How Do I manage High Blood Pressure(Hypertension)?

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How Do I manage High Blood Pressure(Hypertension)?


High blood pressure (hypertension) can lead to stroke, heart failure, kidney failure and other medical problems, if left untreated. 

What is high blood pressure (hypertension)?

Blood pressure is the pressure or force of blood pushing against blood vessel walls. In case of hypertension, the pressure against the blood vessel walls is consistently too high. Hypertension is considered as a “silent killer” as one may not be aware about the constant damage within the body.
Blood pressure has two numbers reading. The first figure is systolic blood pressure; it reflects the pressure on the blood vessel walls when heart contracts. The second figure is diastolic blood pressure; it reflects the pressure on blood vessels when heart is relaxing.

Symptoms when blood pressure is not under control

  • Stroke
  • Heart attack
  • Peripheral vascular disease
  • Kidney disease
  • Eye damage
  • Vascular dementia

SYMPTOMS AND CAUSES


How do I know if I have high blood pressure?
High blood pressure usually doesn’t cause symptoms. The only way to know if you have high blood pressure is to have your provider measure it. Know your numbers so you can make the changes that help prevent or limit damage.
What are the risk factors for high blood pressure?
You are more likely to have high blood pressure if you:

  • Have family members who have high blood pressure, cardiovascular disease or diabetes.
  • Are of African descent.
  • Are older than 55.
  • Are overweight.
  • Don’t get enough exercise.
  • Eat foods high in sodium (salt).
  • Smoke or use tobacco products.
  • Are a heavy drinker (more than two drinks a day in men and more than one drink a day in women).

DIAGNOSIS AND TESTS


How is high blood pressure diagnosed?
Since high blood pressure doesn’t have symptoms, your healthcare provider will need to check your blood pressure with a blood pressure cuff. Providers usually check your blood pressure at every annual checkup or appointment. If you have high blood pressure readings at two appointments or more, your provider may tell you that you have high blood pressure.
What tests will be done to diagnose this condition?
Providers use a blood pressure cuff to measure your blood pressure.

MANAGEMENT AND TREATMENT


What should I do if I have high blood pressure?
If your healthcare provider has diagnosed you with high blood pressure, they will talk with you about your recommended blood pressure target or goal. They may suggest that you:

  • Check your blood pressure regularly with a home blood pressure monitor. These are automated electronic monitors and are available at most pharmacies or online.
  • Eat healthy foods that are low in salt and fat.
  • Reach and maintain your best body weight.
  • Limit alcohol to no more than two drinks each day for men and less than one drink each day for women. One drink is defined as 1 ounce of alcohol, 5 ounces of wine, or 12 ounces of beer.
  • Be more physically active.
  • Quit smoking and/or using tobacco products.
  • Work on controlling anger and managing stress.

What diet helps control high blood pressure?

  • Eat foods that are lower in fat, salt and calories, such as skim or 1% milk, fresh vegetables and fruits, and whole-grain rice and pasta. (Ask your healthcare provider for a more detailed list of low sodium foods to eat.)
  • Use flavorings, spices and herbs to make foods tasty without using salt. The optimal recommendation for salt in your diet is to have less than 1,500 milligrams of sodium a day. Don't forget that most restaurant foods (especially fast foods) and many processed and frozen foods contain high levels of salt. Use herbs and spices that do not contain salt in recipes to flavor your food. Don’t add salt at the table. (Salt substitutes usually have some salt in them.)
  • Avoid or cut down on foods high in fat or salt, such as butter and margarine, regular salad dressings, fatty meats, whole milk dairy products, fried foods, processed foods or fast foods and salted snacks.
  • Ask your provider if you should increase potassium in your diet. Discuss the Dietary Approaches to Stop Hypertension (DASH) diet with your provider. The DASH diet emphasizes adding fruits, vegetables and whole grains to your diet while reducing the amount of sodium. Since it’s rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH diet makes it easier to eat less salt and sodium.

What medications are used to treat high blood pressure?
Four classes of high blood pressure medications are considered “first line” (most effective and commonly prescribed) when starting treatment. Sometimes other medications are coupled with these first-line drugs to better control your high blood pressure. First-line, pressure-lowering medications are:

  • Angiotensin-converting enzyme (ACE) inhibitors block the production of the angiotensin II hormone, which the body naturally uses to control blood pressure. When angiotensin II is blocked, your blood vessels don’t narrow. Examples: lisinopril (Zestril® or Prinivil®), enalapril or captopril.
  • Angiotensin II receptor blockers (ARBs) block this same hormone from binding with receptors in the blood vessels. ARBs work the same way as ACE inhibitors to keep blood vessels from narrowing. Examples: metoprolol (Lopressor®; Toprol® XL), valsartan (Diovan® or Prexxartan®) or losartan.
  • Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels, allowing these vessels to relax. Examples: amlodipine (Norvasc® or Katerzia®), nifedipine (Procardia®XL or Nifedical®XL), diltiazem (Cardizem®, Dilacor® XR or Tiazac®).
  • Diuretics (water or fluid pills) flush excess sodium from your body, reducing the amount of fluid in your blood. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill. Examples: indapamide, hydrochlorothiazide (Microzide® or Oretic®) or chlorothiazide.

PREVENTION


Can I prevent high blood pressure?
Fortunately, there are certain things you can do to help reduce your risk of developing high blood pressure. These include the following:

  • Eat right: A healthy diet is an important step in keeping your blood pressure normal. The DASH diet (Dietary Approaches to Stop Hypertension) emphasizes adding fruits, vegetables and whole grains to your diet while reducing the amount of sodium. Since it’s rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH diet makes it easier to eat less salt and sodium.
  • Keep a healthy weight: Going hand-in-hand with a proper diet is keeping a healthy weight. Since being overweight increases your blood pressure, losing excess weight with diet and exercise will help lower your blood pressure to healthier levels.
  • Cut down on salt: The recommendation for salt in your diet is to have less than 1,500 milligrams of sodium a day (equal to about one teaspoon). To prevent hypertension, you should keep your salt intake below this level. Don't forget that most restaurant foods (especially fast foods) and many processed and frozen foods contain high levels of salt. Use herbs and spices that do not contain salt in recipes to flavor your food; do not add salt at the table. (Salt substitutes usually have some salt in them.)
  • Keep active: Even simple physical activities, such as walking, can lower your blood pressure (and your weight).
  • Drink alcohol in moderation: Having more than one drink a day (for women) and two drinks a day (for men) can raise blood pressure.

OUTLOOK / PROGNOSIS


What can I expect if I have this condition?
Since high blood pressure doesn’t cause many symptoms at first, you probably won’t feel any different with a high blood pressure diagnosis. But it’s important to follow your provider’s instructions to bring your blood pressure down so it doesn’t cause serious illnesses later in life.
How long does high blood pressure last?
If you have primary high blood pressure, you’ll need to control it for the rest of your life.
If you have secondary high blood pressure, your blood pressure will most likely come down after you receive treatment for the medical problem that caused it. If a medication caused your high blood pressure, switching to a different medicine may lower your blood pressure.
What is the outlook for high blood pressure?
You can get seriously ill if you don’t treat your high blood pressure. However, if you take the medicines your provider ordered, you can control your blood pressure. Exercising and eating healthy foods also helps lower your blood pressure.

LIVING WITH


How can I be more active?

  • Check first with your healthcare provider before increasing your physical activity. Ask your provider what type and amount of exercise is right for you.
  • Choose aerobic activities such as walking, biking or swimming.
  • Start slowly and increase activity gradually. Aim for a regular routine of activity five times a week for 30 to 45 minutes each session.

What if lifestyle changes don’t help lower my blood pressure?
If diet, exercise and other lifestyle changes don’t work to lower your blood pressure, your healthcare provider will prescribe medications to help lower your blood pressure. Your provider will take into account other conditions you may have, such as heart or kidney disease and other drugs you’re taking when prescribing medications to treat your high blood pressure. Be sure to follow your provider’s dosing directions exactly.


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