High blood pressure, or hypertension, is one of the most commonly treated conditions in a family doctor’s office. It has been called a silent killer, because most people with high blood pressure do not experience any symptoms. It is usually not until they are seen in the office for other problems that the blood pressure is found to be elevated.
Blood pressure is measured with a sphygmomanometer (blood pressure cuff). Two numbers are obtained. The top number, the systolic reading, is the pressure in the blood vessel while the heart is pumping blood out to the body. The bottom number, the diastolic reading, is the pressure in the vessels during heart relaxation. In general, systolic readings greater than 140 and diastolic readings greater than 90 are considered high.
These numbers are not arbitrary. The reason for these values is that studies show that people with even small increments above 140 or above 90 are more likely to have heart attacks and strokes. Likewise, lowering the pressures below these cutoffs decreases the risk of these complications.
Most people (95 percent) with high blood pressure will have what is called essential, or primary, hypertension. This means it is not caused by other medical conditions, such as kidney disease or hormone imbalances. It is a flaw within the circulatory system that leads to the pressure elevation.
Risk factors for developing high blood pressure include being overweight, smoking cigarettes, ingesting excessive alcohol, having a sedentary lifestyle, eating foods that are high in salt and fat and having a family history of high blood pressure. As you can see from this list, all but one of these risk factors (family history) are things that we can modify to reduce our risk of developing hypertension.
Everyone should have their blood pressure checked periodically beginning around age 2. Some people will develop high blood pressure in their teens and it is important to identify this early to prevent complications. If you’ve had any high readings in the past, you should regularly follow up with your physician for close monitoring and treatment.
If your doctor has determined that you have high blood pressure readings, he may suggest you monitor your pressure at home. Automated home blood pressure machines are readily available and easy to use. However, I usually have the patient bring their machine into the office for calibration to verify its accuracy.
High blood pressure is a serious yet very treatable condition. It’s important to work with your doctor to take active steps to prevent and control it. Daily exercise, losing weight, stopping smoking and watching your salt intake are the first steps to help reduce your risk of hypertension.
The content in this column is for information purposes only and is not intended to be used for diagnostic or treatment purposes. Consult with your physician for appropriate individual treatment. Dr. Reynolds practices Family Medicine in Chesterfield.