HIGH BLOOD PRESSURE aka HYPERTENSION

What is blood pressure?
Blood pressure is a measurement of the force of blood flowing against the walls of the arteries. This pressure is constantly changing during the course of the heart related cycle. The highest pressure in the cycle is called the systolic blood pressure, while the lowest is the diastolic blood pressure. Both pressure readings are necessary to enable a physician to evaluate the status of a patient’s blood pressure. Many factors such as physical activity, time of day etc can influence one’s blood pressure, for example, blood pressure is typically low in the morning and increases from the afternoon to the evening, and it is lower in the summer and higher in the winter.
What is high blood pressure?
High blood pressure, otherwise known as hypertension means high pressure (strain) in the arteries. Arteries are tubes that carry blood from the pumping heart to all the tissues and organs of the body. Veins carry used blood from the organs and tissues back to the heart for recycling. If arteries become narrowed by one or more of several reasons, then the pressure of blood flow within the tubes that carry blood increases. The heart is therefore made to work harder to ensure that fresh and recycled blood is pumped to every organ of the body.
According to medical science the word "hypertension" or “arterial hypertension”, by itself, normally refers to increased pressure of blood passing through the entire arteries of the whole body. In order words the normal pumping pressure of blood through the body is in a way “hyped”. The opposite of it is called “normotensive”.
Damage to the heart and blood vessels may occur if the condition remains unchecked, increasing the risk for stroke (brain damage), heart attack , kidney or heart (cardiac) failure, hardening of the arteries (atherosclerosis or arteriosclerosis), and eye damage. Hypertension is often called the “silent killer,” and usually shows no symptoms until it reaches a life-threatening stage.
High blood pressure does not necessarily mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Hypertension can be classified as either essential (primary) or secondary. Essential or primary hypertension means that no medical cause can be found to explain the raised blood pressure. It is common. About 90-95% of hypertension is essential hypertension. Secondary hypertension indicates that the high blood pressure is a result of (i.e., secondary to) another condition, such as kidney disease or tumors.
How can I know if I have Hypertension?
Primary hypertension has no symptoms until complications develop. Symptoms and signs are not specific and arise from complications in some target organs. Dizziness, flushed facial appearance, headaches, fatigue, nose bleeding and nervousness might be some symptoms that might trigger a suspicion.

The Sphygmomanometer is the common instrument for measuring the blood pressure. This is placed over the upper arm artery, above the elbow, and when the pressure through the rubber bulb has shut off the artery so the pulse cannot be felt at the wrist, the reading in the graded scale at the height of the column of mercury indicates the blood pressure.

There is also the more modern Digital Blood Pressure Monitors or Wrist Measuring Automatic Models which are small and portable with memory for up to 48 readings coupled with time, date and pulse-per-minute easy-to-read LCD display and one touch automatic operation which can be bought from across the counter in a drug shop or a supermarket. It is designed to enable the patient monitor his own blood pressure at home and consult a physician when an unusual shift is observed.
Experts say that, having one’s blood pressure measured by a doctor in a hospital or a clinic, and in group health checks, tend to stimulate nervousness in the subject and may even create high blood pressure. It also varies blood pressure in accordance with a variety of conditions and so judgment is not possible on the basis of a single measurement.

The blood pressure measured first thing in the morning after getting up, before taking any food and with the subject still, is known as the fundamental blood pressure. In practice it is rather difficult to record the fundamental blood pressure, but to come as near as possible to measuring the blood pressure in an environment that is close to this, why it is useful to take the measurement at home.

What do Physicians say about it?
Physicians use two measurements to describe blood pressure. Systolic pressure measures blood pressure as the heart contracts to pump out blood. Diastolic pressure measures blood pressure as the heart relaxes to allow blood to flow into the heart.

Sphygmomanometer (analogue) and digital blood pressure monitors measure systolic and diastolic pressure using units of millimeters of mercury (mm Hg).
Blood pressure is classified in four categories: normal, pre-hypertension, stage 1 hypertension, and stage 2 hypertension. Normal blood pressure in an adult is less than 120/80 mm Hg, in which 120 describes systolic pressure and 80 describes diastolic pressure. Blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high.

Hypertension is a long lasting medical condition. People with pre-hypertension are likely to develop hypertension at some point during their life. Stage 1 hypertension is defined as a systolic pressure of 140 to 159 mm Hg or a diastolic pressure of 90 to 99 mm Hg. Stage 2 hypertension is defined as 160/100 mm Hg or higher.



Classification Systolic pressure Diastolic pressure
mmHg kPa (kN/m2) mmHg kPa (kN/m2)
Normal 90–119 12–15.9 60–79 8.0–10.5
Prehypertension 120–139 16.0–18.5 80–89 10.7–11.9
Stage 1 140–159 18.7–21.2 90–99 12.0–13.2
Stage 2 ≥160 ≥21.3 ≥100 ≥13.3
Isolated systolic
hypertension ≥140 ≥18.7 <90 <12.0
Source: American Heart Association (2003).


Who else has it?
Hypertension affects a large population of people living in the United States. Of this number, almost a third are unaware of their condition. Until the age of 55, more men than women have hypertension. After that age, the condition becomes more prevalent in women. Hypertension is significantly more common in African Americans of both sexes than in other racial or ethnic groups.

The American Heart Association estimates high blood pressure affects approximately one in three adults in the United States - 73 million people. High blood pressure is also estimated to affect about two million American teens and children, and the Journal of the American Medical Association reports that many are under-diagnosed. Hypertension is clearly a major public health problem.

Now that I’ve confirmed that I may have it, how can I live with it?
If you have been diagnosed with hypertension, your goal is simple: Bring your blood pressure down to a healthy level, and keep it there. Very few people should settle for less. In fact, many people with hypertension could do fine without medication. Take these simple steps, and watch your blood pressure fall.
Know what’s going on in your arteries

Don’t wait for your next trip to the doctor’s office. With proper instruction, measuring your blood pressure at home is easy and accurate. Regular self-monitoring also gets you intimately involved in your own care.
Keep a blood pressure diary. Record your blood pressure measurements, including the time of day and notations about events that might have affected the readings, such as changes in medication, diet, or physical activity. Take your blood pressure diary with you every time you visit the doctor.

A word of caution: Don’t use your blood pressure readings to self-medicate or to change doses of prescribed medications. That’s your doctor’s responsibility.
Shed those extra pounds and move a little
Lose the weight. Nothing is more critical than dropping those extra pounds. For some people, excess weight means the difference between normal and elevated blood pressure. Weight loss may also allow you to take lower doses of hypertension medications.

Move a little! Sedentary folks have a significantly greater chance of developing hypertension. Regular exercise lowers blood pressure—and you don’t have to run a marathon to reap benefits. Brisk walking for 30 to 45 minutes three times each week will do just fine. Swimming and biking also help control hypertension, and they’re fun. But whatever exercise you choose, make it a regular part of your life, just like sleeping and eating.
Another word of caution: If you have been inactive for some time, consult your doctor before starting any exercise program.

Avoid table salt
The sodium found in ordinary table salt can elevate blood pressure, especially in African Americans and the elderly. That’s one reason why diuretics—pills that rid the body of sodium—are so effective in treating hypertension in some people.
To reduce salt intake, remove the saltshaker from the table. Cut back on snacks such as potato chips and pretzels, fast foods, processed foods, and frozen foods. Read the label on every type of food you buy—you may be shocked at how much sodium is in that little package!

Potassium is a form of salt, too. But unlike sodium, potassium has positive effects on blood pressure. Folks who ingest a lot of potassium tend to have lower blood pressure. Most fruits and vegetables are high in potassium, and as an added bonus, they are low in calories and high in fiber.
Other salts include calcium and magnesium. Despite some evidence that these salts may help lower blood pressure, their role is uncertain right now. For the time being, focus on lowering your sodium intake and adding more potassium to your diet.

Cut back on fat
You’ve surely heard this one before: restrict your intake of fatty foods. One of the main reasons for controlling blood pressure is to reduce the risk of developing atherosclerosis, which leads to heart disease and stroke. Diets high in saturated fats accelerate atherosclerosis.
Confused? Follow DASH, an ideal diet for persons with hypertension. DASH stands for Dietary Approaches to Stop Hypertension. This diet is rich in low-fat dairy products, calcium, potassium, magnesium, fiber, and vitamins. And don’t keep the fun all to yourself; following DASH is good for everyone. Put your whole family on DASH. After all, if you have hypertension, it’s likely someone else in your family is at risk as well.

Cut back on the hooch, and quit smoking already
Drink less alcohol. Excess alcohol intake contributes to hypertension, reduces the effectiveness of blood pressure medications, and increases the risk for stroke.
Need guidelines? Adult men should limit their daily intake to 24 ounces of beer, 10 ounces of wine, or 2 ounces of 100-proof whiskey. Women and lightweight males should consume only half these amounts. A note of caution: A heavy drinker who suddenly stops consuming all alcohol may develop higher blood pressure for a few days.

Stop smoking. Now. The nicotine in cigarettes raises blood pressure with every puff.
Need help? Consider nicotine replacement products. These stop-smoking aids don’t contain enough nicotine to raise blood pressure. Need more help? The Centers for Disease Control maintains a list of resources to help you quit smoking.
Don’t believe the hype
As with any disease, hypertension has its share of stories about miracle cures and remedies. Make sure you’re not putting your money and energy into a treatment that won’t work.

Myth: Garlic and onion reduce blood pressure
You may have heard that diets high in garlic and onion will lower your blood pressure. Scientific studies have failed to show that these foods have any consistent effect on blood pressure. Don’t endure garlic or onion breath to lower your blood pressure—they don’t work.

Myth: To bring down blood pressure, just relax
While it is true that emotions like stress and anxiety can temporarily raise blood pressure, relaxation-training therapies including biofeedback and meditation have not been scientifically proven to reduce hypertension. And learning these techniques can be pricey. You might do better investing your time and money in a good pair of walking shoes, a bicycle helmet, or a swimsuit.

Myth: People with high blood pressure shouldn’t drink coffee
Go ahead, enjoy that cup of joe. The caffeine in a cup of coffee may temporarily increase blood pressure, but the long-term effects are not harmful.