The Lowdown on High Blood Pressure

Health, Home & Family
on February 5, 2006

"We don’t know exactly what causes hypertension," says Dr. Jim King, a family physician in Selmer, Tenn. "We do know you are more at risk as you age if you have a family history of the condition and if you are overweight and inactive. In addition, high blood pressure is more common among African-Americans than other groups."

High blood pressure is dangerous. It can cause:

• Hardening of the artery walls and fatty deposits in artery linings, leading to a heart attack

• Thickening of the heart’s main pumping chamber, causing heart failure

• Blocked or torn blood vessels in the brain, triggering a stroke

• Kidney failure

• Damaged blood vessels in the eyes, resulting in vision loss or even blindness

• A decrease in your ability to think clearly, remember and learn as you age

Your blood pressure should be checked at least every two years and more often depending on your last reading, risk factors and health history. The test is simple and painless. You sit or lie down and a blood pressure cuff is wrapped around your arm and inflated, temporarily stopping the blood flow. Then the air in the cuff is released and the person measuring your blood pressure listens to the blood flow with a stethoscope while watching a gauge. Two measurements are recorded.

A blood pressure reading is written as two numbers separated by a slash. The first number is the systolic pressure: the pressure your heart produces as it pumps blood through your arteries. The second number is the diastolic pressure: the pressure in your arteries when your heart rests between beats. Normal blood pressure for an adult is 120/80 mmHG (millimeters of mercury), expressed as "120 over 80." High blood pressure is a reading of 140/90 or higher. If your blood pressure is between 120/80 and 140/90, you are said to be prehypertensive.

"We measure blood pressure in both the left and right arms," King says, "since they can vary somewhat. Blood pressure may also rise if someone is nervous as they might be at a medical visit. That’s why, unless a patient’s pressure is dangerously high, we check it several times on different days. I also suggest buying an inexpensive home blood pressure monitor so the patient can note their pressure several times a day for a few weeks."

If blood pressure is above normal but not in the danger zone, most health care professionals first suggest lifestyle changes that may lower it. These include:

• Eating a healthy diet that includes a variety of foods. Ask about the Dietary Approach to Stop Hypertension (DASH) diet, which emphasizes lots of grains, vegetables, fruits and low-fat dairy products.

• If you are overweight, shed some pounds.

• Get moving. Make exercise part of your life: walk briskly 30 minutes a day; park your car at the far end of the lot; use stairs instead of the elevator; wash the car.

• If you smoke, work on quitting.

• Limit alcohol and caffeine, including colas; both can raise blood pressure.

• Reduce your salt intake. Check food labels; the word "sodium" means salt. Many packaged foods have a high-sodium content, so rinse canned foods and use spices instead of salt to flavor food. Check drug labels, too. Some over-the-counter drugs such as cold and cough medicines have a high-sodium content.

If blood pressure doesn’t respond to these changes, there are many effective medications. What’s most important is to have your blood pressure checked regularly and to follow your doctor’s advice.