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Preventing High Blood Pressure

by the National Heart, Lung, and Blood Institute

What do I need to know?
What Is Blood Pressure - What Happens When It is High?
Who's Likely To Develop It?
How Is Blood Pressure Checked?
What Do the Numbers Mean?
What Causes High Blood Pressure?
How Can I Prevent It?
What Else Might Prevent It?
Other Factors


What do I need to know about high blood pressure?

High Blood Pressure, also called hypertension, is a risk factor for heart and kidney diseases and stroke. This means that having high blood pressure increases your chance (or risk) of getting heart or kidney disease, or of having a stroke. This is serious business: heart disease is the number one killer in the United States, and stroke is the third most common cause of death.

About one in every four American adults has high blood pressure. High blood pressure is especially dangerous because it often gives no warning signs or symptoms. Fortunately, though, you can find out if you have high blood pressure by having your blood pressure checked regularly. If it is high, you can take steps to lower it. Just as important, if your blood pressure is normal, you can learn how to keep it from becoming high.


What Is Blood Pressure - And What Happens When It is High?

Since blood is carried from the heart to all of your body's tissue and organs in vessels called arteries, blood pressure is the force of the blood pushing against the walls of those arteries. In fact, each time the heart beats (about 60-70 times a minute at rest), it pumps out blood into the arteries. Your blood pressure is at its greatest when the heart contracts and is pumping the blood. This is called systolic pressure. When the heart is at rest, in between beats, your blood pressure falls. This is the diastolic pressure.

Blood pressure is always given as these two numbers, systolic and diastolic pressures. Both are important. Usually they are written one above or before the other, such as 120/80 mm Hg, with the top number the systolic, and the bottom the diastolic.

Different actions make your blood pressure go up or down. For example, if you run for a bus, your blood pressure goes up. When you sleep at night, your blood pressure goes down. These changes in blood pressure are normal.

Some people have blood pressure that stays up all or most of the time. Their blood pushes against the walls of their arteries with higher-than-normal force. If untreated this can lead to serious medical problems like these:

Arteriosclerosis ("hardening of the arteries"). High blood pressure harms the arteries by making them thick and stiff. This speeds the build up of cholesterol and fats in the blood vessels like rust in a pipe, which prevents the blood from flowing through the body, and in time can lead to a heart attack or stroke.

Heart Attack. Blood carries oxygen to the body. When the arteries that bring blood to the heart muscle become blocked, the heart cannot get enough oxygen. Reduced blood flow can cause chest pain (angina). Eventually, the flow may be stopped completely, causing a heart attack.

Enlarged heart. High blood pressure causes the heart to work harder. Over time, this causes the heart to thicken and stretch. Eventually the heart fails to function normally causing fluids to back up into the lungs. Controlling high blood pressure can prevent this from happening.

Kidney Damage. The kidney acts as a filter to rid the body of wastes. Over a number of years, high blood pressure can narrow and thicken the blood vessels of the kidney. The kidney filters 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.

Stroke. High blood pressure can harm the arteries, causing them to narrow faster. So, less blood can get to the brain. If a blood clot blocks one of the narrowed arteries, a stroke (thrombotic stroke) may occur. A stroke can also occur when very high pressure causes a break in a weakened blood vessel in the brain (hemorrhagic stroke). Click here to learn more about preventing stroke.


Who's Likely To Develop High Blood Pressure?

Anyone can develop high blood pressure, but some people are more likely to develop it than others. For example, high blood pressure is more common - it develops earlier and is more severe - in African-Americans than in whites.

In the early and middle adult years, men have high blood pressure more often than women. But as men and women age, the reverse is true. More women after menopause have high blood pressure than men of the same age. And the number of both men and women with high blood pressure increases rapidly in older age groups. More than half of all Americans over age 65 have high blood pressure. And older African-American women who live in the Southeast are more likely to have high blood pressure than those in other regions of the United States.

In fact, the southeastern states have some of the highest rates of death from stroke. High blood pressure is the key risk factor for stroke. Other risk factors include cigarette smoking and overweight. These 11 states - Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia - have such high rates of stroke among persons of all races and in both sexes that they are called the "Stroke Belt States."

Finally, heredity can make some families more likely than others to get high blood pressure. If your parents or grandparents had high blood pressure, your risk may be increased. While it is mainly a disease of adults, high blood pressure can occur in children as well. Even if everyone is healthy, be sure you and your family get your blood pressure checked. Remember, high blood pressure has no signs or symptoms.


How Is Blood Pressure Checked?

Having your blood pressure checked is quick, easy, and painless. Your blood pressure is measured with an instrument called a sphygmomanometer (sfig-mo-ma-nom-e-ter).

It works like this: A blood pressure cuff is wrapped around your upper arm and inflated to stop the blood flow in your artery for a few seconds. A valve is opened and air is then released from the cuff and the sounds of your blood rushing through an artery are heard through a stethoscope. The first sound heard and registered on the gauge or mercury column is called the systolic blood pressure. It represents the maximum pressure in the artery produced as the heart contracts and the blood begins to flow. The last sound heard as more air is released from the cuff is the diastolic blood pressure. It represents the lowest pressure that remains within the artery when the heart is at rest.


What Do the Numbers Mean?

Blood pressure is always expressed in two numbers that represent the systolic and diastolic pressures. These numbers are measurements of millimeters (mm) of mercury (Hg). The measurement is written one above or before the other, with the systolic number on the top and the diastolic number on the bottom. For example, a blood pressure measurement of 120/80 mm Hg is expressed verbally as "120 over 80."

If your blood pressure is less than 120/80 mm Hg, it is considered normal. However, a blood pressure below the normal values is even better for your heart and blood vessels. People use to think that low blood pressure (for example, 105/65 mm Hg in an adult) was unhealthy. Except for rare cases, this is not true. High blood pressure or "hypertension" is classified by stages and is more serious as the numbers get higher.


What Causes High Blood Pressure?

For most people, there is no single known cause of high blood pressure. This type of high blood pressure is called "primary" or "essential" hypertension. This type of blood pressure can't be cured, although in most cases it can be controlled. That's why it's so important for everyone to take steps to reduce their chances of developing high blood pressure.

In a few people, high blood pressure can be traced to a known cause like tumors of the adrenal gland, chronic kidney disease, hormone abnormalities, use of birth control pills, or pregnancy. This is called "secondary hypertension." Secondary hypertension is usually cured if its cause passes or is corrected.


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See also:
Blood Pressure 101
Preventing Stroke

For More information contact the NHLBI at:
P.O. Box 30105
Bethesda, MD 20824-0105
(301) 592-8573

 


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