What Is Blood Pressure?
The pressure of circulating blood against the walls of blood vessels is known as the Blood Pressure. This pressure is the result of the heart pumping blood through the circulatory system.
Blood pressure is the force that moves blood through the circulatory system to carry oxygen and nutrients to nourish tissues and organs.
It is an important body function because it delivers hormones such as cortisol, insulin, etc., and WBCs (white blood cells) and antibodies for immunity.
Friends, your blood pressure is highest from where it starts its journey i.e. your heart and it is lowest where its journey ends i.e. smaller branches of arteries.
While the heart is mainly responsible for blood pressure but the properties of arteries like their elastic nature are also important for maintaining this pressure and helping blood to flow throughout your body.
To understand this you can see the example of stroke or heart attack, where narrowing of arteries can eventually block the blood supply and can lead to these life-dangerous conditions.
What Do Blood Pressure Numbers Mean?
Blood pressure is expressed as systolic pressure (it is the pressure in your arteries when your heart beats) over diastolic pressure (it is the pressure in your arteries when your heart rests between two heartbeats) in the cardiac cycle.
Blood pressure is measured in units of millimeters of mercury (mm Hg). The reading is expressed in a pair with systolic pressure value first followed by the diastolic value.
For example, if someone has a reading of 112/78 mm Hg (generally spoken as 112 over 78), has a systolic pressure of 112 mm Hg, and a Diastolic pressure of 78 mm Hg.
I am giving you another example, if someone has a reading of 116/86 mm Hg, has a systolic pressure of 116 mm Hg, and a Diastolic pressure of 86 mm Hg.
How Is Blood Pressure Measured?
Blood pressure fluctuates over the course of the day, so it is necessary to measure it more than once. It can also fluctuate due to stress, pain, physical exertion, or cold, etc. But it should be noted that this fluctuation in blood pressure is temporary and it soon returns to normal.
To get an accurate reading your blood pressure is taken on some different days, while you are resting. It is advised to take approximately 14 readings over a period of 1 week (with both morning and evening readings taken).
A visit to the doctor makes some people nervous, which can increase their blood pressure. That’s why doctors always advise you to take about three minutes rest before measuring your blood pressure.
To take a perfect reading it is also advised that your upper arm (which is being used for measurement), your heart, and the sphygmomanometer (or other blood pressure measuring machine) should be at the same height.
Blood pressure is generally measured by a device known as a sphygmomanometer that uses the height of a column of mercury to indicate the blood pressure by auscultation.
Auscultation with an aneroid gauge or a mercury-tube sphygmomanometer is considered to be the most accurate in blood pressure measurement.
Semi-automatic blood pressure monitors have become more common these days. As compared to early semi-automated devices nowadays these devices have justified to international standards and have a standard deviation of less than 8 mm Hg.
These devices read your blood pressure automatically according to the variations in the blood volume in the arteries.
What Is Normal Blood Pressure?
Friends, Blood Pressure is a vital sign that healthcare providers or doctors use to evaluate a patient’s health.
In an adult, Normal Resting Blood Pressure is 120/80 mm Hg means a systolic pressure of 120 mm Hg and a diastolic pressure of 80 mm Hg.
So, your blood pressure is said to be normal when your systolic pressure is less than 120 mm Hg and the diastolic pressure is less than 80 mm Hg.
When you measure your blood pressure for the first time then, it should be measured in both arms because it’s sometimes high on only one side. After that, you should measure your blood pressure only in the arm that shown the higher reading.
Friends, blood pressure is measured on a number of different days, and that too when you are at rest. After measuring blood pressure several times, if these measurements are high then you have high blood pressure (hypertension), even if only the systolic pressure or the diastolic pressure is high.
In medical terms, high blood pressure is called hypertension.
What Is High Blood Pressure (Hypertension or HTN)?
High blood pressure is a condition when the pressure of circulating blood against the walls of blood vessels is high enough that it may finally cause health problems, like heart disease and stroke.
It is also known as hypertension, HTN, HT, HBP, essential hypertension, or high bp.
You can have high blood pressure for a long time without any symptoms. But the damage to your blood vessels and organs, especially the heart, kidneys, and eyes, continues even without any symptoms.
High blood pressure is quite common and it usually develops over many years. Its early detection is very important.
Luckily high blood pressure can easily be identified. So, the regular blood pressure measurement can help you and your doctor to notice any changes.
If your blood pressure reading is high, then your doctor may take your blood pressure readings over a week to check whether the number stays elevated or comes back to normal.
And if you come to know you have high blood pressure, then you can control it with the help of your doctor.
Treatment of high blood pressure includes both healthy lifestyle changes and prescription medication.
Lifestyle changes include physical exercise, weight loss, reducing alcohol intake, a healthy diet, reducing salt intake, etc. But if these changes are not sufficient to control the high blood pressure then medicines are used.
What Causes High Blood Pressure?
Friends, there are two types of high blood pressure (hypertension):
1) Primary hypertension
2) Secondary hypertension
Approximately 90 to 95% of high blood pressure cases are of primary hypertension, while approximately 5 to 10% of cases fall under secondary hypertension.
1) Primary Hypertension
In most adults, there is not any identifiable cause of high blood pressure. And this type is known as primary hypertension or essential hypertension.
This type of hypertension tends to develop over several years without any identifiable cause.
2) Secondary Hypertension
In some people, high blood pressure is caused by an underlying condition. And this type is known as secondary hypertension.
This hypertension tends to appear suddenly and can cause higher blood pressure than primary hypertension.
Various medications and conditions can lead to secondary hypertension, including:
– Certain medications, like decongestants, over-the-counter pain relievers, birth control pills, etc.
– Illegal drugs like amphetamines, cocaine etc.
– Thyroid problems
– Kidney disease
– Adrenal gland tumors
– Congenital heart defects
– Alcohol abuse or chronic use
– Obstructive sleep apnea
What Are The Risk Factors For High Blood Pressure?
High blood pressure has many risk factors, these are as follows:
The risk of high blood pressure increases as you get older.
The increasing risk of hypertension with age is mostly due to structural changes in the arteries (mainly large artery stiffness).
The blood vessels lose their elastic tissue with time and become stiffer and less compliant; causing the blood pressure to rise.
2) Too much salt (sodium) in the diet
Using too much sodium in your diet can cause your body to retain fluid, which increases your blood pressure.
3) Too little potassium in the diet
Potassium is very helpful in balancing the amount of sodium in your cells. But if you don’t get enough potassium in your diet then you can accumulate more sodium in your blood.
Potassium also causes the smooth muscle cells in your arteries to relax, which lowers your blood pressure.
4) Overweight or obesity
The more you weigh the more blood you need to supply the nutrients and oxygen to your tissues. Thus, as the volume of blood circulated through your blood vessels increases, the pressure on your artery walls also increases.
5) Family history
High blood pressure or hypertension tends to run in families. This may be due to genetic abnormalities inherited from your parents.
6) Not being physically active
Physical activity leads to the release of cytokines and natural hormones that relaxes the blood vessels, which in turn lowers blood pressure.
Lack of physical activity increases the risk of obesity.
Physically inactive people also tend to have higher heart rates. The higher your heart rate is, the harder your heart has to work with each contraction and thus there is a stronger force on your arteries.
7) Too much alcohol consumption
Over time, consuming too much alcohol can cause damage to your heart.
Consuming more than two drinks per day for men and more than one drink per day for women may affect their blood pressure.
Here, one drink equals 5 ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof liquor.
8) Using tobacco
Smoking or chewing tobacco can immediately raise your blood pressure temporarily.
Also, the chemicals in tobacco can damage the lining of artery walls and this can result in the narrowing of arteries and an increase in the risk of heart disease.
High levels of stress can cause a temporary rise in blood pressure.
Meditation and relaxation techniques can help in lowering stress and thus can help in lowering the blood pressure.
10) Certain chronic conditions
Certain chronic conditions like diabetes, kidney disease, sleep apnea may also increase your risk of blood pressure.
What Are The Symptoms of High Blood Pressure?
In most people, high blood pressure has no signs and symptoms, even if it’s reading reach dangerously high levels.
It may take several years for the condition to reach levels severe enough that symptoms become clear. Even then, these symptoms may be credited to other problems.
Some people may experience these symptoms:
– Shortness of breath
– Visual changes
– Blood in the urine
– Chest pain
These symptoms aren’t specific and mostly appear when high blood pressure has reached a life-threatening stage.
It should be clear that these symptoms don’t appear in everyone suffering from hypertension, thus waiting for them to appear could prove fatal. Also, if these symptoms appear in anyone then he/she requires immediate medical attention.
What Are The Complications of High Blood Pressure?
By causing excessive pressure on the artery walls, high blood pressure can cause damage to blood vessels and organs of your body. The longer your blood pressure goes uncontrolled, the greater will be the damage caused by it.
Uncontrolled high blood pressure can cause following complications:
1) Damage to your arteries
a) Damaged and narrow arteries
Friends, healthy arteries are strong, elastic, and flexible. The inner lining of the arteries is smooth allowing blood to flow freely.
But high blood pressure increases the pressure of blood flowing through these arteries. it can damage the cells of the inner lining of your arteries. And when fats from your food enter your bloodstream, they get collected in these damaged arteries. This makes your artery walls less elastic and thus limiting blood flow through your body.
Over time, the continuous pressure caused by blood moving through a weakened artery can cause a section of the artery’s wall to form a bulge known as an aneurysm.
If an aneurysm ruptures, it can cause life-threatening internal bleeding.
Aneurysms are most common in body’s largest artery, aorta.
2) Damage to your heart
a) Enlarged left ventricle of the heart
Your heart has to work harder to pump your blood against the higher pressure in your blood vessels. This can cause left ventricular hypertrophy (i.e. thickening of walls of the heart’s pumping chamber).
The enlarged left ventricle increases your risk of heart failure, heart attack, and sudden cardiac death (SCD).
b) Heart failure
Gradually, the strain on your heart due to high blood pressure can result in weakened and less efficient heart muscle, which can lead to heart failure.
c) Coronary artery disease
Arteries, which get damaged and narrowed due to high blood pressure, supply less blood to your heart.
And when your heart doesn’t get adequate blood, you can have irregular heart rhythms (arrhythmias), chest pain (angina), or even a heart attack.
3) Damage to your kidneys
a) Kidney failure
High blood pressure (hypertension) is the most common cause of kidney failure. Damaged blood vessels of kidneys don’t allow them to effectively filter waste from your blood causing dangerous levels of fluid and waste to accumulate.
4) Damage to your brain
A stroke occurs when the blood supply to part of your brain is interrupted or reduced, and your brain tissue is deprived of oxygen and nutrients. This causes your brain cells to die. A stroke is a medical emergency.
High blood pressure can block or burst arteries that supply blood to the brain, causing a stroke.
b) Transient ischemic attack (TIA)
TIA (also known as ministroke) is a temporary disruption of blood supply to your brain. Hardening of arteries or blood clots caused by hypertension can cause TIA.
High blood pressure can cause narrowed or blocked arteries in the brain, which can cause limited blood and can lead to vascular dementia.
5) Damage to your eyes
a) Damage to your retina (retinopathy)
Damage to the retina of your eyes can lead to bleeding in the eye, blurred vision, or complete loss of vision.
Thickened, torn, or narrowed blood vessels in the eyes due to hypertension can cause damage to the retina.
b) Nerve damage
Blocked blood flow can result in optic nerve damage, leading to loss of vision.
High Blood Pressure Emergencies
High Blood pressure is generally a chronic condition that slowly causes damage to your blood vessels and organs over several years. But sometimes it increases so rapidly and severely that you might require an emergency medical treatment.
High blood pressure emergencies are:
- Chest pain
- Sudden loss of kidney function
- Heart attack
- Sudden impaired pumping of heart (sometimes may cause pulmonary edema)
- Memory loss, Irritability or personality changes
- Complications in pregnancy (preeclampsia and eclampsia)
- Damage to aorta (aortic dissection)
How To Understand Blood Pressure Readings?
To take your blood pressure reading, your doctor generally places an inflatable arm cuff around your arm and takes your reading by using a pressure-measuring gauge.
This reading, measured in units of millimeters of mercury (mm Hg), has two numbers. The first number is the systolic pressure i.e. the pressure in your arteries when your heart beats. And the second number is the diastolic pressure i.e. the pressure in your arteries when your heart rests between two heartbeats.
These blood pressure measurements fall into five categories:
1) Normal blood pressure
Your blood pressure is said to be normal if it’s below 120/80 mm Hg i.e. systolic pressure below 120 mm Hg and a diastolic pressure below 80 mm Hg.
2) Elevated blood pressure
When your systolic pressure ranges between 120 to 129 mm Hg and a diastolic pressure below 80 mm Hg, then your blood pressure is called elevated blood pressure. It tends to get worse gradually if you don’t take steps to control your blood pressure.
3) Stage 1 hypertension
In stage 1 hypertension, your systolic pressure ranges from 130 mm Hg to 139 mm Hg, or a diastolic pressure ranges from 80 mm Hg to 89 mm Hg.
4) Stage 2 hypertension
In stage 2 hypertension your systolic pressure is 140 mm Hg or higher, or a diastolic pressure of 90 mm Hg or higher.
5) Hypertensive crisis
In hypertensive crisis, your systolic pressure is over 180 mm Hg, or diastolic pressure is over 120 mm Hg. urgent medical attention is required in a hypertensive crisis.
Headache, chest pain, shortness of breath, or visual changes may occur in this condition.
Systolic pressure and diastolic pressure both are important to measure, but after the age of 50, systolic pressure measurement is more important. This is because, after the age of 65 isolated systolic hypertension is very common. In this condition diastolic pressure is normal (i.e. less than 80 mm Hg) but systolic pressure is high (i.e. 130 mm Hg or higher).
Blood pressure fluctuates over the course of the day, so it is necessary to measure it more than once.
Your doctor generally takes up to 14 readings over a period of 1 week (with both morning and evening readings taken) before diagnosing you with high blood pressure.
How Is High Blood Pressure Diagnosed?
Generally, high blood pressure has no symptoms. The only way to find out whether you have high blood pressure or not is to take regular blood pressure readings.
Your doctor or health care provider will use a sphygmomanometer or a Semi-automatic blood pressure monitor to take a reading.
Your doctor may take blood pressure measurements on a number of different days and that too when you are at rest before making a diagnosis. Its diagnosis is generally not given just after one or two readings.
Your doctor may conduct some tests to rule out any underlying condition. These tests are:
- Blood tests like hematocrit, fasting blood glucose, Cholesterol screening (lipid profile), TSH.
- Electrocardiogram also called ECG (test of heart’s electrical activity)
- Chest radiograph
- Ultrasound of your kidneys
- Urine test
These tests can be helpful for your doctor to identify or rule out any secondary issue causing your hypertension. These can also help your doctor to look at the damage that may be caused by your high blood pressure.
Additional tests for high cholesterol levels and diabetes are performed as these conditions are additional risk factors for the development of cardiac diseases.
What Is The Management And Treatment Of High Blood Pressure?
Home Remedies For Managing High Blood Pressure
Home Remedies like healthy lifestyle changes are the standard, first-line treatment for high blood pressure. Some of these are:
Regular physical exercise
According to current recommended guidelines, all people (whether hypertensive or not) should perform at least 150 minutes of moderate-intensity aerobic exercise every week, or 75 minutes of high-intensity exercise every week. People should perform an exercise at least 5 days a week.
Limit the amount of alcohol you drink
People should limit the amount of alcohol, as consuming too much alcohol can gradually cause damage to your heart.
If you want to consume alcohol then have it in moderation. This means that healthy adult women can have up to one drink a day and healthy adult men can have up to two drinks a day. Here, one drink equals 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of 80-proof liquor.
Avoiding stress or learning techniques to reduce stress can be helpful for a person to control blood pressure.
Warm baths, yoga, meditation, are examples of relaxation techniques that help to reduce stress.
Getting plenty of sleep and regular physical activity can also help to reduce stress.
Avoid smoking or use of tobacco
Tobacco can injure walls of the blood vessels and can speed up the process of plaque building in the arteries. So, it is better to avoid smoking or use of tobacco to control your blood pressure.
To control your high blood pressure you should eat a heart-healthy diet that is lower in salt (sodium), limit the consumption of foods high in saturated fats, and include more fruits and vegetables in your diet.
Try to get an adequate quantity of potassium in your diet, which can prevent and control high blood pressure. Also, decrease the quantity of sodium in your diet; you can aim to limit the quantity of sodium to less than 2.3 grams a day or less.
Maintain healthy weight
You should lose weight if you are obese or overweight, i.e. you should maintain a healthy weight to control high blood pressure.
Practice slow and deep breathing
Practicing slow and deep breathing may help to relax. There are some devices available in the market that promotes slow and deep breathing.
According to the American Health Association, this device guided breathing may be a good non-drug option for lowering blood pressure, particularly when anxiety accompanies hypertension.
Medications For High Blood Pressure
But for some people these lifestyle changes aren’t sufficient, that’s why they have to take medication to lower their blood pressure.
Most people go through a trial and error phase with blood pressure medicines (or antihypertensive medicines). Your doctor may need to try different medicines until and unless he/she find a single or combination of medicines that work for you.
Some of the medicines used to treat high blood pressure are:
Calcium channel blockers
Friends, calcium causes your heart and arteries to contract more strongly.
Calcium channel blockers, also known as calcium antagonists, lower your blood pressure by blocking some of the calcium from entering the cells of your heart and arteries. This helps to relax the muscles of your blood vessels and thus lower your blood pressure.
Some of these calcium channel blockers also slow your heart rate; this effect further reduces your blood pressure, and control an irregular heartbeat.
These medications may work better for older people than ACE inhibitors.
Amlodipine, nifedipine, felodipine are examples of calcium channel blockers.
Excess fluid and high sodium levels in your body can increase your blood pressure.
Diuretics, also known as water pills, are medicines that act on your kidneys to help your body remove excess sodium and water, reducing blood volume and hence lower your blood pressure.
Thiazide diuretics are the often the first choice diuretics in high blood pressure medications. Hydrochlorothiazide, chlorthalidone are examples of the thiazide diuretics.
Increased urination is the common side effect of diuretics.
Angiotensin is a chemical that causes your artery walls tighten and narrow.
Angiotensin-converting enzyme (ACE) inhibitors prevent an enzyme in your body from producing angiotensin. This helps your blood vessels relax and lowers your blood pressure.
People suffering from CKD (Chronic Kidney Disease) may benefit from the use of ACE inhibitors as one of their medications.
Lisinopril, captopril, are examples of ACE inhibitors.
ARBs (Angiotensin II receptor blockers)
ARBs are the medications that block the action of angiotensin II by preventing it from binding to angiotensin II receptors. That helps relax blood vessels and reduce blood pressure.
Losartan, candesartan are examples of ARBs.
Beta-blockers lower the workload on your heart and open your blood vessels, which make your heartbeat slower and with less force. This in turn causes a reduction in the amount of blood pumped through arteries with each beat and hence lowers your blood pressure.
Beta-blockers are generally not recommended as the only medicine for your blood pressure management, as they are more effective when combined with other antihypertensive medicines.
Atenolol, propranolol, metoprolol are examples of beta-blockers.
Alpha-blockers, also known as α- adrenoreceptor antagonists or α-blockers, lower your blood pressure by keeping the hormone norepinephrine from tightening the muscles in the walls of blood vessels. due to this, your blood vessels remain relaxed and your blood pressure gets lowered.
These medications can also help to improve urine flow in older men with benign prostatic hyperplasia (BPH).
Doxazosin, prazosin, terazosin, are examples of alpha-blockers used to treat hypertension.
These are alpha and beta dual receptor blockers. They block the binding of catecholamine hormones to both alpha and beta receptors.
Therefore, like alpha-blockers, they decrease the constriction of blood vessels and like beta-blockers, they slow down the rate and force of the heartbeat.
Carvedilol, labetalol, dilevalol, are examples of alpha-beta blockers.
Final Word About Antihypertensive medicines
To reduce the number of daily doses of medicines you need, your doctor may prescribe a combination of low doses of medications instead of larger doses of a single medicine.
Generally, two or more antihypertensive drugs are more effective than one.
Some antihypertensive medicines should be avoided during pregnancy. You should talk to your doctor about possible side-effects and problems that can occur when you take antihypertensive medicines.
If you get any side-effect from the high blood pressure medication, then you should consult your doctor. He/she may change your dose or may prescribe you a different medication. But you shouldn’t stop taking the medicine on your own.
This article is intended for informational purposes only. Any information associated with this article should not be considered as a substitute for prescription suggested by local health care professionals.