High blood pressure (hypertension)

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What is it

High blood pressure, known as hypertension, affects at least 50 million people in the United States and 4 million in Canada. It is probably the most common medical problem in the industrialized world, and the major treatable risk factor for heart attack and stroke.

Blood pressure is created by the pumping of your heart. It is a variable force that moles blood through the circulator) system. When your heart contracts, blood flows into the arteries, and at the end of the contraction the pressure is at its high point. Then as the heart relaxes, blood flows from the veins into the heart, and the pressure reaches its low point. Thus a blood pressure measurement is expressed as two numbers systolic (high point) and diastolic (low point).

A complex bodily system regulates blood pressure, which fluctuates normally according to your activity level and many other factors. The main regulators of blood pressure are small blood vessels called arterioles, which widen and constrict, causing pressure to fall and rise. When the regulatory system goes awry, the arterioles stay constricted, and blood pressure stays chronically high.

About 70 percent of people with high blood pressure have what is now referred to as Stage 1 hypertension systolic pressure in between 140 and 159, diastolic pressure ┬áin between 90 and 99. Doctors used to talk about “mild” or “border line” hypertension, but this language is falsely reassuring, since many cases of Stage 1 hypertension worsen over time if untreated. And many researchers believe that even slightly elevated blood pressure (85 to 89 diastolic), or “high normal,” can be a health hazard if it persists for years.

Anybody in any walk of life can get hypertension. The major risk factors are advancing age, high sodium and/or alcohol intake, being overweight, being sedentary, and a family his- tory of hypertension. Incidence is also higher among black people, among poor people, and among those with lower educational levels.

In addition to being a major risk factor for stroke and heart attack, untreated hypertension can harm the arteries, resulting in damage to the brain, heart, and kidneys. Yet in the United States only about half of the individuals who have hypertension know it, mainly because it seldom causes noticeable symptoms. This is unfortunate, since blood pressure can be controlled in most people through lifestyle changes and, when necessary, treatment with drugs.

Symptoms

  • High blood pressure usually has no symptoms, which is why it’s called the silent killer. Some patients with very high blood pressure complain of headaches, but most often hypertension is discovered during a routine physical exam or when there is a complication due to hypertension for example, a heart attack or stroke.

What causes it

In most cases the cause of the condition is unknown this is called essential hypertension. In about 10 percent of cases, the elevated blood pressure is due to kidney disease or another underlying disorder.

Hypertension that develops as people grow older is common in the industrialized world but almost unheard of among rural peoples in underdeveloped countries. People who move from other cultures and adopt a westernized lifestyle tend to develop hypertension, too. Nobody knows exactly what causes this diet, especially sodium intake, and lack of exercise may be part of it. So may the demands of modern life. Job stress can certainly contribute to hypertension, especially a job that demands careful attention to detail but offers little personal satisfaction or sense of control. Job insecurity can also contribute to hypertension.

Emotions, such as fear and anger, temporarily raise blood pressure, but then it drops to its prior level when the emotions subside. No personality type is more prone to high blood pressure, although one study did suggest that middle-age men (not women) with high anxiety levels were more likely to develop hypertension than others.

What if you do nothing

In many people blood pressure increases with age so if you are in your 30s, for example, and your blood pressure is slightly elevated, it may eventually rise into the Stage 1 category. In addition, if you have certain lifestyle risk factors for hypertension if you smoke, are overweight, consume too much alcohol, or are sedentary and you do nothing to modify these factors, your blood pressure is likely to increase over the years. For example, if your blood pressure is normal and you are sedentary, you have a 20 to 50 percent greater risk of developing hypertension than a person who’s fit and active.

Home remedies

Some of the risk factors associated with hypertension heredity, race, and age can’t be altered. Nonetheless, there is increasing evidence that a number of dietary and lifestyle changes can often help reduce elevated blood pressure. Such changes are the first step in treating people with high-normal or Stage 1 blood pressure, who may be able to avoid or postpone the need for anti- hypertensive medications. Even if you are prescribed such drugs, you should continue to modify your behavior, since this may help you get by on a lower dose and thus reduce any adverse effects the drugs may cause.

Maintain a healthy weight

Losing even a few pounds if you’re overweight can reduce your blood pressure.

Don’t smoke

Smoking doesn’t cause hypertension, but it does promote heart disease. A hypertensive who smokes is at serious risk.

Exercise regularly

For one thing, exercise can help you lose weight. It can also lower your blood pressure somewhat, though it’s not understood exactly how this happens. If you are sedentary and just beginning an exercise program to combat hypertension, remember that you may not see the effects for months.

Keep your sodium intake low

About 10 to 15 percent of the population is salt-sensitive, meaning that salt (sodium chloride) drives their blood pressure up. Since you can’t know in advance whether you are in this group, you should moderate your salt intake in hope of controlling or preventing hypertension. Reducing sodium intake is always the first line of treatment for people who have developed high blood pressure.

Consume a diet rich in low fat dairy products, vegetable and fruits

Diet, by itself, is seldom an adequate treatment for hypertension. But at least one study has shown that a diet emphasizing fruits and vegetables along with low-fat dairy products (and whole grains) a healthy, well balanced diet, in other words can considerably decrease blood pressure. Such a diet helps control weight, is low in sodium, and supplies good amounts of potassium. (A diet high in potassium has been shown to produce modest drops in blood pressure in some hypertensive.)

If you drink alcohol, do so in moderation

No more than one drink daily for a woman, or two for a man. A drink is defined as 1.5 ounces of 80-proof spirits, 5 ounces of wine, or 12 ounces of beer, all of which contain the same amount of alcohol.

Don’t rely on garlic

Garlic promoters have made countless claims about the health benefits of garlic including its ability to lower blood pressure. However, the studies testing garlic’s effects on blood pressure have been flawed and the results contradictory. Eating garlic can’t hurt you but it’s also unlikely to be of help if you have hypertension.

Prevention

The same factors that help control hypertension may help prevent it in the first place. There’s no guarantee but even if these measures don’t work, they offer other potential health benefits, most importantly a reduction in risk factors for cardiovascular disease.

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