Published on June 11, 2021

Controlling Your Blood Pressure

What is hypertension?

Hypertension, or high blood pressure, is a very common medical condition that affects millions of people worldwide, of all ages, races and sexes. Almost half of the U.S. adult population has hypertension.

Hypertension is defined as excessive pressure, applied by blood flow, against the walls of your blood vessels, which if sustained, can have many long-term health consequences.

Blood pressure is measured using at home or office-based manual or automatic measurement devices.

It is represented by two numbers; for example, 120/80.

  • The top number (120 in this example) is your systolic pressure, or the pressure in your arteries (the blood vessels that carry blood away from your heart) when your heart beats.
  • The bottom number (80 in this example) is your diastolic pressure, or the pressure in your arteries between heartbeats.

Systolic blood pressure measures the pressure in your arteries (the blood vessels that carry blood away from your heart) when your heart beats.

Diastolic blood pressure measures the pressure in your arteries between heartbeats.

A commonly accepted “good” blood pressure is 120/80. However, an acceptable blood pressure varies by age and medical condition. For most people, a blood pressure of less than 130/80 is acceptable.

What causes hypertension?

For some people, hypertension has no known cause. We call this essential or primary hypertension. This is a very common class of hypertension. Several factors can contribute to this type (and other types) of hypertension, however.

  • Obesity
  • Family history of hypertension
  • Excessive alcohol use
  • Smoking
  • High salt diet
  • Advanced age
  • Physical inactivity
  • High cholesterol
  • Diabetes

Hypertension that can be linked to a specific cause is referred to as secondary hypertension. Conditions that can lead to secondary hypertension include:

  • Obstructive sleep apnea
  • Certain medications (e.g. decongestants, NSAIDs)
  • Illicit drug use (e.g. methamphetamine)
  • Kidney disease
  • Abnormalities in blood flow
  • Adrenal and thyroid gland disorders

What are symptoms of hypertension?

Unfortunately, many people do not have any symptoms of hypertension until they develop severe medical issues related to the hypertension, usually years after they initially--unbeknownst to them--became hypertensive. This is why hypertension is referred to as the “silent killer.”

In patients who do experience symptoms, common ones include:

  • Headache
  • Chest pain
  • Blurry vision
  • Shortness of breath
  • Fatigue
  • Difficult sleeping
  • Dizziness
  • Nervousness or jitteriness
  • Sweating
  • Abnormal bleeding

There are no specific blood pressure readings at which patients will experience symptoms. Some patients will only experience symptoms at higher readings while others will experience symptoms with mild elevations.

How bad is hypertension?

Hypertension is associated with many different complications. Some of the more severe complications include:

  • Heart disease
  • Heart attacks
  • Heart failure
  • Heart enlargement
  • Kidney disease
  • Stroke
  • Bleeding, including brain bleeding

Hypertension is the most common modifiable risk factor for premature heart disease. So, basically, if you want to do anything to prevent early onset heart disease, keep your blood pressure in check.

How do you prevent and/or treat hypertension?

Most preventive treatment involves avoiding risk factors listed above (e.g. not smoking or using alcohol in excess, avoiding high salt foods/eating a well-balanced diet, exercising, maintaining a healthy body weight). However, if you are diagnosed with hypertension, your primary care provider may perform additional tests to ensure that you do not have any complications related to your hypertension and/or to uncover the causes of your hypertension.

If you need medication to treat your hypertension, your primary care provider will select the correct medication or medications that are best suited for you.

How do you check your blood pressure at home?

There are many different ways to check your blood pressure outside of the medical office. Preferred monitors assess the blood pressure in the brachial artery (upper arm). Monitors that utilize the wrist/forearm are less accurate. With any blood pressure monitor, I recommend that you take it to your primary care provider’s office so that the readings can be compared with in-office readings to ensure accuracy.

Be sure to change batteries frequently as low batteries can lead to inaccurate readings. Additionally, you need to be sure that you have the correct cuff size (see your specific monitor for sizing).

When you check your blood pressure, you need to be in a quiet room and have rested for at least five minutes. You should be in a seated position with your back and arm supported with your legs uncrossed.

If you have several blood pressure measurements at home that you believe are high, you need to follow-up with your primary care provider to further discuss.

There are no parameters regarding how frequently you should check your blood pressure, especially if you do not have a diagnosis of hypertension. If you do have hypertension, your primary care provider will further guide you on how often to check your blood pressure. If you do not have hypertension, I recommend that you have a yearly physical with your primary care provider during which your blood pressure should be assessed.

Almost half of the U.S. population has hypertension. Have your primary care provider check your blood pressure every year.