure to get enough potassium in the foods you eat. Some good sources are various fruits, vegetables, dairy foods, and fish.

Values were obtained from the USDA Nutrient Database for Standard References, Release 15 for Potassium, K (mg) content of selected foods per common measure.

Calcium and Magnesium. These nutrients have not been consistently shown to prevent high blood pressure, but are important nutrients for overall good health.

Good sources of calcium are dairy foods such as milk, yogurt, and cheese. Be sure to choose skim or lowfat varieties. Lowfat and nonfat dairy products have more calcium than the high fat versions.

Values were obtained from the USDA Nutrient Database for Standard References, Release 15 for Calcium, Ca (mg) content of selected foods per common measure.

You should get enough magnesium if you follow a healthy diet. Magnesium is found in whole grains, green leafy vegetables, nuts, and dry peas and beans.

Values were obtained from the USDA Nutrient Database for Standard References, Release 15 for Magnesium, Mg (mg) content of selected foods per common measure.

The Answer:

They do not directly affect blood pressure. However, saturated fats and cholesterol in foods raise blood cholesterol, which increases the risk for heart disease. Foods high in fats also are high in calories, which must be reduced if you need to lose weight.

The Answer:

Caffeine in coffee as well as in other drinks, such as tea and sodas, only raises blood pressure temporarily. So you should be able to continue to have drinks that contain caffeine, unless you are sensitive to it or have heart disease and your doctor tells you not to have any.

The Answer:

Stress can make blood pressure go up for a while, and it has been thought to contribute to high blood pressure. But the long-term effects of stress are as yet unclear. Stress management techniques do not seem to prevent high blood pressure. However, such techniques may have other benefits, such as making you feel better or helping you to control over-eating.

The Answer:

No. However, it can temporarily raise blood pressure, and it DOES increase the risk of heart and blood vessel diseases.

Smoking and Heart Health: Smoking injures blood vessel walls and speeds up the process of hardening of the arteries. So even though it does not cause high blood pressure, smoking is bad for anyone, especially those with high blood pressure. If you smoke, quit. If you don't smoke, don't start. Once you quit, your risk of having a heart attack is reduced after the first year. So you have a lot to gain by quitting.

The Answer:

Tranquilizers and sedatives will not keep your blood pressure down.

The Answer:

It is important to take steps to keep your blood pressure under control. The treatment goal is blood pressure below 140/90 and lower for people with other conditions, such as diabetes and kidney disease. Adopting healthy lifestyle habits is an effective first step in both preventing and controlling high blood pressure. If lifestyle changes alone are not effective in keeping your pressure controlled, it may be necessary to add blood pressure medications.

The Answer:

Although many pregnant women with high blood pressure have healthy babies without serious problems, high blood pressure can be dangerous for both the mother and the fetus. Women with pre-existing, or chronic, high blood pressure are more likely to have certain complications during pregnancy than those with normal blood pressure. However, some women develop high blood pressure while they are pregnant (often called gestational hypertension).

The effects of high blood pressure range from mild to severe. High blood pressure can harm the mother's kidneys and other organs, and it can cause low birth weight and early delivery. In the most serious cases, the mother develops preeclampsia—or "toxemia of pregnancy"—which can threaten the lives of both the mother and the fetus.

The Answer:

If you are thinking about having a baby and you have high blood pressure, talk first to your doctor or nurse. Taking steps to control your blood pressure before and during pregnancy--and getting regular prenatal care--go a long way toward ensuring your well-being and your baby's health.

Before becoming pregnant:

• Be sure your blood pressure is under control. Lifestyle changes such as limiting your salt intake, participating in regular physical activity, and losing weight if you are overweight can be helpful.
• Discuss with your doctor how hypertension might affect you and your baby during pregnancy, and what you can do to prevent or lessen problems.
• If you take medicines for your blood pressure, ask your doctor whether you should change the amount you take or stop taking them during pregnancy. Experts currently recommend avoiding angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II (AII) receptor antagonists during pregnancy; other blood pressure medications may be OK for you to use. Do not, however, stop or change your medicines unless your doctor tells you to do so.

While you are pregnant:

• Obtain regular prenatal medical care.
• Avoid alcohol and tobacco.
• Talk to your doctor about any over-the-counter medications you are taking or are thinking about taking.

The Answer:

Preeclampsia is a condition that typically starts after the 20th week of pregnancy and is related to increased blood pressure and protein in the mother's urine (as a result of kidney problems). Preeclampsia affects the placenta, and it can affect the mother's kidney, liver, and brain. When preeclampsia causes seizures, the condition is known as eclampsia--the second leading cause of maternal death in the U.S. Preeclampsia is also a leading cause of fetal complications, which include low birth weight, premature birth, and stillbirth.

There is no proven way to prevent preeclampsia. Most women who develop signs of preeclampsia, however, are closely monitored to lessen or avoid related problems. The way to "cure" preeclampsia is to deliver the baby.

The Answer:

High blood pressure problems occur in 6 percent to 8 percent of all pregnancies in the U.S., about 70 percent of which are first-time pregnancies. In 1998, more than 146,320 cases of preeclampsia alone were diagnosed.

Although the proportion of pregnancies with gestational hypertension and eclampsia has remained about the same in the U.S. over the past decade, the rate of preeclampsia has increased by nearly one-third. This increase is due in part to a rise in the numbers of older mothers and of multiple births, where preeclampsia occurs more frequently. For example, in 1998 birth rates among women ages 30 to 44 and the number of births to women ages 45 and older were at the highest levels in 3 decades, according to the National Center for Health Statistics. Furthermore, between 1980 and 1998, rates of twin births increased about 50 percent overall and 1,000 percent among women ages 45 to 49; rates of triplet and other higher-order multiple births jumped more than 400 percent overall, and 1,000 percent among women in their 40s.

The Answer:

• Women with chronic hypertension (high blood pressure before becoming pregnant).
• Women who developed high blood pressure or preeclampsia during a previous pregnancy, especially if these conditions occurred early in the pregnancy.
• Women who are obese prior to pregnancy.
• Pregnant women under the age of 20 or over the age of 40.
• Women who are pregnant with more than one baby.
• Women with diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma.

The Answer:

Unfortunately, there is no single test to predict or diagnose preeclampsia. Key signs are increased blood pressure and protein in the urine (proteinuria). Other symptoms that seem to occur with preeclampsia include persistent headaches, blurred vision or sensitivity to light, and abdominal pain.

All of these sensations can be caused by other disorders; they can also occur in healthy pregnancies. Regular visits with your doctor help him or her to track your blood pressure and level of protein in your urine, to order and analyze blood tests that detect signs of preeclampsia, and to monitor fetal development more closely.

The Answer:

The effects of high blood pressure during pregnancy vary depending on the disorder and other factors. According to the National High Blood Pressure Education Program (NHBPEP), preeclampsia does not in general increase a woman's risk for developing chronic hypertension or other heart-related problems. The NHBPEP also reports that in women with normal blood pressure who develop preeclampsia after the 20th week of their first pregnancy, short-term complications - including increased blood pressure - usually go away within about 6 weeks after delivery.

Some women, however, may be more likely to develop high blood pressure or other heart disease later in life. More research is needed to determine the long-term health effects of hypertensive disorders in pregnancy and to develop better methods for identifying, diagnosing, and treating women at risk for these conditions.

Even though high blood pressure and related disorders during pregnancy can be serious, most women with high blood pressure and those who develop preeclampsia have successful pregnancies. Obtaining early and regular prenatal care is the most important thing you can do for you and your baby.

The Answer:

Women taking oral contraceptives experience a small but detectable increase in both systolic and diastolic blood pressure, usually in the normal range. Talk to your doctor about a possible rise in blood pressure and what you can do about it. Women age 35 and older who smoke cigarettes are at even greater risk for heart disease and stroke and are encouraged to quit smoking. If they are unable to quit smoking, they should talk to their doctor about using other forms of contraception.

The Answer:

A recent study indicated that blood pressure does not increase significantly with hormone replacement therapy in most women with and without high blood pressure. However, a few women may experience a rise in blood pressure attributable to estrogen therapy. Therefore, it is recommended that all women treated with hormone replacement therapy have their blood pressure monitored more frequently after such therapy is started. Your doctor can be very helpful in answering your questions.