High Blood Pressure & Hypertension

High Blood Pressure / Hypertension

What Is High Blood Pressure / Hypertension

Hypertension, or high blood pressure (HBP), is a common disease in which blood flows through blood vessels (specifically arteries) at higher than normal pressures. Blood pressure is the force of blood pushing against the artery walls as the heart pumps blood. High blood pressure, sometimes called arterial hypertension, happens when this force is too high. This happens when the arteries are not as elastic as they should be because of scarring or the build-up of cholesterol and plaque. This causes the heart to pump harder to get blood into the arteries. Over time, this increased effort can result in damage to the heart itself, particularly in the heart’s muscles and valves.

Approximately 67 million Americans—or 31% of the American population has high blood pressure. It can occur at any age, though it is more common in older age. In the United States, an estimated 65% of men and 70% of women over the age of 60 suffer from high blood pressure.

Most people with high blood pressure have no symptoms; in fact, you can have high blood pressure for years and not know it. For this reason, it’s often referred to as a “silent killer.” The only way to know if your blood pressure is high is to have it checked regularly, which is why blood pressure is always taken at check ups. Everyone, from kids to adults, should have their blood pressure checked regularly.

What Causes High Blood Pressure / Hypertension

Risk Factors For High Blood Pressure / Hypertension

Diagnosing High Blood Pressure / Hypertension

Symptoms of High Blood Pressure / Hypertension

Prognosis

Living With High Blood Pressure / Hypertension

There are several things that you can do to help lower your blood pressure and boost your overall health to prevent your risk of future heart problems, like:

Stop smoking. An estimated 20% of all deaths due to heart disease are directly linked to smoking.
Keep your blood pressure and cholesterol under control. People with high blood pressure and cholesterol are at an elevated risk for heart disease. About 50% of ischemic strokes (caused by a blockage of the artery to the brain) are caused by high blood pressure.
Manage your weight. About one in three American adults is obese (weighing at least 20 percent above the “suggested” weight for their height), which doubles their risk for coronary artery disease (CAD) at a given age.
Engage in regular cardiovascular exercise. Exercise helps the heart work more efficiently, reducing blood pressure, raising HDL cholesterol, decreasing the tendency of blood to form clots, moderating stress, helping the body use insulin, and helping people maintain a healthy weight. Sedentary people who begin a regular program of exercise reduce their risk of a heart attack by 35 to 55 percent. Low-intensity activities, such as gardening or walking, if done regularly and over the long term, can decrease the risk of heart attack. Speak with your doctor about the right routine for you.
If you have diabetes, keep your blood sugar levels under control. People with diabetes are twice as likely to have a heart attack or stroke.
Eat a healthy diet. Opt for high fiber foods such as fruits, vegetables, and whole grains, as well as omega-3 oils such as coldwater fish and salmon), and mono- and polyunsaturated fats. But limit saturated fats and avoid trans fats, often found in fried foods, processed foods, and commercial baked goods.
Limit salt. The American Heart Association recently reduced the amount of salt recommended for everyone to just 1,500 mg a day, which is about two-thirds of a teaspoon.
Control stress.
Tame alcohol intake. There’s a growing consensus that light to moderate alcohol consumption–that is, two drinks or less a day for a man, one drink for a woman (a drink is defined as 12 oz. of beer, 4 oz. of wine, or 1.5 oz. of 80-proof spirits) can help prevent heart attacks. However, drinking more than that can increase the risk of heart attack and stroke.
Educate yourself about your condition so that you can know as much as you can about heart disease. This will help ensure you are getting the best treatment available, as well as train you to recognize any potentially harmful side effects or disease progression.

Screening

Prevention

Common Treatment

Your doctor can choose from several dozen possible medications and/or a combination of medications to treat your high blood pressure.

Diuretics help the kidneys eliminate sodium and water from the body. This process decreases blood volume, so your heart has less to pump with each beat, which in turn lowers blood pressure. Among the most popular are:

Chlorthalidone (Hygroton)
Hydrochlorothiazide (Hydrodiuril, Microzide, Esidrix)
Indapamide (Lozol)
Metolazone (Mykrox, Zaroxolyn).

Side effects of diuretics include:

Frequent urination
Arrhythmia (irregular heartbeat)
Weakness
Muscle cramps
Dehydration
Dizziness/confusion
Nausea/loss of appetite

Anti-adrenergics lower blood pressure by limiting the action of the hormones epinephrine and norepinephrine, thereby relaxing the blood vessels and reducing the speed and force of the heart’s contractions. This class of medicines includes:

Guanadrel (Hylorel)
Guanethidine monosulfate (Ismelin)
Reserpine (Serpasil)
Clonidine hydrochloride (Catapres)
Guanabenz acetate (Wytensin)
Guanfacine hydrochloride (Tenex)
Methyldopa (Aldomet).

Side effects of anti-adrenergics include:

Drowsiness
Vomiting/Nausea
Headache
Muscle weakness
Diarrhea
Dry mouth
Impotence
Irregular heartbeat

Direct-acting vasodilators relax the arteries. They act quickly and are often used in emergencies. Vasodilators include:

Hydralazine hydrochloride (Apresoline)
Minoxidil (Loniten).

Side effects of direct-acting vasodilators include:

Dizziness
Headache
Anxiety
Mild Rash
Muscle or Joint pain
Nausea/vomiting
Diarrhea/constipation
Fast heartbeat
Flu-like symptoms
Swelling in the hands, ankles, or feet

Calcium channel blockers slow the movement of calcium into the smooth-muscle cells of the heart and blood vessels. This weakens heart muscle contractions and dilates blood vessels, lowering blood pressure. Some calcium channel blockers include:

Amlodipine (Norvasc)
Diltiazem (Tiazac)
Felodipine (Plendil)
Isradipine (DynaCirc)
Nicardipine (Cardene SR)
Nifedipine (Adalat, Procardia)
Nisoldipine (Sular)
Verapamil (Calan, Verelan, Covera-HS)

Side effects of calcium channel blockers include:

Constipation
Nausea
Headache
Rash
Edema (swelling of the legs with fluid)
Low blood pressure
Drowsiness
Dizziness
Liver disease

ACE (Angiotensin-converting enzyme) inhibitors lower your blood pressure by inhibiting the formation of angiotensin, which causes blood vessels constriction and increases blood pressure. . Some ACE inhibitors are:

Benazepril hydrochloride (Lotensin)
Captopril (Capoten)
Enalapril maleate (Vasotec)
Fosinopril sodium (Monopril)
Lisinopril ( Prinivil, Zestril)
Moexpiril (Univasc)
Quinapril hydrochloride (Accupril)
Ramipril (Altace)
Trandolapril (Mavik).

Side effects of ACE inhibitors include:

Cough
Elevated blood potassium levels
Weakness
Drowsiness
Rash
Headache
Low blood pressure

Angiotensin-receptor blockers (ARBs) blocks angiotensin II, a substance in the body, from constricting the blood vessels and stimulating salt and water retention. They include:

Azilsartan (Edarbi)
Candesartan (Atacand)
Eprosartan (Teveten)
Irbesartan (Avapro)
Losartan (Cozaar)
Olmesartan (Benicar)
Telmisartan (Micardis)
Valsaartan (Diovan)

Side effects of ARBs include:

Dizziness
Insomnia
Vomiting/Diarrhea
Muscle cramps
Dehydration
Irregular heartbeat
Upper respiratory tract infection

Direct renin inhibitors, which block the action of angiotensin II. They represent a newer generation of blood pressure medications. Renin inhibitors work by inhibiting the activity of renin, the enzyme largely responsible for angiotensin II levels.

Aliskiren (Tekturna)

Side effects of direct renin inhibitors include:

Dizziness
Headaches
Diarrhea
Stuffy nose
Back pain
Joint swelling

Complementary and Alternative Treatment

The following list of supplements is offered by the University of Maryland Medical Center. Always check with your cardiologist or primary doctor before adding supplements to your regimen for treating and preventing heart failure. Many people with heart conditions take multiple medications, including blood-thinning medications, blood pressure medications, and others. The supplements below may interact with these (and other medications) and may not be right for people with certain medical conditions.

Magnesium is particularly important for maintaining a normal heart rhythm and is often used by physicians to treat irregular heartbeat (arrhythmia). People with heart failure are often at risk for developing an arrhythmia. In addition, some diuretics (water pills) may cause your body to lose too much magnesium.
Carnitine. Early studies show L-carnitine supplements may reduce your chances of developing heart failure after a heart attack and improve exercise capacity if you already have heart failure.
Coenzyme Q-10. Several research studies suggest that CoQ10 supplements can help reduce swelling in the legs, enhance breathing by reducing fluid in the lungs, and increase exercise capacity in people with heart failure.
Creatine is a naturally occurring amino acid (protein building block) found mainly in muscles. In a few studies of people with heart failure, injections of creatine (in addition to standard medical care) provided improvement in heart function and ability to exercise compared to those who received placebo.
Vitamin B1 (Thiamine may be related to heart failure in several ways. First, low levels of thiamine can contribute to the development of heart failure. On the flip side, people with severe heart failure can lose a significant amount of weight, including muscle mass (called cachexia), and become deficient in many nutrients, including thiamine. In addition, diuretics (water pills) can cause your body to lose too much thiamine..
Amino acids. A few small studies suggest these amino acids might be helpful for heart failure, but more research is needed:
- Arginine (needed for the body to make nitric oxide, which helps blood flow)
- Taurine (helps heart muscle contract)

Stress reduction practices. Since stress is associated with heart disease, it’s prudent to try techniques to help reduce it. The following methods have been shown to reduce stress in some people:

Meditation
Yoga, Tai’ Chi, and other forms of moderate exercise such as walking
Deep breathing
Visualization
Biofeedback